Springfield Residential Home

We found the following examples of good practice.

The service was only receiving essential visitors at the time of our inspection. Visitors were required to have their temperature checked and wash their hands. Visitors were provided with personal protective equipment (PPE) where needed to keep everyone safe.

People were supported by staff who wore full PPE, this is called barrier nursing. This is to protect both staff and people living in the service. People who had tested positive for COVID-19 had appropriate signage on their doors. Staff understood the importance of changing their PPE as required for good infection control.

All staff commencing their shift used the same entrance. They were required to have a temperature check and use the hand washing facilities. Staff changed into their uniforms and their PPE before commencing their shift. Staff changed out of their uniforms before leaving to travel home.

There were stations within the home for donning and doffing (this is where staff put on and take off their PPE). There were notices on display throughout the home about how to wash your hands and maintain good infection control. Staff and people were regularly tested for COVID-19.

The building looked clean and free from clutter. Chlorine-based products were used for cleaning all surfaces, cleaning cloths used were single use only, this ensured good infection control. All high touch points were cleaned every few hours and this was regularly monitored by the management team.

The registered manager told us that they were working collaboratively with colleagues from the Local Authority and CCG (Clinical Commissioning Group) and had received good support and advice.

The home accommodates up to 29 people. It is a Victorian property in a residential area of March, within walking distance of the town centre. The original house has been extended and provides accommodation on two floors. Nursing care is not provided.

At our previous comprehensive inspection in January 2017 the home was rated as requires improvement. This unannounced inspection took place on 10 May 2018. The service is now rated as good.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run. The registered manager was present during this inspection.

People felt safe living at the home and staff understood their responsibilities in protecting people from harm. Risks to people had been identified, assessments were carried out and guidance put in place to minimise the risks to people.

There was an effective recruitment process in place to reduce the risk of unsuitable staff being employed. There were enough staff available to provide care and support. Training and supervision systems were in place to provide staff with the knowledge and skills that they required to care for the people accommodated

Assessments of people’s needs were carried out before the person was offered a place at the home. This was to ensure that the home could provide the care and support that the person needed and in the way they preferred. Technology and equipment, such as hoists, were used to enhance the support being provided.

People's nutritional needs were met and people were supported to have enough to eat and drink. A range of external health and social care professionals worked with the staff team to support people to maintain their health and well-being.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Information about advocacy services was available if anyone wanted an independent person to assist them with any decisions they wanted to make. Staff respected people’s privacy and dignity and encouraged people to remain as independent as possible.

Care plans were personalised and gave staff guidance on the care each person needed. People and their relatives were involved in planning their care. People were encouraged to participate in activities and interests of their choice.

People and their relatives were given opportunities, such as meetings, to give their views about the service and how it could be improved.

The provider and registered manager were aware of their responsibilities to uphold legal requirements, including notifying the CQC of various matters.

This was a comprehensive inspection. The visit to the home took place on 16 January 2017 and was unannounced. There were 25 people living at the home when we visited.

At our previous inspection, in January 2016, we found that the provider was in breach of two regulations. We found that people were at risk of inappropriate care as their care plans did not reflect their needs and that people were not protected against risks to their health and safety. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

During this inspection in January 2017 we found that improvements had been made and the provider was no longer in breach of the regulations.

Although we saw some kindness and compassion, we also saw that staff did not interact with people or engage them in conversation. Staff did not always treat people with respect, ensure people’s privacy and dignity were maintained or support people to be independent. People’s personal information was not always kept securely. Visitors were welcomed.

There was not always a sufficient number of staff on duty to make sure that people’s needs were met in a timely manner. Staff had received an induction and had undertaken training in topics relevant to their role. Staff had been recruited in a way that made sure that only staff suitable to work in this care home were employed.

Audits of a number of aspects of the service provided had been carried out, action plans put in place and some improvements undertaken. The audits had not always identified the issues we found. Records were maintained as required.

This home requires a registered manager as a condition of its registration. 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 home is run. At the time of this inspection there was a registered manager who had been at the home for almost 25 years.

People and their relatives were mostly content with the service provided at Springfield Residential Care Home. Staff enjoyed working at the home and were supported by the registered manager and deputy manager.

Staff had undergone training and knew how to recognise and report any incidents of harm or abuse. Most potential risks to people had been assessed and guidance provided for staff so that the risks were minimised. Medicines were managed well, which meant that people received their prescribed medicines safely.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS), which apply to care services. People’s capacity to make decisions for themselves had not always been fully assessed and some staff had a limited understanding of the principles of the MCA and DoLS. This was being addressed by the managers. Appropriate applications had been made to the relevant authorities to ensure that people’s rights were protected if they lacked mental capacity to make decisions for themselves.

People’s healthcare needs were monitored and staff involved a range of healthcare professionals to make sure that people were supported to maintain good health and well-being. People were given sufficient amounts of food and drink and people’s dietary needs were met.

Pre-admission assessments had been carried out. People and their relatives had been involved in planning the person’s care and support. People’s care plans gave staff information about the ways in which each person wanted their care and support delivered. The care delivered was not always personalised and not always delivered in a timely manner.

Complaints were listened to and addressed. The activities and entertainment that were planned and delivered were limited and were not based on people’s individual interests or hobbies.

The managers were approachable and supportive. People, relatives and staff were given opportunities to share their views about the service and put forward ideas for improvements. Notifications relating to significant events in the home were sent to CQC as required.

This inspection was unannounced and took place on 12 January 2016.

The home had a registered manager in post. 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 and associated Regulations about how the service is run.

The CQC monitors the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Staff had received training in this subject but those spoken with during this inspection were not able to demonstrate that they were fully aware of the principles of the MCA or DoLS and their obligations under this legislation.

Care plans did not contain all of the relevant information that staff required so that they knew how to meet people’s current needs. We could not be confident that people always received the care and support that they needed.

Risks had not always been managed to keep people as safe as possible. Risk assessments had not always been completed when necessary. This meant that staff did not have the information they required to ensure that people received safe care.

The provider had a recruitment process in place and staff were only employed within the home after all essential safety checks had been satisfactorily completed.

People’s privacy was respected at all times. Staff were seen to knock on the person’s bedroom door and wait for a response before entering. People’s dignity was not always protected because there were instructions for staff on display around the home.

People were provided with a varied, balanced diet and staff were aware of people’s dietary needs. Staff referred people appropriately to healthcare professionals. People received their prescribed medicines in a timely manner and medicines were stored in a safe way.

The provider had a complaints process in place and people were confident that all complaints would be addressed.

The provider did not have effective quality assurance systems in place to audit all areas of the home to identify areas for improvement. Therefore they were not able to demonstrate how improvements were identified and acted upon.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

We found that care plans were current and reflected the needs of people living in the home. Staff demonstrated a good understanding and knowledge of the care and support people required.

A safeguarding policy for vulnerable adults was in place and staff had undertaken training and information was available for people who lived in the home should they want to raise a concern.

The premises were well maintained and records showed that appropriate safety checks had taken place on systems and equipment which meant it was safe for people to live in.

Information was available for people who lived in the home and their relatives informing them how to raise any concerns or complaints. People and relatives we spoke with told us they knew who to speak too and felt concerns would be dealt with. A procedure was in place to ensure these would be dealt with appropriately.