Archived: Springfield House Residential Home

At our last inspection on 12 April 2016, we rated the service overall Good. The key questions Effective, Caring, Responsive and Well-Led were rated good. The key question Safe was rated Requires Improvement as medicines were not always managed safely and people were not always protected from the risk of abuse. At this inspection, we found that improvements had been made and sustained and now Safe is rated as Good. We found that that evidence continued to support the overall rating of Good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating has not changed since our last inspection.

Staff understood their responsibilities and knew how to keep people safe from harm and abuse. People had received their medicines safely, and on time as prescribed. There were enough suitably trained staff to meet people’s needs and risks were managed effectively in line with their care plans. People were protected from the risk of the spread of infection.

People were encouraged and supported to make choices about the way in which they received their care and staff supported people in the least restrictive way possible. People had their nutritional needs met and people had the necessary access to healthcare. People were treated with kindness and compassion and people had their privacy respected and dignity upheld.

People had their needs assessed and planned for and people received care that was personalised and responsive to their individual needs. People participated in meaningful activities and end of life wishes were considered and planned for.

The registered manager understood the conditions of registration with us and people felt that the registered manager was friendly and approachable.

Further information is in the detailed findings below.

The service was registered to provide personal care for up to 35 older people. At the time of inspection 20 people were using the service.

There was a registered manager at the service. 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.

Some people were not protected from abuse as staff had not recognised all the categories of potential abuse. Where people received medicines on an ‘as required’ basis, safe systems were not always in place to ensure their needs were met.

People told us they felt safe. Risks to people were identified and managed to keep them safe from harm. The staff who worked within the service had checks to ensure their suitability to work with people. Staff received an induction and training that enabled them to support people effectively. There were sufficient staff to meet people’s needs.

People were treated in a caring way and were happy with the staff that supported them. People told us staff knew them well and had the skills to support them. People were encouraged to make choices about their day to day routine and remain independent.

People were supported to eat and drink sufficiently amounts to maintain good health and when people needed access to health professionals it was provided for them. We found that people had the opportunity to take part in activities they enjoyed.

We found that staff followed the requirements of the Mental Capacity Act 2005 and when needed, mental capacity assessments and best interest decisions were completed. People and relatives were involved with planning and reviewing their care.

Quality monitoring checks were completed to bring about improvements. The provider also sought the opinions of people who used the service and used this information to make changes. People liked the home and felt the management team was approachable. Staff felt listed to and had the opportunity to raise concerns. People knew how to complain and were confident this would be dealt with.

We considered our inspection findings to answer the questions we always ask;

Is the service safe?

People told us they felt safe living at the home. One person said: "The staff are gold". Relatives told us they felt happy that their relatives were looked after.

Staff were trained in safeguarding adults and knew how to respond if they had any concerns. The home had a safeguarding procedure in place.

We looked at the home's recruitment procedures. We saw that appropriate checks were completed before staff started work. This meant that care staff were suitable to provide care to vulnerable people.

Is the service effective?

People said that they were happy with their care but said that they sometimes had to wait for support. We observed times when people had to wait for their care to be provided. We also saw that when people were in the lounges nurse call bells were not readily available to call for staff support. We have asked the provider to tell us how they are going to make sure that people receive the care they need in a timely way.

People were usually provided with choices about their daily lives. People could choose where to spend their time. People told us they were always offered a choice at breakfast but not at lunchtime.

People were assessed when they moved to the home and plans of care were in place. People were supported to receive health care support. People's nutritional needs were assessed and regularly evaluated. There were gaps in some of the daily records.

Is the service caring?

People said they liked living at Springfield House. They said they got on well with the staff although they were very busy. One person said: "The staff are kind but very busy". Another person said: "The staff are wonderful".

We observed that when staff spent time with people they treated them in a respectful manner. We saw there was a relaxed atmosphere in the home and people appeared comfortable with the staff.

A health care professional we spoke with told us that the care staff knew the people that lived at the home well.

Is the service responsive?

The home did not provide enough stimulating and interesting things for people to do. We have asked the provider to tell us how they are going to improve this aspect of people's care.

The home had a complaints procedure that was available to people. Records were not always kept when concerns were acted upon.

People had the opportunity to take part in a satisfaction survey but the outcome included the neighbouring home. This meant the outcome for this home was unclear.

Is the home well led?

The home has recently had a new manager and a new regional manager.

Systems were in place to monitor and check the quality of care but these were not being used effectively and actions identified have not always been followed up. Records keeping needed to be improved to ensure that people were receiving appropriate and safe care. We have asked the provider to tell us how they are going to improve these aspects of the service.

Everyone we spoke with said they were happy living at the home. One person said: "I'm really happy here. They really care". Relatives said that they had seen improvements in their relative's health and welfare since they moved to live at the home.

People had their health and personal care needs attended to in the way they wished. People told us that they saw the GP when they felt ill and that they were supported to have health checks ups.

Although the home provided people with activities, this was an area that could be further developed. This would make sure that people had the opportunity to take part in activities they had chosen.

Care staff supported people to have their medication. Care staff were trained in administering medication. Managers at the home completed regular checks to make sure that medication was given correctly.

People received support from care staff that were trained and supported. There were adequate care staff on duty to provide people with the support they needed.

The provider has systems in place to check and monitor the care people received. People were asked for their views of the care they received. When issues were raised these were acted upon.

We spoke with eight people who lived in the home and two visiting relatives. People we spoke with were positive about the care and support that they or their relative received. There was a planned programme of activities each week.

The environment was well maintained by the provider.

We checked the administration of medication, and found that people had their medicines at the times they needed them, and in a safe way.

Individual care plans and risk assessments were comprehensively and clearly documented. They provided detailed information for care staff on actions that were needed to minimise risks to people.

We found that staff were safely recruited and supported into their role and responsibilities. Staff supervision and training was taking place.

We saw that there had been regular audits of the service, these had been undertaken by the regional manager and the manager. There had also been yearly surveys undertaken by the home to provide assurance that people received safe and appropriate care.