Archived: Spiral Health C.I.C

Updated 14 July 2017

Updated 14 July 2017

Spiral Health Preston Unit is operated by Spiral Health Community Interest Company (CIC). We carried out an announced inspection of the Spiral Health Preston Unit on 27 March and 5 April 2017 as part of our national programme to inspect all independent services. We inspected the core service of community health inpatients as this was the activity undertaken by the provider at this location.

An unannounced inspection was carried out in August 2015 in response to an increase in the number of patients with pressure sores and to assess the criteria for admission to the unit. Following this inspection a requirement notice was issued to the provider for them to make sure the service adhered to policies and procedures for the safe disposal of medication.

To get to the heart of patients’ experiences of care and treatment, we ask the same five questions of all services: are they safe, effective, caring, responsive to people's needs, and well-led?

Throughout the inspection, we took account of what people told us and how the provider understood and complied with the Mental Capacity Act 2005.

We found the following areas of good practice:

• The unit had systems in place to report and investigate incidents and safeguarding concerns about vulnerable adults.
• The unit was visibly clean and had sufficient and appropriately maintained equipment to safely provide care.
• The unit used assessments to identify and monitor patient risk, before and after patients were admitted to the unit.
• The unit had sufficient staffing levels to provide safe care to the patients. Staff were supported with training and appraisal with over 90% of staff having completed both.
• The unit used a recognised tool to monitor the improvements of performance in daily activities for patients on the unit.
• There were strong working relationships between the disciplines and with external stakeholders which supported safe and effective care.
• Staff were kind and respectful to patients on the unit and respected and protected patients' privacy and dignity.
• Patients were involved in their care and were given information and explanations about the care they were receiving.
• The unit had good links with charities and other organisations to provide support and empowerment to patients to manage their own health once they left the unit.
• The services were planned to meet the needs of people in the local population who had been admitted to hospital. The services were delivered to provide additional support to those who needed it.
• Staff were positive about the leadership and the culture within the unit.
• Good response to audits and information of concern meant the service and staff had learned from and acted upon such information.
• The ward clerk gave a telephone call to patients two weeks after they had been discharged from the unit to see how they progressing. If there were any concerns these would be passed to clinical staff or to social services.

However, we also found the following issues that the service provider needs to improve:

• The oxygen cylinder on the resuscitation trolley was empty at the time of the inspection, despite having been checked on the previous day.
• The unit was not routinely completing the consent form in the patient records which gave consent for physical examination and to be involved in the assessment and care planning.
• The cleaning schedules for daily, weekly and monthly cleaning by staff were poorly completed.
• We saw examples of the evaluations of the pressure wounds being unclear in medical records.
• We saw induction checklists for new staff which had not been fully completed.
• The unit did not arrange regular social or group activities for patients on the unit.
• The unit did not arrange any social or group activities for patients on the unit.
• The unit did not have access to an interpreting service for patients and families who did not speak English as their first language.
• The complaints procedure and complaints leaflet gave different information about how to complain. The complaints procedure signposted people to the incorrect ombudsman.
• The unit had not completed quality and governance reports from August 2016 to January 2017.
• The unit did not have a risk register in place to record and assess clinical risks affecting the unit.
• The unit did not collect feedback from the patients.

Following this inspection, we told the provider that it must take some actions to comply with the regulations and that it should make other improvements, even though a regulation had not been breached, to help the service improve. We also issued the provider with a requirement notice that affected Spiral Health Preston Unit. Details are at the end of the report.