Springfield House

Springfield House is a residential care home providing personal care and accommodation for up to 21 people aged 18 and over, some of whom live with dementia. At the time of our inspection visit, there were 19 people living at the home.

People’s experience of the service and what we found:

People felt safe and supported by the staff who worked at Springfield House. Staff recognised different types of abuse and how to report it. The registered manager understood their safeguarding responsibilities and how to protect people from abuse. People’s care had been planned and potential risks to people had been identified, with mitigation in place to protect people from potential harm. There were enough staff on duty to keep people safe and meet their needs. People's medicines were managed and stored in a safe way, however, improvements were required in the recording of prescribed creams. The home was clean and staff followed safe infection control practices.

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 had systems in place to monitor the quality of the service provision and drive improvement. People, relatives and staff were involved and engaged throughout. External professionals worked with staff to provide good outcomes for people.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 29 November 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvement had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks. This inspection was also undertaken to check whether they were now meeting the legal requirements, as the previous inspection found breaches of regulation.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘All inspection reports and timeline’ link for Springfield House on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Springfield House is a residential care home providing personal care and accommodation for up to 21 people aged 65 and over, some of whom live with dementia. At the time of our inspection visit, there were 20 people living at the home.

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

Potential risks to people's health and wellbeing had been identified, but were not always assessed appropriately to ensure staff were meeting their needs in line with best practice.

There were aspects of the home environment that required action to ensure it was safe. For example, ensuring water temperatures were of a safe temperature and wardrobes were secured to the walls.

People's medicines were given in a safe way, however, medicines which were given covertly were not administered in line with pharmacist advice. Record keeping of controlled drugs was not always accurate or up to date.

Staff carried out safe practice to reduce the risk of infection, however malodours were noted in some areas of the home. The registered manager recognised this, and advised they would speak with the provider about an additional cleaner to support with the home.

The provider could not be assured their staff team were consistently up to date with regulations and care delivery in line with best practice. We have made a recommendation about this.

The provider’s checks were not consistently applied or robust to identify shortfalls in a timely way. We found areas that required improvement. Where the provider did have checks in place, they had not identified areas of concern identified at this inspection.

People told us they felt safe and were supported by staff. Relatives felt their family member was safe and cared for in the right way. Staff recognised different types of abuse and how to report it. The provider understood their safeguarding responsibilities and how to protect people from abuse.

There were sufficient numbers of staff on duty to keep people safe and meet their needs.

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.

All people, relatives and staff felt the service was well run. One relative told us, “[Person’s name] has bloomed since being there. We see staff give [them] a hug, it’s a very loving care home. It’s not a modern home or high class, but the care side is second to none. [Registered managers name] is a great manager and [deputy manager] is fantastic. The registered manager was visible within the home and listened to people's and staff's views 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 24 December 2021).

Why we inspected

We received concerns in relation to the management of medicines and people’s moving and handling. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

The provider has taken action to mitigate the risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement 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.

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

Recommendations

We have made a recommendation about the provider keeping up to date with regulations and best practice.

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 continue to monitor information we receive about the service, which will help inform when we next inspect.

Springfield House is a residential care home providing personal care and accommodation for up to 21 people aged 65 and over, some of whom live with dementia. At the time of our inspection visit, there were 20 people living at the home.

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

Since our previously rated inspection improvements had been made including ensuring potential hazardous items were safely stored. There were systems in place to reduce the risk of harm to people. Accidents and incidents were monitored effectively. Risks to people had been identified and measures were in place to support people safely. Staff understood what they needed to do to keep people safe.

There were safe systems for the management and administration of people's prescribed medicines. People received their medicines when they needed them from staff who were trained and competent.

The home environment was clean, and staff observed and followed infection control procedures in line with national guidance for reducing the spread of COVID-19.

Staff received on-going training and support. People were provided with meals and drinks which considered their needs and preferences. People saw healthcare professionals when they needed. Before moving to the home people were assessed to ensure their needs and preferences could be met.

People lived in a comfortable and well-maintained environment. People were able to personalise their rooms.

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.

Staff showed caring communications with people and they were passionate about supporting people. People’s independence, dignity and privacy were valued and maintained by staff.

Care planning was personalised to provide staff with guidance about people's likes and dislikes. People were supported emotionally and physically with a range of things to do for fun and interest, which included singing and celebrating events. People were supported to be comfortable and pain free at the end of their lives.

