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

This was an unannounced inspection which took place on 30 October 2017. The inspection was undertaken by one adult social care inspector.

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. At the time of our inspection there were 26 people staying at the home. 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.

At our last inspection in June 2017 we rated the service Requires Improvement in the Safe and Well-led domains. This was because we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of Care Quality Commission (Registration) Regulations 2009. We found medicines were not managed effectively and the service had failed to provide all the required notifications to the Care Quality Commission (CQC.) The service was rated Good in Effective, Caring and Responsive domains. Because of the breaches of regulations we found, the service was given an overall rating of Requires Improvement.

Following our inspection in June 2017 we received an action plan from the provider which informed us of what action they intended to take to make the necessary improvements to the service.

During this inspection we checked to see what action had been taken to address the breaches in the regulations and to see if the required improvements had been made. We found that the required improvements had been made.

Medicines were managed safely and people received their medicines as prescribed. Staff had received appropriate training in the safe handling of medicines and had regular assessments of their competency. We found that protocols were in place to guide staff on the administration of “as required medicines” e.g. paracetamol. Daily checks on the storage temperature of all stocks of medicines were carried out and recordings of these checks were complete. We found that since our last inspection the provider had introduced extra checks and auditing of medicines administration. This ensured that any errors were identified in a timely manner. There was a robust system of daily, weekly and monthly monitoring and auditing of medicines administration in place to help improve the quality of the service provided.

The service are required to notify CQC of events such as accidents, serious incidents and safeguarding’s. Records we reviewed showed that the service had notified CQC of all events they are required to.

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. At the time of our inspection there were 32 people staying at the home. 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.

This was an unannounced inspection which took place on the 5 and 6 June 2017. The inspection was undertaken by one adult social care inspector and an expert by experience. This was the first inspection of this service since the service transferred to a new provider.

During this inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and one breach of Care Quality Commission (Registration) Regulations 2009. This was because medicines were not managed effectively and the service had failed to make all the required notifications to CQC.

You can see what action we have told the provider to take at the back of the full version of the report.

Staff had received appropriate training in the safe handling of medicines and had regular assessments of their competency. We found that protocols were not always in place to guide staff on administration of “as required medicines” e.g. paracetamol. Routine checks on the storage temperature of stocks of some medicines were not carried out or recordings were incomplete.

The service had not notified CQC of all events they are required to. They had notified CQC of events such as serious incidents and when Deprivation of Liberty Safeguards applications were authorised, but had not notified CQC when safeguarding concerns were raised. We have written to the provider asking them to tell us how they will meet this regulation in future.

The service is required to have a registered manager in place. 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. The service had a registered manager in place who was present during this inspection. Everyone we spoke with was very positive about the registered manager and the way the service was managed.

Staff we spoke with were aware of safeguarding and how to protect vulnerable people. Staff were confident the registered manager would deal with any issues they raised.

Recruitment procedures were in place which ensured staff had been safely recruited. There were sufficient staff to meet people’s needs. Staff received the training, support and supervision they needed to carry out their roles effectively.

The home was clean. There was an on-going programme of improvements taking place. Areas of the home had been redecorated, with new furnishings and flooring fitted. The work was planned to be completed by October 2017.

Accidents and incidents were appropriately recorded. Risk assessments were in place for the general environment. Appropriate health and safety checks had been carried out and equipment was maintained and serviced appropriately.

People told us they liked the food and their preferences were respected. People at risk of poor nutrition and hydration had their needs assessed and monitored.

We saw records that showed people had given their consent to the support they received. The registered manager was meeting their responsibility under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected.

All the people we spoke with were positive about the support they received and the caring attitude of the staff. People we spoke with said, “The staff are welcomin