Springfield Care Home

Springfield Care Home is a residential care home, in a purpose-built building, providing personal care to up to 40 people aged 65 and over. At the time of our inspection there were 19 people using the service.

People’s experience of using this service and what we found

The service was not always safe. People were not protected from infection because infection prevention and control measures were not effective.

The environment was poorly maintained and was unclean. Much of the décor and furnishings were old and some items were in a state of disrepair and needed replacing. The provider had commenced a programme of redecoration and refurbishment in both private and communal areas. However, the general cleanliness of the building should be maintained during the refurbishment.

Medicines were not always safely managed. As a result, one person had not received their medicines as prescribed and protocols were not in place for “when required” medication. The audit systems in place to monitor the administration of medicines were not sufficiently robust.

Whilst it was evident that the provider had quality control systems in place, we observed that they did not always result in good care and support, and were therefore not always effective.

There was not always enough staffing to meet people’s needs. People told us that they do not do as many activities as they used to. Also, we observed difficulties with supporting all people appropriately during lunchtime as the available staff were deployed over two floors.

People’s individual risks were managed in a safe way and staff knew how to protect people from the risk of harm and abuse. Risk assessments were completed appropriately, for example around nutrition, pressure sores and mobility.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems at Springfield Care Home supported this practice.

Care records were person centred and contained sufficient information about people’s preferences, specific routines, their life history and interests.

Improvements were required to end of life care planning to meet best practice guidance such as that provided by the Gold Standards Framework.

Staff and the management team were kind, caring and compassionate. People told us that the staff were kind to them and this was confirmed during our observations.

People were supported to maintain a healthy diet by a staff team which knew their individual preferences. People had options regarding their meals and alternatives were provided if required.

People and their representatives were involved in the planning of their care and given opportunities to feedback on the service they received. People’s views were acted upon.

The provider had systems in place to encourage and respond to any complaints or compliments. The provider and management team had good links with the local communities within which people lived.

Rating at last inspection: At the last inspection Springfield Care Home was rated as good. The last inspection report was published on 13 October 2017. At this inspection the home had deteriorated to requires improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

This was a planned inspection based on the previous rating.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Springfield Care Home on our website at www.cqc.org.uk.

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Springfield Care Home was last inspected in August 2015 and was rated Good. At this inspection, the service remained Good.

The provider is registered to provide accommodation for up to 40 older people living with or without dementia in the service over two floors. There were 24 people using the service at the time of our inspection.

A registered manager was in post and was available throughout the 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 2008 and associated Regulations about how the service is run.

Staff knew how to keep people safe and understood their duty to protect people from the risk of abuse. Risks were managed so that people were protected from avoidable harm.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Medicines were managed safely and staff generally followed correct infection control practices.

Staff received induction, training, supervision and appraisal. People’s rights were protected under the Mental Capacity Act 2005.

People received sufficient to eat and drink but their mealtime experience could be improved. External professionals were involved in people’s care as appropriate but further adaptations could be made to the design of the home to better support people living with dementia.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People generally received care that respected their privacy and dignity and promoted their independence. However, some dignity issues were observed.

People received personalised care that was responsive to their needs. Care records contained information to support staff to meet people’s individual needs, though activities could be further improved. A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident raising concerns with the management team and that appropriate action would be taken.

The registered manager and provider were meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.

If you wish to look at our findings in detail please see the full report.

Is the service safe?

People were supported in a clean environment.

People told us they were happy with the care that had been delivered and said they felt able to approach staff with any concerns or complaints they had.

There were sufficient staff on duty to meet the needs of the people and there was always a senior member of staff on duty to manage any emergencies.

Staff were trained in safeguarding and whistleblowing and were confident to raise any concerns.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made and how to submit one.

Is the service effective?

Staff had a good understanding of people's care needs. Staff told us their training was useful for them to support people to the best of their abilities. The service monitored the quality of care by the use of regular audits.

Is the service caring?

We saw staff listened to people when they were with them. People told us they were not rushed. One person told us, 'The girls are very nice.' People confirmed to us staff offered them choices of a range of activities every afternoon.

Is the service responsive?

People's needs had been assessed before they moved into the service. Care records described how people wanted to be supported. Care was provided in accordance with each person's wishes. Care records were reviewed monthly and updated where necessary.

People had access to activities which were important to them. Systems were in place to allow people choice, involvement and as much independence as possible.

Is the service well-led?

Staff told us they felt well supported by the registered manager. There was a clear quality assurance system in place and staff told us they were clear about their roles and responsibilities. There was a calm and relaxed atmosphere to the service when we visited.

We spoke with two relatives who stated they had been very satisfied with the service. One relative said; 'staff could not be better. They are all very friendly and caring '.

We carried out a short observational framework inspection. This is an inspection method whereby we sit and observe life in the home to see if people were treated properly and their needs were met. We found that staff were friendly, helpful and caring.

This was a mixed inspection. People living in the home we spoke with and two relatives told us said that the care that staff supplied was very good. We observed a number of positive staff practices. However, we also found that people's care needs were not always met because of issues with care planning and medication had not always been kept securely.

There were a number of suggestions: to have more frequent residents and relatives meetings, to reintroduce the cafe that had been available in the past, to have more activities and individual photograph books to stimulate people with dementia.