Families were welcomed into the home, when COVID-19 pandemic guidelines had allowed this to happen. There was a complaints procedure in place and the provider responded to complaints appropriately.

People's views were valued and responded to. The registered manager worked in partnership with other professionals to ensure people received a service which met their needs and preferences. People were cared for by a staff team who were supported in their role.

There were effective systems in place to monitor and improve the quality of the service people received.

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 requires improvement published 8 February 2020.

Why we inspected

This was a planned inspection based on the previous rating.

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.

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

Follow up

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

Springfield House is a residential care home providing personal care and accommodation for up to 21 people aged 65 and over, some of whom live with dementia. At the time of our inspection visit, there were 20 people living at the home.

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

People received their medicines as prescribed by trained staff who regularly had their competencies assessed. Improvements to the safe storage of medication had been made since our last inspection.

Infection prevention measures had been established. Staff had a good understanding of these procedures

and confirmed they were provided with sufficient supplies of personal protective equipment [PPE]. Improvements had been made to the environment since our last inspection.

The registered manager had quality assurance systems in place to monitor the overall quality of the service provided to people. These systems had led to improvements in the quality of the service being provided to people.

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.

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 requires improvement (published 07 December 2019).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about safe care and treatment. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

Targeted inspections do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We found no evidence during this inspection that people were at risk of harm from this concern.

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 coronavirus and other infection outbreaks effectively.

Springfield House is a residential care home providing personal care and accommodation for up to 21 people aged 65 and over, some of whom live with dementia. At the time of our inspection visit, there were 21 people living at the home.

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

The provider and registered manager had quality assurance systems and processes in place to monitor the quality and safety of people's care however, these needed to be further enhanced. The storage of some potential hazardous items required improvement to ensure people’s safety and daily infection control practices needed to be strengthened.

People were supported to take and manage their medicines safely. The registered manager was aware the temperature room checks where medicines were stored required further improvement so these were consistently completed.

People were supported to stay as safe as possible by staff who understood what actions to take to reduce individual risks to their well-being. This included reducing risks to people's physical health and mental well-being. Relatives and staff were confident if they had any concerns for people's safety the registered manager would put plans in place to help them. There was enough staff to meet people's care needs.

Staff had received training in, and understood, how to identify and report abuse. Prospective staff underwent pre-employment checks before they started work at the home.

Relatives described the positive relationship they had with the registered manager and felt the home was well-managed. Staff and the registered manager sought to work together with community health and social care professionals to ensure people’s care needs were monitored and met.

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 03 July 2018).

Why we inspected

We received concerns in relation to the management of people’s care needs. As a result, we undertook a focused inspection to review the Key Questions of Safe and Well-led only. We found no evidence during this inspection that people were at risk of harm from this concern.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions; therefore, we did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection. The overall rating for the service has deteriorated to Requires improvement. This is based on the findings at this inspection.

Follow up

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

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

Springfield is a residential care home for 20 people with dementia. There were 20 people living at the home at the time of 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.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

There was 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.

People living in the home told us they felt safe and that staff support and guidance made the home safe. People told us that staff assistance maintained their safety and staff understood how they were able to minimise the risk to people’s safety. We saw staff help people and support them by offering guidance or care that reduced their risks. Staff understood their responsibilities in reporting any suspected risk of abuse to the management team who would take action. Staff were available for people and had their care needs met in a timely way. People told us their medicines were managed and administered for them by staff. Infection control measures were in place to prevent the spread of infections and where incidents or accidents had happened the provider had reviewed and made changes where needed to ensure that learning from these events took place.

Staff knew the care and support needs of people and people told us staff were knowledgeable about them. Staff told us their training courses and guidance from the registered manger helped to maintain their skills and knowledge. People were supported to have 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 had a choice of where they ate their meals, and enjoyed the meals offered. Where people needed support to eat and drink enough to keep them healthy, staff provided assistance. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People were seen talking with staff and spent time relaxing with them. Relatives we spoke with told us staff were kind and friendly. Staff told us they took time to get to know people and their families. Family members were updated about their family member’s well being from staff. People’s privacy and dignity was supported by staff when they needed personal care or assistance. People’s daily preferences were known by staff and those choices and decisions were respected. Staff promoted a people’s independence and encouraged people to be involved in their care and support.

People’s care needs had been planned, with their relative’s involvement where agreed. Care plans included people’s care and support needs and were reviewed and updated regularly. People told us activities were offered in the home which were of interest to them.

