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Inspection carried out on 26 September 2018

During an inspection to make sure that the improvements required had been made

This inspection took place on the 26 September 2018 and was unannounced. This meant the provider and staff did not know we would be visiting.

We carried out an unannounced comprehensive inspection of this service on 3 February 2017 and rated it as good. After that inspection we received concerns in relation to their conditions of registration, namely that more people were using the service than it was legally registered to accommodate. As a result, we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to those/this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

We undertook this unannounced, focussed inspection on the 26 September 2018. We inspected the service against two of the five questions we ask about services: is the service well led? And is the service effective? No risks, concerns or significant improvement were identified in the remaining Key Questions through our on-going monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these Key Questions were included in calculating the overall rating in this inspection.

Springfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Springfield House accommodates up to three people in a converted farm. At the time of our inspection three people were living there. The service is located near town of Wigton. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in post. 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.

At the time of our inspection the service had offered one person respite care on an informal basis. The registered manager agreed to apply to alter their registration to take this into account in the future. Any accidents or incidents had been reported to the Care Quality Commission as necessary. The home was clean and odour free.

People were supported to take adequate nutrition and hydration and told us the food was satisfactory. People were not unnecessarily deprived of their liberties .

Inspection carried out on 3 February 2017

During a routine inspection

The inspection took place on 10 February 2017 and was unannounced, which meant that the staff and provider did not know we would be visiting. The care home was last inspected on 17th January 2015 and we found them to be meeting all the legal requirements in force at the time.

Springfield House is a three bedded care home set in a rural location being a farmhouse that has been adapted and extended to provide accommodation for up to three people living with a learning disability. The provider's family also lived in the house. Each person had their own room and there was a separate lounge area and an adapted bathroom and toilet. The house had an extensive garden.

The service had a registered manager in post at the time of our 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 and associated Regulations about how the service is run.

The provider was also the manager of the home. She ran the home with the assistance of a senior support worker who was her daughter-in-law. They both lived in the house with other members of their immediate family. One other person assisted them from time to time and they had a volunteer who helped with some of the domestic tasks. We looked at dependency levels of people in the home and judged that there were suitable staffing levels to meet people’s needs.

This service was safe because it had suitable systems in place to ensure that people were protected from harm and abuse. The care team in the home were suitably trained and had information to allow them to report any allegations of abuse.

The home was safe and secure with suitable adaptations to meet the needs of the three people living there. The home was clean and hygienic and there had been no outbreaks of infectious disease. Suitable systems were in place to control infection.

There was a strong person centred and caring culture in the home. Person centred means that care is tailored to meet the needs and aspirations of each person, as an individual. People were supported to lead interesting lives of their choosing, and had a variety of interests, hobbies and were part of the local community.

We saw that people were being treated with dignity, respect and care. There were affectionate and caring relationships between the care staff in the home and the people who lived there. We also saw that other members of the family interacted well with people in the home.

People were encouraged to be as independent as possible. There was no restriction on when people could visit the home. People were able to see their friends and families when they wanted.

People’s individual care files contained good assessments of support needs and risk assessments. The care plans were detailed and focussed on each individuals needs and how staff met these and these were regularly reviewed and were up to date.

The staff knew how people communicated and gave people the time they needed to make choices about their lives and to communicate their decisions.

Records showed that systems for recording and managing complaints, safeguarding concerns and incidents and accidents were very well managed and organised.

Staff were experienced in the care of people with learning disability and they kept their practice up to date by attending regular training. The senior support worker had established good local networks with other providers for sharing good practice.

The provider was aware of her responsibilities under the Mental Capacity Act 2005. We made a recommendation that the home looks in more depth about people’s capacity to make decisions and how best to record this.

People in the home had regular access to health care. There was evidence of good measures in place to prevent ill health. People received their medications in a sa

Inspection carried out on 17th January 2015

During a routine inspection

This unannounced inspection took place on Saturday 17th January 2015 and was conducted by one adult social care inspector.

Springfield House was a family home set in a rural location. This farmhouse had been adapted and extended to provide accommodation for up to three people living with a learning disability. The provider's family also lived in the house.

Each person had their own room and there was a separate lounge area and residents' bathroom and toilet. The house had an extensive garden. It was in a rural location between Wigton and Silloth with little access to public transport but the provider had assisted transport so that people could go out every day if they wished.

The provider, Mrs Margaret Blair, was also the manager of the home. She ran the home with the assistance of her daughter-in-law. They both lived in the house with other members of their immediate family. One other person assisted them from time to time and they had a volunteer who helped with some of the domestic tasks.

This service was safe because it had suitable systems in place to ensure that people were protected from harm and abuse. The care team in the home were suitably trained and had information to allow them to report any allegations of abuse.

We judged the house to be safe and secure with suitable adaptations to meet the needs of the three individuals we met on the day of our inspection visit. There had been no accidents or incidents reported for some years.

