We undertook an unannounced focused inspection of The Spinney on 20 February 2018. This inspection was done to check that improvements to meet legal requirements, planned by the provider after our comprehensive inspection on 22 and 23 February 2017, had been made. The team inspected the service against two of the five questions we ask about services: is the service safe and well-led. This is because the service was not meeting some legal requirements. No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection. At this inspection the service was meeting all the legal requirements and was rated as Good.

The Spinney provides accommodation for up to 48 older people living with dementia in one adapted building over three floors with a lift. There were 44 people living at the home when we visited. The Spinney 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.

There was a registered manager at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

People and their relatives told us they felt the service was safe, and the care received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults from abuse.

Risk assessments were in place which provided guidance on how to support people safely. Medicines were managed in a safe manner. There were sufficient numbers of suitable staff employed by the service in order to meet people’s needs. Staff had been recruited safely with appropriate checks on their backgrounds completed. The home environment was clean and the home was free of malodour.

Staff told us the service had an open and inclusive atmosphere and the registered manager and deputy manager were approachable and open. The service had various quality assurance and monitoring mechanisms in place.

We undertook an inspection of The Spinney on 22 and 23 February 2017. This was an unannounced inspection. At the last inspection in February 2015 the service was rated Good.

The Spinney provides accommodation for up to 48 older people living with dementia. There were 44 people living at the home when we visited.

The service had a manager who had been in place since January 2017. They were about to start the process of applying to become the registered manager of the service. A registered manager is a person who has registered with the Care Quality Commission 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.

At this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.

Recruitment and selection procedures were not always carried out in line with the provider’s policy and procedure and may have placed people using the service at risk of harm by unsafe recruitment and selection practices.

The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were kind and compassionate and the care they received was good. Staff had a good understanding of their responsibility with regard to safeguarding adults.

People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and plans were in place to monitor and reduce risks. People had access to relevant health professionals when they needed them. Medicines were stored and administered safely.

Staff undertook training and received one to one supervision to help support them to provide effective care. The manager and staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests.

People told us they liked the food provided and we saw people were able to choose what they ate and drank.

People’s needs were assessed and met in a personalised manner. Care plans were in place which included information about how to meet a person’s individual and assessed needs. People’s cultural and religious needs were respected when planning and delivering care. Discussions with staff members showed that they respected people’s sexual orientation so that lesbian, gay, bisexual, and transgender people could feel accepted and welcomed in the service.

The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.

Staff told us the service had an open and inclusive atmosphere and senior staff were approachable and accessible. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and resident meetings.

We inspected The Spinney on 17 February 2015. This was an unannounced inspection. At the last inspection in January 2014 the service was found to be meeting the regulations we looked at.

The Spinney provides accommodation for up to 48 older people who have dementia care needs. There were 43 people living at the home when we visited. There was a registered manager at the service at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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 and associated Regulations about how the service is run.

The experiences of people who lived at the home were positive. People told us they felt safe living at the home, staff were kind and compassionate and the care they received was good. We found staff had a good understanding of their responsibility with regard to safeguarding adults.

People’s needs were assessed and their preferences identified as much as possible across all aspects of their care. Risks were identified and plans in place to monitor and reduce risks. People had access to relevant health professionals when they needed them. Medicines were stored and administered safely. The service was not always following good practice when special monitoring was needed for people's prescribed anti-psychotic medicines, as these can place people with dementia at risk of serious side effects, such as a stroke as well as increasing the risk of falls.

Staff undertook training and received one to one supervision to help support them to provide effective care. The registered manager and staff we spoke with had a good understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). MCA and DoLS is law protecting people who are unable to make decisions for themselves or whom the state has decided their liberty needs to be deprived in their own best interests. People told us they liked the food provided and we saw people were able to choose what they ate and drank. People had access to health care professionals as appropriate.

People’s needs were assessed and met in a personalised manner. We found that care plans were in place which included information about how to meet a person’s individual and assessed needs. The service had a complaints procedure in place and we found that complaints were investigated and where possible resolved to the satisfaction of the complainant.

The service had a registered manager in place and a management structure with clear lines of accountability. Staff told us the service had an open and inclusive atmosphere and senior staff were approachable and accessible. The service had various quality assurance and monitoring mechanisms in place. These included surveys, audits and staff and resident meetings.

We saw that people’s permission to provide care and treatment was sought appropriately. People we spoke with said, ''They are very good. If there is anything I need I just ask, there is no need to complain.'' We saw that signed consent to provide care and treatment was obtained on admission.

People’s needs were assessed and reviewed every month to ensure people received safe and appropriate care. Care plans were thorough and addressed all aspects of daily living for each person. There were arrangements in place for dealing with foreseeable emergencies.

Medicines were observed to be handled safely, securely and administered correctly by staff who had received appropriate training.

We saw that there were safe effective recruitment procedures in place to ensure that people's needs were met by staff that were fit and trained to do their job.

People we spoke with were confident their concerns and complaints were listened to and acted upon. One person said, ''I had a concern about my meal; the cook was fantastic she just sorted it there and then, they will do whatever they can for you.''

People we spoke with who used the service told us that they felt respected by staff and that they were treated with respect and dignity. People could chose what they wore and what they liked to do. We found people's rooms were individualised which reflected their choice. Some people enjoyed reading the news paper or socialising with other people who used the service.

One relative we spoke to told us the care "couldn't be better." We found people suffering from dementia were supported by staff to engage in stimulating activities. People were in a stimulating and tactile environment that supported their individual needs.

We found staff were qualified and experienced to undertake the roles they were employed to do. However we found that there were not always a sufficient number of staff in the night to meet the needs of people who used the service.

We found the provider had an effective system to regularly assess and monitor the quality of service that people receive. There was evidence the views of people and their relatives were sought and the information gathered was used to make informed decisions about the quality of the service provided.