Archived: Springfield Care Home

Springfield Care Home is registered to provide personal and nursing care to up to 69 people including those living with dementia. The home has self-contained units on four floors that accommodate people according to their needs. There were 52 people living in the home at the time of the inspection.

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

People told us they felt safe living in the home and that staff treated them well. Relatives were generally happy with the care their family members received. One person was concerned regarding the number of falls their relative had experienced and were unsure what action staff had taken to reduce the risk of further falls occurring. The regional manager told us they would contact the relative to provide reassurance regarding the care being provided to their family member.

The provider had systems in place to monitor the quality and safety of the service. However, these had not been effective as we identified a number of shortfalls during the inspection. We found there was no robust process to check the COVID-19 vaccination status of professional visitors to the home. Staff had not always been safely recruited, complaints had not been properly recorded and the registered manager had failed to submit required notifications regarding significant events in the service. The provider had deployed a regional management team to support the home as they had already identified shortfalls in the way the home was being run,

Staff had received training in safeguarding and knew what action to take to protect people from the risk of harm. There were sufficient numbers of staff to meet people’s needs in a timely manner. Staff managed medicines safely. The home was clean and staff wore PPE correctly. There was an outbreak of COVID-19 in the home when the inspection took place. We saw the provider had systems to ensure government requirements were in place regarding isolation, social distancing, cleaning and staff movement across the home to reduce the risk of further spread of infection. However, the provider’s own audit systems showed infection control measures in the home needed to be further improved.

Staff told us they enjoyed working in the home and would recommend it to others. They told us the management team were supportive and approachable. The registered manager used meetings with staff to share any concerns or lessons learned from incidents and accidents.

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

Rating at last inspection

The last rating for this service was good (published 17 July 2019).

Why we inspected

The inspection was prompted in part due to concerns received about staffing and the quality of care people were receiving in the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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 the safe and well led sections of this full report. As a result, the overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Springfield Care Home on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to governance systems, the recruitment of staff and the requirement to check the vaccination status of professional visitors to Springfield Care Home. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Springfield care home is registered to provide rehabilitation, personal and nursing care to up to 69 people including those with dementia and mental health needs. The home has self-contained units on four floors that accommodate people according to their needs.

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

People gave us consistently positive feedback about what it was like in the home and told us that staff treated them as if they were a family member. People told us staff always respected their dignity and privacy and that they had control over the support they received. We saw that staff were kind and caring towards people. Staff expressed a commitment to ensuring people received high-quality care. Staff worked in close partnership with other professionals to help people achieve their rehabilitation goals.

Staff knew how to protect people from abuse. People told us they felt safe in the home and there were enough staff to support them. The registered manager acted to ensure lessons were learned if things went wrong. Medicines were generally safely managed. The registered manager had an action plan in place regarding medicines errors which they had identified during their regular audits prior to the inspection.

Staff completed training to help them deliver effective care. The provider had processes to support the career development of staff. Staff received supervision and appraisal during which they were able to discuss their development. They also attended regular staff meetings where they were invited to put forward ideas and suggestions for improving the service.

The provider had refurbished some areas of the home since the last inspection. The registered manager had plans in place to further improve the environment on the unit for people living with dementia.

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.

The provider employed an activity coordinator. They encouraged and supported people to be involved in a range of activities. The registered manager told us they would review how people admitted for rehabilitation could be enabled to undertake more activities of daily living while in the home.

People had opportunities to provide feedback on the care they received. The provider had effective systems in place to monitor the quality and safety of the service. People were positive about the way the service was run.

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

Rating at last inspection

The last rating for this service was good (published 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information, we may inspect sooner.

Following the inspection in October 2015 the provider wrote to us to tell us the action they intended to take to ensure they met all the relevant regulations. This inspection was undertaken to check whether the required improvements had been made.

Springfield Care Home is a purpose built service which is registered to accommodate up to 69 people who have nursing or personal care needs. The service is split into four separate floors. Two floors provide specialist rehabilitation services. The service also has a residential unit and a unit for people living with a dementia. On the days of our inspection there were a total of 61 people using the service.

