Springfield

We found the following examples of good practice.

The service was clean, hygienic and well ventilated. Cleaning schedules were in place, including regular cleaning of high touch areas.

People and staff were tested regularly for COVID-19 and had been offered the vaccination.

Staff wore PPE appropriately and had completed infection prevention and control training including the correct use of PPE. Staff were patient and supported people gently and kindly to maintain social distancing.

People were supported by staff to keep in touch with family and friends via video and telephone calls. Staff also held regular welfare calls with relatives to keep them updated about any changes.

The service has experienced COVID-19 cases and throughout the pandemic the staff had continually looked at ways in which they could make improvements for people. For example, thinking of creative ways to increase people’s fluid intake by offering mocktails, milk shakes, ice creams and lollies.

The service was hoping to open soon for internal visiting, subject to COVID-19 test results. Relatives had been supplied with procedural guidance about indoor visiting and staff had made preparations for screening and testing visitors, the provision of PPE and identified dedicated visiting areas.

Springfield has 99 beds and at the time of our inspection there were 92 people using the service. Accommodation is spread over three floors and there are numerous communal areas such as lounges and dining rooms and an enclosed garden.

At our last inspection in April 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Everyone we spoke with was highly complimentary about the service and said they would recommend the home. There was a strongly embedded culture within the service of treating people with dignity and respect.

People and their relatives told us staff were helpful, attentive and caring. We saw people were treated with the utmost respect and compassion.

Staff were recruited safely and there were enough staff to take care of people and to keep the home clean. Staff were receiving appropriate training and they told us the training was good and relevant to their role. Staff were supported by the management team and were receiving formal supervision where they could discuss their ongoing development needs.

Care plans were up to date and detailed what care and support people wanted and needed. Risks to peoples' safety and welfare were identified and managed.

People felt safe at the home and appropriate referrals were being made to the safeguarding team when this had been necessary. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People's healthcare needs were being met and medicines were stored and managed safely. Staff knew about people's dietary needs and preferences. People told us there was an excellent choice of meals and most people said the food was good. There were plenty of drinks and snacks available for people in between meals.

Activities were on offer to keep people occupied both on a group and individual basis. Visitors were made to feel welcome. The home was well decorated, clean and tidy and had been adapted to take account of the needs of people who used the service.

People knew how to make complaints and were confident any concerns they raised would be dealt with. Everyone spoke highly of the management team and senior staff saying they were approachable and supportive. The provider had effective systems in place to monitor the quality of care provided and where issues were identified they acted to make improvements.

We found all the fundamental standards were being met. Further information is in the detailed findings below.

On the date of the inspection 61 people were living in the home.

A registered manager was in place. 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.

People and relatives generally spoke positively about the service and said people received good quality care. They said staff were kind and caring and treated them with a good level of dignity and respect. During the inspection we saw some good interactions between staff and people, with care delivered by staff who knew people well.

Medicines were managed safely and people received their medicines in a timely manner. However the process for managing covert medicines needed to be more robust.

There were sufficient staff available to ensure people received safe care. Robust recruitment procedures were in place to help ensure staff were of suitable character to care for vulnerable people.

People told us they felt safe using the service and staff had a good understanding of how to recognise and act on allegations of abuse. Safeguarding procedures were in place and we saw these had been followed to help keep people safe.

Risks to people’s health and safety were appropriately assessed and managed with detailed plans of care put in place for staff to follow. Following incidents appropriate preventative measures were put in place to help protect people from harm.

The premises were safely managed. The home had been adapted to meet the needs of people living with dementia for example through the use of pictorial displays, and a secure garden which provided a sensory environment where people could also reminisce.

The service had a strong focus on promoting good hydration and nutrition. People had access to an excellent range of food which could be cooked to order. Personalised menus had been developed for people based on their individual preferences. The menu and food was presented to people using a range of creative methods to encourage people to maintain good nutrition.

Health professionals provided excellent feedback about the quality of the service and said the home was effective in meeting people’s needs and achieving positive health outcomes. The service had set up a contract with local health professionals to receive in depth training and support.

Several mechanisms used by the service to improve and monitor people’s health outcomes had been adopted by other organisations due to their success in Springfield Nursing Home.

The service was compliant with the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS)

Staff had received a range of training and support and were up-to-date with mandatory training topics for example safeguarding and manual handling. Specialist training and support had been provided to staff to develop their skills in areas such as nutrition and dementia care.

Mechanisms were in place to listen to and act on people’s feedback. This happened on both a formal and informal basis by a range of staff groups.

A system was in place to record, investigate and manage complaints. People and relatives we spoke with generally said they were happy with the service.

Systems were in place to assess, monitor and improve the quality of the service. Management and head office staff undertook a range of audits which identified issues and ensured continuous improvement of the service. People’s feedback was regularly sought to identify how satisfied they were with the service.

We identified some really good care practice on the lower ground floor and ground floor. However we identified the general atmosphere and attentiveness of staff was not as exceptional on the upper floor of the home. The registered manager told us they were currently looking at developing the care and support strategy on the upper floor.

We asked people whether they thought staff treated them with dignity and respect. Most people said they generally felt that staff treated them well, however several people told us that although most staff were nice they were less keen on others who were abrupt and less polite with them. People told us that they were involved in various activities such as visits from singers, puppet shows and dancing. People said that various religious clergy regularly attended to meet people's religious needs.

We observed care in the communal areas of the home and found staff treated people with respect, interacted warmly with people and were attentive to their needs. Assessments of people's needs were in place so staff could plan and deliver appropriate care.

We found the provider had systems in place which ensured allegations of abuse were promptly reported and investigated.

We found there were enough staff to meet people's needs, although a number of staff and people told us that they could do with more staff so they could spend more quality time with people.

Systems were in place to assess and monitor the quality of the service provision.

One person's relative said 'they do their best to make it as homely as possible'. Another person's relatives said they had seen a steady improvement in the service over the past five years. They told us they had no concerns and had 'peace of mind' knowing their relative was well cared for and they would be informed if there were any changes.

Two people's relatives said the laundry service was not as good as it could be. They said it seemed to take a long time for clothes to be returned. One said most items of clothing turned up 'eventually' and another said they felt they were constantly chasing laundry.

Some people said they felt the management team could be more proactive when it came to keeping people informed about things that were happening in the home.