This inspection was an unannounced and took place on the 12 September, 15 and 18 October 2018.Spurr House Short Stay is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.
Spurr House Short Stay Service provides accommodation and personal care for up to 36 older people, some of whom are living with dementia. Care is provided for people who require respite, short term or emergency support. The home is a large detached property in its own grounds. All accommodation is on the ground floor and the home is split into four self-contained units, each with their own lounge area. On the first day of our inspection there were 28 people staying at the home.
We last carried out a focused inspection of this service in November 2017. We found the service to be good in safe and well-led. It had an overall rating of Good.
During this inspection we found breaches of three of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because medicines were not managed effectively, suitable arrangements were not in place to ensure people were protected from the risks of cross infection, systems for recruitment of staff were not always safe and systems in place to assess, monitor and improve the quality and safety of the service provided were not robust. You can see what action we have told the provider to take at the back of the full version of the report. We also made one recommendation about managing the risks from hot water
Medicines were not always managed safely. Records for the administration of medicines were incomplete. Protocols were not always in place to guide staff on administration of some ’as required medicines‘ including topical creams. Checks of storage temperatures of some medicines were not carried out properly and audits of medicines administration were not robust.
People were not protected from the risk of infection. Cleaning schedules were not clear and records of cleaning undertaken were incomplete.
Recruitment of staff were not always safe. All the required checks on staff’s suitability to work with vulnerable people were not made.
Systems in place to assess, monitor and improve the quality and safety of the service provided were not sufficiently robust to ensure best practice was followed and compliance with regulations.
Health and safety checks were completed on the building and equipment. However, some checks were incomplete. We found that all the required checks on the temperature of bathing water were not being completed. We have recommended the provider follows appropriate Health & Safety Executive guidance about managing the risks from hot water in health and social care.
The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. People were positive about the registered manager and the way the home was organised and managed.
Staff were aware of their responsibilities in protecting people from abuse and could demonstrate their understanding of the procedures to follow so that people were kept safe.
Risks to people who lived at the service were well managed. Accidents and incidents were appropriately recorded.
There were sufficient numbers of staff to meet people’s needs. Staff received the training, support and supervision they needed to carry out their roles effectively.
The requirements of the Mental Capacity Act 2005 were being met. We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment.
Care records were person centred, detailed and written using respectful terms. They gave staff information about what was important to and for the person. People told us they were involved in decisions about their care and support.
People had access to a range of health care professionals. People enjoyed the food on offer.
The registered manager and staff all knew people very well. We saw staff interactions that were caring, helpful and kind. People told us that staff respected their privacy and treated them with respect.
Staff we spoke with enjoyed their work, took a pride in the care they provided and demonstrated a commitment to person centred care.
There were a range of activities and social events in the home and in the community on offer to reduce people’s social isolation. People told us they enjoyed the activities and were positive about the enthusiasm of the activity coordinator.
There was a system in place to record complaints and the service’s responses to them.
Staff meetings were held regularly where staff had an opportunity to raise any issues and were used to look at developing good practice. Staff we spoke with liked working for the service and told us they felt supported in their work.
The service had notified CQC of any accidents, DoLS authorisations, serious incidents, and safeguarding allegations as they are required to do.
The provider had displayed the CQC rating from the last inspection in the home and on their website.