The service had a registered manager in place as required under the conditions of the provider’s registration with CQC. 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. The registered manager was supported in the day to day running of the service by a deputy manager.

People who used the service told us they had no concerns about their safety in Springfield Care Home. Staff had received training in safeguarding adults. They were able to tell us of the correct action to take if they witnessed or suspected abuse. Policies were available to provide staff with information about possible indicators of abuse and reporting procedures. Staff told us they would be confident to report any poor practice they observed, using the whistleblowing procedure if necessary. We noted the registered manager had taken appropriate action following concerns being raised regarding the conduct of two staff.

There were sufficient numbers of staff available to meet people’s needs in a timely manner. People who used the service told us staff were always kind, caring and respectful of their dignity and privacy; this was confirmed by our observations during the inspection. Our discussions with staff showed they had a good understanding of people’s needs and were committed to providing high quality care. We saw that people were supported to maintain their independence as much as possible.

Systems were in place to help ensure the safe handling of medicines. Staff responsible for the administration of medicines had received training for this role. The competence of staff to administer medicines safely was regularly assessed.

People's care records contained detailed information to guide staff on the care and support required. The care records showed that risks to people's health and well-being had been identified, such as the risk of falls, pressure sores and poor nutrition. We saw that plans were in place to help reduce or eliminate the identified risks. Risk assessments had been regularly reviewed to ensure they fully reflected people’s needs.

People were cared for in a safe and clean environment. Procedures were in place to prevent and control the spread of infection. Regular checks were made to help ensure the safety of the premises and the equipment used. Systems were in place to deal with any emergency that could affect the provision of care.

Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely. Care staff were able to access additional training to further their professional development and enable them to carry out higher level tasks.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. The registered manager was aware of their responsibility under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) to ensure that people's rights were considered and protected.

Systems were in place to help ensure people’s health needs were met; this included regular input from two GPs, each of which was attached to one of the rehabilitation units. Good working relationships existed between staff employed at Springfield Care Home and community based professionals.

People who used the service told us the quality of the food was generally good. We saw that robust monitoring systems were in place to ensure people’s nutritional needs were met. Where necessary staff made referrals to specialist services including dieticians and speech and language therapists (SALT).

People were provided with the opportunity to engage in a range of activities to promote their well-being. Most of the activities provided on the rehabilitation units were carried out on a 1-1 basis and were aimed at assessing and improving people’s daily living skills to enable them to return home.

People had a number of opportunities to comment on the care they received in Springfield Care Home, including the completion of I-pad based surveys. Systems were in place to investigate and respond to any complaints received. All the people we spoke with told us they would know how to make a complaint although they had not had a reason to do so.

Staff told us they enjoyed working in Springfield Care Home. They told us the registered manager and senior staff were approachable and supportive. Regular staff meetings meant that staff were able to make suggestions about how the service could be improved. Staff told us their views were always listened to.

There were a number of quality assurance processes in place. The registered manager showed us how the information generated from audits, feedback, complaints and incidents was used to drive forward improvements in the service. The registered manager demonstrated a commitment to continuing to improve the quality of care people received.

Residents also told us they had sufficient involvement and choices in their care and routines, such as being able to spend time in their rooms, when to get up and go to bed, and in the meals. People expressed their views in questionnaire surveys and residents meetings.

Some residents who could talk to us about the care and support they received said they were very satisfied. Four people in the rehabilitation (rehab) unit said they were receiving the right kind of care and support to enable them to become independent and return home. One person said they did 'exercises' several times a day with staff support. Other comments included: "Nothing is too much trouble", "They can't do enough for you" and "We are very well looked after".

Some people told us they enjoyed varied activities, including trips out. One person spoke appreciatively of these trips. She said, "I love it when I go out".

The staff we spoke with told us there was sufficient training and support to help them do their work properly. Some said they had undertaken additional training to help them better understand people with dementia.