Springfield Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant people’s needs were not always met.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Most care plans included information about people’s personal histories, likes and dislikes and wishes and interests. However, we were not assured these were always understood or considered by all staff. For example, not all staff were able to confidently describe the people they cared for and did not demonstrate they knew people well.

People and relatives told us staff supported them to maintain family and friendship circles, and we observed relatives and friends were able to visit people without restriction. A person and their relative told us about how staff had arranged a private dining room so the person and their family could celebrate a birthday together. People were supported to partake in activities personal to them. For example, 1 person was supported to attend a football match, and another was supported to attend a weekly club linked to their needs.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

While staffing rotas supported some consistency of allocation, variability in staff knowledge of people and incomplete communication of significant events limited assurance that care was consistently informed and person-centred.

Staff knowledge of people’s needs and circumstances was inconsistent, with some staff being unable to describe people’s needs, wishes and abilities. Care routine prompts were set up on the electronic care planning system when someone required regular support. For example, with repositioning and support with fluid intake, however on our review of these records we could not be assured these prompts were always adhered to.

There were examples of integration with external professionals, such as regular GP visits. However, some care records contained contradictory or incomplete information, particularly around repositioning, diet modification and mobility which could affect continuity of care. For example, a person’s care records stated they “mobilised with a ‘Pedi turn’, they were unable to walk, normal weight baring, and I walk slowly.” The manager told us they have reviewed this person’s care plan once highlighted at this assessment.

Arrangements were in place to ensure staff had appropriate access to support from leaders in emergencies when a member of the leadership team was not on site. This included a clear on-call rota and emergency protocols. Service user guides provided information about available services and links with the local community. Relatives confirmed transport and staff support could be arranged when people needed to attend appointments.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider followed the Accessible Information Standard, which tells organisations what they have to do to help ensure people with a disability or sensory loss get information in a way they can understand. It also says people should get the support they need in relation to communication.

People’s communication needs were assessed during the pre-admission process, with information recorded about how staff could communicate with them. This included information on any equipment used to improve communication, glasses and hearing aids for example. The management team told us people and relatives were provided with written information about the service and how to complain should the need arise, which would be provided in different formats and alternative languages if required.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People and relatives told us they were listened to, given the opportunity to share their viewsand encouraged to provide feedback at any time. People and relatives described the staff and management team as attentive, responsive and approachable.

People and relatives were invited to attend regular relative and resident meetings which allowed them to be involved in the running of the service and fully involved in care. A person said, they had made suggestions for different activities, and they [staff] had listened and tried to arrange them. People and relatives also confirmed they have been involved in care planning meetings, where appropriate and received quality assurance questionnaires to complete about their experiences.

The provider had a complaints policy. Complaints we reviewed showed the provider had responded in line with their policy, detailing any changes that had been implemented as a result of the concern. People and relatives told us they knew how to raise concerns or make a complaint and felt confident to do so.

The management team told us they took all feedback, complaints and compliments seriously and ensured all concerns were investigated. They were able to provide evidence of this.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

Where people had a disability which impacted their ability to contact health services or access health, care or wellbeing support outside of the home, or into the home if they were unable to leave, people were not consistently supported to have equitable access. From discussions with the manager they demonstrated they understood how to access specialist health or social care support should this be required. However, we identified barriers to accessing health and care services were not always considered, and those with higher needs were negatively impacted as a result. For example, a person waited a number of weeks before staff took action in relation to dental pain.

Feedback we received from healthcare professionals, relatives and people did not provide assurance people were always supported to access specialist healthcare and support in a timely way.

We saw some information which demonstrated specialist services such as speech and language therapy and tissue viability nurses had been contacted for additional support.

Staff and leaders did not always actively listened to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People with disabilities were affected in unequal ways by poor care. The service did not respond promptly to call bells, did not carry out regular proactive checks, and did not ensure consistent access to food and fluids. These failures particularly affected people who were less able to speak up for themselves, communicate their needs, or move around independently.

Some consideration had been made to reasonable adjustments to support equity in experience and outcomes had been made. For example, mobility aids and specialist cutlery were provided where required and people with religious and cultural needs were supported to follow their faith. The adjustments described helped to improve people’s experience. Staff had completed training in Equality and Diversity and demonstrated this was understood.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care plans included individual information about any specific wishes people may have. Staff knew about people’s wishes in respect of the level of emergency care (resuscitation) or hospital admission. Documentation was in place via electronic care plans and original copies were maintained within an office which staff always had access to.