Springfield Healthcare (Sheffield)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The management team were open and transparent and wanted to drive improvement at the service. Accidents and incidents were recorded and monitored for themes and trends. Where incidents had occurred, action was taken to learn lessons and mitigate any future risks.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. However, care records for some people did not always accurately reflect their needs or provide sufficient guidance to staff to allow them to support people effectively or provide accurate information if shared with other parties. A meeting was already planned to discuss the review of these care records and updating them to include all relevant and necessary information. Records evidenced input from external professionals and positive feedback was received from professionals of partnership working.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Overall people and their relatives told us they felt safe with the support provided by Springfield Healthcare (Sheffield). One person told us, “I feel safe when they are here and trust them to look after me.” A relative commented, “I feel [person] is safe with them in the house. They always check [person] is settled before leaving.” Staff were trained and understood their roles in relation to safeguarding. Staff told us they knew how to raise a concern and were confident their concerns would be listened to and acted upon. One staff member told us, “If I suspect someone is at risk of being harmed or neglected, I will act immediately to ensure their safety. I will report my concerns to the supervisor, line manager as soon as possible. I do the correct documentation.” Effective systems to provide robust oversight of accidents and incidents including safeguarding’s were in place. Records showed safeguarding concerns were reported promptly to the local authority. However, a small number were not reported to CQC. We discussed this with the provider who agreed to ensure all safeguarding concerns are shared with CQC going forward.

The provider did not always work well with people to understand and manage risks. Care records for some people had missing information or required additional detail to allow staff to have sufficient guidance to support people appropriately and mitigate risks. For example, one person had epilepsy but there was no detail in the risk assessment to guide staff what to do should they have a seizure. This was a recording concern, and we found no evidence of harm to people as it mainly related to people where family provided overall support. However, staff should have access to all information they may need to support a person safely and effectively. The provider had already identified that some care records needed more detail, and a meeting was planned to address this. Staff had completed a range of training to assist them in managing risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.Assessments were undertaken of people’s properties to ensure risks posed to people and staff were managed effectively. Risk assessments were in place for people, their home and any equipment they used to enable them to mobilise or maintain their independence such as mobility aids or hoists. Care plans included guidance on how staff should safely use equipment. Staff were aware of risks associated with the environment and knew where to find the information to guide them.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. However, we received some concerns from people, relatives and staff at the service regarding call times and the continuity of staff. One person told us, “Chop and change, we never really know who’s coming. So many different carers all the time.” Another person told us, “There’s not continuity, they are always different. They’re lovely but not regular.” One staff told us, “The rota should be consistent in terms of the carer attending the call and also the times allocated to service users as per their request.” Another commented about not having sufficient travel time for some calls, “Not enough time for walking. It’s challenging.” We reviewed the electronic records of support provided and noted some issues which we discussed with the provider. Documentation was provided which explained the issues noted and evidenced call monitoring was completed. The provider agreed to continue to work with staff and people to ensure people received timely support. The provider had experienced some challenges around staffing during transition but had been working hard to resolve these and overall feedback from people and staff noted improvements had been made. Recruitment procedures were in place, so people were cared for by suitably qualified staff who had been assessed as safe to work with people. Where staff had transferred into the service, some staffing information was missing from records. The provider had taken steps to ensure staff were safe and suitably qualified in these instances. Staff completed an induction on commencement of employment and ongoing training and refreshers to enable them to carry out their role effectively. Staff working with adults with a learning disability or autistic people had completed training in learning disability and autism. The provider confirmed this training was in line with the Oliver McGowan Code of Practice. Staff overall told us they felt supported in their roles and received regular support and supervision.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Staff received training in infection control, and no concerns were raised by staff about the availability of personal protective equipment (PPE). People and their families also raised no issues with the management of infection. One relative told us, “They always wear gloves and aprons.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. Staff were trained in medicines administration, and their competency checked. Staff used electronic medicines administration record charts (EMARs) to record the support they provided to people, and these were audited on a regular basis with action taken where issues had been noted. Overall people and their families felt medicines were managed safely. One relative commented, “It reassures me when they check [person] has taken their tablets properly.” One relative commented that they had taken over responsibility for medicines due to previous inconsistencies with call times. We discussed this with the provider who advised that there is now an option to flag on the system where people are on time sensitive medicines. This is to provide greater oversight to ensure people receive their medicines within their required timeframe. The provider had a medicines policy, and this reflected the principles of STOMP (stopping over-medication of people with a learning disability, autism or both). People were supported with their medicines in line with the policy.