The Spires

Updated 12 September 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection team consisted of an inspector, an assistant inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Spires is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection-

We spoke with seven people who used the service and four relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, deputy manager, senior care workers, care workers and the regional support manager. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records. We also spoke with two professionals who regularly visit the home.

Updated 12 September 2019

About the service

The Spires is a care home providing personal and nursing care to 35 people aged 65 and over at the time of the inspection.

The Spires is a purpose built care home which accommodates up to 70 people in one adapted building spread over two floors. One of the floors specialises in providing care to people living with dementia.

People’s experience of using this service and what we found

People's medicines were not always administered as prescribed. Records relating to 'as required' medicines were not always completed.

People were supported by staff who knew them well. However, people's care files did not always contain up to date or completed information. This meant whilst people's needs were met, records did not always accurately reflect the support people were receiving.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, documentation in relation to best interests decisions was not always complete.

Quality assurance tools were not effective in ensuring the quality of people's care files and medicines administration and records. This meant we could not be assured improvements were always identified and made to people's care where they were required.

People were supported by trained staff to maintain their wellbeing and people had access to a variety of health professionals. People were supported by caring and respectful staff who encouraged people to remain independent.

People were offered choice around their diet and meal times were an opportunity to build relationships with other people and staff. People had access to a variety of activities both in the home and in the wider community to reduce their risk of isolation.

The management team encouraged people to feedback about the service to ensure people received personalised and quality care. This meant people felt listened to.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 05/07/2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to how the quality of the service was reviewed and maintained at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.