Springfield Grange

Springfield Grange is a care home providing personal and nursing care. The service can support up to 80 people. Care was provided over 4 units, this included nursing needs and people living with dementia. At the time of the inspection 49 people were using the service.

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

We found care and treatment of people was not always appropriate and did not meet their needs or reflect their preferences.

We found people were not supported to have maximum choice and control of their lives and staff supported them in a restrictive way and not always in their best interests. There was no information recorded on care records as to when people preferred to be supported to go to bed or get up.

We observed a lack of engagement and activities in communal areas and for people who were cared for in bed. The provider had 2 activity co-ordinator posts, but these were both vacant at the time of the inspection.

We found shortfalls in the safe management of medicines. Medicines administration was not safely recorded, and medicines were not always stored safely. The balance of some medicines was incorrect, the provider could not explain why the count of medicines was not correct.

Risk assessments for people were not up to date, incorrectly completed or blank. We found information recorded on a person’s personal emergency evacuation plan (PEEP) did not match the information in the person’s care plan.

Complaints received were not always investigated, and the necessary and proportionate action was not taken in response to any failure. There were no established, effective, or accessible system for identifying, receiving, recording, handling, and responding to complaints made by people who used the service.

We found systems or processes were not in place and operated effectively to monitor and improve the quality and safety of the services provided. Risks were not always assessed, monitored, and mitigated.

Mental Capacity Assessments (MCA), Best interest decisions (BID) and Deprivation of Liberty applications (DoLS) was not consistently in place for people who required them. DoLS conditions were unclear, and the provider was unsure whether DoLS had been applied for. Two care plans, which should have had a DoLS applied for or in place and neither one did.

We found staff had not had regular supervisions and appraisals had not been completed in 2023. Not all staff had completed all mandatory training.

We received mixed feedback about the quality of care provided from both people who lived at the service and relatives.

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

Rating at the last inspection

The last rating for this service was requires improvement (published 2 March 2023). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Enforcement

At this inspection we found breaches of regulations concerning safe care and treatment for people, person centred care, receiving and acting upon complaints, staffing, need for consent and good governance.

Why we inspected

The inspection was prompted due to concerns received regarding the quality of care for people. Concerns included quality of care, medicines administration and leadership of the service. A decision was made for us to inspect.

The overall rating for the service has changed from requires improvement to inadequate based on the findings of this inspection.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

Springfield Grange is a care home providing personal and nursing care. The service can support up to 94 people. Care was provided in 3 units the Rowan, Willow and Hawthorne unit. A further 2 units were not in use. At the time of inspection 40 people were using the service.

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

The provider had a comprehensive improvement plan to address the shortfalls highlighted under the previous provider. They had also identified further areas they wished to improve and included these in the plan.

The people we spoke with felt they were safe, and we observed the atmosphere was calm and people were happy and relaxed in the home. We were assured people were safeguarded from abuse and neglect. There were no significant concerns found in relation to cleanliness and infection prevention and control. Improvements were being made to the way risks to people were assessed and managed. Although, there was a need for further improvement. The service was going through a period of change and there was a reliance on agency staff to cover staff vacancies.

We have made a recommendation about the recording of some medicines.

People’s care plans had been in place prior to the provider becoming registered and held limited information. As the new team became familiar with people’s needs, amendments had been made to people’s assessments and care plans. However, some people’s assessments had yet to be fully reviewed. The provider told us they were working towards a change from frozen food to home cooked meals to improve people’s mealtime experience. Overall, people felt their health needs were met. The team had made referrals to support people with access to health care services and equipment. This was with the aim to better meet people’s needs, enhance their independence and improve their quality of life.

The provider was aware there was a need to improve the premises to provide a more pleasant living environment and had started planning for refurbishment. The provider and manager had a strong commitment to providing the right training and support for staff. 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 in the service supported this practice.

Everyone we spoke with felt staff were kind. People and their relatives told us they were able to express their views and were involved in decisions about their care. Staff were careful to maintain people’s dignity and privacy and supported people’s independence. Most people gave positive feedback about the care they received. Newly recruited activity staff had commenced work delivering opportunities for people to engage in activities. People’s wishes were recorded and acted upon. Complaints were investigated and responded to appropriately.

It was evident the management team were addressing the issues and shortfalls they were presented with upon taking over the running of the service. We saw evidence of improvements in people’s quality of life and overall and people’s feedback was positive about the service. Staff told us the home was becoming a better place for people to live.

We have made a recommendation about further embedding the provider’s quality assurance systems into practice.

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

Rating at last inspection

This service was registered with us on 1 July 2022 and this is the first inspection. The last rating for the service, under the previous provider was requires improvement (published on 10 June 2022).

Why we inspected

This was a first planned inspection since ownership of the home changed. The inspection was prompted in part due to concerns received about staffing, moving and handling, lack of social stimulation and people not receiving appropriate care and treatment. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see all sections of this full report.

Follow up

We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.