People and relatives were aware of who they would make a complaint to if needed. People told us they would talk though things with staff or if they were not happy with their care.

The manager provided leadership for the staff team and people had the opportunity to state their views and opinions. The provider worked in partnership with other local agencies to promote people’s well-being. The provider had a range of audits in place to monitor the quality and safety of people’s care and support. Action plans were developed to maintain the home and care of people. The provider’s planned improvements were followed up to ensure they were implemented.

Further information is in the detailed findings below.

The provider of Springfield House is registered to provide care for up to 18 older people, including people with dementia. There were 17 people living at the home 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 2008 and associated Regulations about how the service is run.

At our previous inspection visits the provider was required to make improvements to evidence risks to people’s safety and wellbeing were identified with risks reduced. We found the provider had taken action to implement preventative measures to identify and reduce the likelihood of similar incidents from happening. Improvements had been made so people had their prescribed medicines available to them and these were administered by staff who had received the training to do this. People had their prescribed medicines available to them and these were administered by staff who had received the training to do this.

Staff knew how to protect people against the risk of abuse or harm and how to report concerns they may have. Risks to people's health and wellbeing were assessed and measures put in place to meet people's needs with safety in mind. This included the staffing arrangements which took into account the care and support people required in order to reduce risks to their safety and wellbeing.

People were supported by staff who showed they were kind and had developed positive relationships with people who appreciated the tactile approaches of staff showing they cared. However, staff practices did not always reflect a personalised approach to meeting people’s care needs and at times this showed a lack of respecting people’s dignity and privacy.

People’s care and support needs were met by staff who had their backgrounds checked before they started work at the home to provide assurances they were suitable to work with people who lived at the home. Staff had a planned induction to prepare them for their role and training and support to ensure they understood and met people's needs effectively. The registered manager had increased staffs' opportunities to gain support through more practical training to effectively carry out their caring roles. Staff appreciated the registered manager’s approach to training and the support they provided to staff so they were confident in their caring roles.

Staff understood the importance of seeking people’s consent to care and how to support people whose liberty was restricted. Training in the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), was planned to support staff understanding.

People were supported to access health and social care services to maintain and promote their health and well-being. People’s changing needs were monitored and reviewed by staff who acted upon these where required so these could be met by the most appropriate healthcare professionals. The monitoring and recording of what people ate and drank was completed. Staff took additional advice from a healthcare professional to ensure this was achieved in the best way to monitor risks to people from not eating and drinking sufficient amounts to stay well.

People were supported to access planned and spontaneous activities. The registered manager told us further work was in hand to improve the regularity of fun and interesting things for people to do which were personalised to meet their individual recreational interests.

People knew the registered manager and they felt they were approachable and visitors to the home felt they were welcomed. The registered manager had introduced more opportunities for people and staff to make suggestions about the services people received. Staff understood their roles and responsibilities and believed the registered manager was trying to make things better for people who lived at the home and staff. The registered manager showed they had an accountable and responsive approach to the issues we identified and was committed to make sure people received good quality care.

The inspection took place on the 23 and 29 February 2016 and was unannounced. Two inspectors were involved in the inspection.

At the time of our inspection a manager was 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.

We carried out this inspection because we received information of concern and were also aware of incidents which had taken place at the home.

People we spoke with and their relatives felt people were kept safe however this was not always the case. People did not always receive their medicines safely and as prescribed and at times medicines were not available for staff to administer. Staff were not aware of whether healthcare professionals wished people to remain on a medicine and creams and gels were not always applied as prescribed.

Risks to people’s safety were not always assessed and staff failed to recognise potential risks in the care and support people were receiving. Care plans were not always provided or reviewed to reflect the care people needed. This placed the health and welfare of people at risk.

Management systems were not always effective and did not always fully follow up on shortfalls identified as part of audits. Agencies such as the Care Quality Commission and the local authority were not always informed in a timely way about incidents which had an effect on people’s health and welfare.

Staff were aware of the how to report signs of abuse as well as of other agencies who may be involved. Staff told us they received training and support to provide them with the skills to support people who lived at the home. Staff sought people’s consent prior to providing care and support and ensured people’s privacy and dignity was maintained.

People had a choice of food and drink they enjoyed available to them. People were provided with help and assistance as needed to maintain their independence while ensuring their dietary needs were met. People has access to healthcare professionals to maintain their well-being. People told us they felt listened to and were aware of the provider’s complaints procedure.

You can see what action we have told the provider to take at the back of the full version of this report.