The Vines

Updated 4 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on the 7 December 2018. This visit was unannounced and the inspection team consisted of an inspector and an expert by expert. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of service.

The provider had completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the home, including previous inspection reports and the action plan submitted in December 2017. We considered information which had been shared with us by the local authority and looked at safeguarding alerts that had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law. We contacted the local authority to obtain their views about the care provided by the service. During the inspection process we also contacted three health professionals that visited the service.

During the inspection, we met and spoke with all the people who lived at the service, the registered manager, the area manager, quality manager, five care staff, and the deputy manager. We looked at all areas of the building, including people’s bedrooms, the kitchen, bathrooms and the lounge and dining room.

Most people were able to tell us of their experience of living at The Vines. However, there were some people unable to share their experience so we used other methods to help us understand their experiences. We used the Short Observational Framework for Inspection (SOFI) in the lounge area. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We reviewed the records of the home, which included quality assurance audits, staff training schedules and policies and procedures. We looked at five care plans and the risk assessments included within these, along with other relevant documentation to support our findings. We also ‘pathway tracked’ five people living at The Vines. This meant we followed a person’s life and the provision of care through the home and obtained their views. It was an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

Updated 4 January 2019

We inspected The Vines on 7 December 2018 and the inspection was unannounced.

The Vines 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 Vines is a care home registered to provide accommodation and personal care for a maximum of seventeen people. The Vines specialises in the treatment of acquired brain injury and neuro-rehabilitation for adults. The service aims to promote independence and help each resident back into the community. People required a range of support in relation to their support needs and some people had limited mobility. At the time of the inspection there were eleven people living in the service.

There was a registered manager in post. The registered manager had been in post for just over one year. 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.

We previously carried out an unannounced comprehensive inspection of this service in December 2017. The Vines was awarded an overall rating of ‘Requires improvement’ as improvements were needed in the safe, responsive and well led questions. At that inspection improvements were needed to ensure that as required medicines were managed appropriately and that changes to people’s health needs were responded to and that the quality assurance systems were further developed.

This inspection found that the necessary improvements had been made and the overall rating had improved to ‘Good’ with the well led question remaining Requires Improvement to further embed changes to care documentation and audits.

The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement. Whilst the provider had progressed quality assurance systems to review the support and care provided, there was a need to further embed and develop some areas of practice that the existing quality assurance systems had missed. This included updating care plans when an identified need or directive of care changed. We found not all care plans reflected people’s current needs and associated risks. For example, when a person had experienced seizures and unstable blood sugars.

People were comfortable and relaxed with staff. They said they felt safe and there were sufficient staff to support them. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff. Staff were knowledgeable and trained in safeguarding adults and what action they should take if they suspected abuse was taking place. Staff had a good understanding of Equality, diversity and human rights. Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including the care of people with diabetes and epilepsy. Formal personal development plans, including two monthly supervisions and annual appraisals were in place. Staff were supported to become ‘champions’ in areas of care delivery such as health and safety, medicines and well-being. People were supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).

People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. Health care was accessible for people and appointments were made for regular check-ups as needed.

People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. Care and support plans described people’s preferences and needs in relevant areas, including communication, and they were encouraged to be as independent as possible. People chose how to spend their day. Activities were mixed and people could choose either small group activities or one to one sessions. People told us that they enjoyed swimming, the gym and going out to local venues. People were encouraged to stay in touch with their families and receive visitors.

Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers were always available to discuss suggestions and address problems or concerns.

Further information is in the detailed findings below.