All the members of the care team had been in post for more than ten years and there was no planned new recruitment. We looked at dependency levels and we judged that the provider and her daughter-in-law were able to provide suitable levels of care.

We checked on medicines. We saw that only two people took medication and that this was kept to a minimum by the local GP. No one was on strong medicine and no one had any form of sedation.

The house was clean and hygienic and there had been no outbreaks of infectious disease. Suitable systems were in place to control infection.

We judged that the dependency levels of the three people in the house were met by the arrangements in place for staffing. The provider and her daughter-in-law lived in the property and were around by day and night. Both of these people and the other person who delivered care were experienced in the care of people with learning disability and they kept their practice up to date by attending regular training.

The provider was aware of her responsibilities under the Mental Capacity Act 2005. No one in the home was deprived of their liberty. The provider was careful about the assessment of new people and did not accommodate anyone who needed help with behavioural issues. The home did not use restraint.

People in the home had regular access to health care. They went out to health appointments and no one had any problems with their health. There was evidence of good measures in place to prevent ill health.

No one in the home had any problems with maintaining a normal weight. People could tell us they enjoyed their food and liked to go out to eat. People were weighed regularly so that the provider could ensure no one was losing weight.

We saw affectionate and caring interactions between the care providers in the home and the three people who lived there. We also saw that other members of the family interacted well with people in the home. The care in the home was very much as it would be in a large family. People were encouraged to be as independent as possible. They were given explanations and information about daily arrangements when we were in the house. Privacy and dignity was maintained by the care approach and people could spend their time in their own personal rooms or spend time with the family.

We looked at individual care files and saw that there were good assessments, risk assessments and care plans in place. The care plans were detailed, focussed on individual needs and strengths and were up to date and appropriate to each person.

One person in the house went out to a day centre and was involved in some active pursuits. The other two people preferred a quieter life but all three people went on regular holidays and days out. They all attended a weekly social club and were supported to visit their family where appropriate.

There had been no complaints or concerns about the care and services provided and no one on the day had any complaints. There were suitable systems in place to manage complaints.

We judged that the service was well led by the provider who had over thirty years of experience in caring for people with a learning disability in a family setting. The systems in place for monitoring all aspects of care and services were simple but effective.

We saw that there were audits of medication and money held on people’s behalf. We also saw that care plans were kept up to date. The local authority and the pharmacist who provided medication did some audits for the provider. We also saw that the provider surveyed the people in the home, their relatives and visiting professionals. There were no concerns raised in the surveys but some minor adjustments were made from suggestions made.

The provider had a lot of local knowledge and ran a weekly social club for people with disability in the area. She also ensured that people in the service went out to local entertainments and events. We judged that the provider encouraged people to be part of the local community and to have as full a life as possible.

Inspection carried out on 3 December 2013

During a routine inspection

Three people live at Springfield House. Two of those people were at the home when we visited. One person was attending a local day centre. One of the people was unable to communicate verbally, another person spent time with us throughout the inspection. They wanted to show us information in their care and support plan, as well as looking at photographs. These were recordings of a range of activities people had been involved with. This is a service where there were no additional staff other than the provider and another member of the family. People living there had their own accommodation. The atmosphere was very relaxed and homely.

During the inspection we looked at how people’s needs were being reviewed and risks were being managed. We looked at the records of those living there to see how this was being done. There was a good understanding of individual needs, likes and dislikes. Comments included, “We update the records regularly, especially when there are any changes”. Also, “We know everyone inside out. It’s a small home and we have been together for a long time”.

Observations we made confirmed people responded positively with staff and were being supported in a way which suited them. We saw they were able to communicate their wishes and these were clearly understood. People were moving around the home freely and doing things they wanted to do without restriction.

Inspection carried out on 17 November 2012

During a routine inspection

People in this service were able to voice their needs and opinions. Nothing was done without their consent and we had evidence to show that their views were sought on a daily basis.

People in the service were given support and care in the way they preferred. They were encouraged to be part of the life of the house and they were supported to be as independent as possible. They had a varied and active social life. The provider made sure they had access to health care services when needed. There were care plans in place that detailed their needs and aspirations.

The home was clean and comfortable on the day of our visit and people were relaxed in their surroundings. People had their own single rooms decorated and furnished to their tastes. They had access to a private lounge but spent most of their time with the provider and family.

The provider and her daughter-in-law were the main care providers and the people in the home benefitted from their training and experience.

There had been no formal complaints about the service. People in the home said they were happy living there.

"I like living here...don't want to go anywhere else. This is my house."

Inspection carried out on 28 June 2011

During a routine inspection

We met two of the people who live in the home and both of them made it very clear that Springfield House was their home and that they were happy and settled there.

Reports under our old system of regulation (including those from before CQC was created)