The inspection of Spratslade House was carried out on 12 June 2014. We spent time with the deputy manager, members of staff, people who lived at Spratslade House and a family representative. We reviewed care plans and documentation given to us by the provider.We considered our inspection findings in respect of the following issues:
Is the service safe?
From our observations and from the information we saw set out in care plans, policies, procedures and audits the provider's safety monitoring systems were robust. The staff showed that they had a clear understanding of their role in providing care and safeguarding the people they supported. The staff demonstrated that they knew the people well and had read and understood the instructions set out in individual care plans.
We saw evidence that people were supported to make decisions and maintain their independence. The care plans detailed each person's capacity to consent. When people lacked the capacity to make important decisions, meetings were held to make decisions for them that were in their best interests. The service had the support of an advocacy service when required.
Staff showed people respect and maintained people's dignity at all times.
The deputy manager told us there were no current deprivations of liberty safeguards in place for the people who lived at Spratslade House. They said that in the light of new guidance they were reviewing the requirements.
The building and living environment in the home was maintained to a high standard. All the risk assessments and safety checks were in place and up to date. This meant that the building was safe and met the needs of the people who used the service.
The staff rotas showed that the management had taken people's care needs into account when making decisions about the number of staff required, the skills mix and experience staff would need. The night time staffing levels and on call system showed that the staffing provision was safe out of main hours.
There were systems in place to make sure that management and staff learned from events such as accidents and incidents, complaints, concerns and investigations. This meant that people were benefiting from a service that was taking on board lessons learnt.
Is the service effective?
People's care needs had been assessed and detailed care plans were in place. There was evidence that the people and/or their representatives were involved in the assessments of their needs and care plan reviews.
We saw that people's health care needs were continually assessed and included in care plans. Specialist health and social care professionals regularly gave support to the service.
All care, activity and risk assessment plans were reviewed regularly. We saw that the people who lived at the home were supported to maintain their mobility and independence. We saw evidence in care plans and from talking with people who used the service that the care provided was being constantly adapted to meet people's needs.
Is the service caring?
The people we spoke to who lived at the home told us they were very comfortable there. They said the care and support they received was very good. One person said, "The staff are really nice, I like it here." Another person said, "Everyone looks after me and I have no complaints at all." A family representative we spoke with said, 'The care is excellent and the staff are brilliant, they cannot do enough to help'.
The staff we spoke with told us they were committed to provide high standards of care for the people who used the service. They demonstrated they were aware of potential risks, people's rights and their responsibilities.
Is the service responsive?
We found that care plans were person centred and contained detailed information about people's choice and preferences. We saw that people's health and support plans were regularly up dated to reflect people's changing needs.
There was regular support from external social care and health professionals when needed. This meant that people's health and welfare was regularly reviewed and monitored.
The families and people who lived at Spratslade House said that if they had any concerns, they could talk with the manager or the staff as they would always listen and addressed anything they raised.
The staff said they had regular training which equipped them with the knowledge to meet the support needs of the people who used the service.
Is the service well-led?
Spratslade House has had a stable staff team for many years and there was a clear management structure. The deputy manager and the staff we spoke with were knowledgeable about all the people who lived at the home.
The people we spoke with who lived at the home and the staff said that the manager, deputy and senior staff were always around to give advice and support. There were systems in place to provide feedback to staff about changes and developments.
All the staff we spoke with said they understood their responsibilities around safeguarding people's welfare. They said that if they witnessed poor practice they would report their concerns.