Spring Lake

Updated 17 August 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

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

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was announced.

We gave the service 24 hours’ notice of the inspection. This was because the service is small and people are often out and we wanted to be sure there would be people at home to speak with us.

What we did before the inspection

We reviewed information we had received about the service since it was registered with the CQC. The provider completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The PIR also provides data about the organisation and service. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

All people who lived at Spring Lake had learning disabilities and other complex needs. They were unable to communicate with us in a way which we always understood. We spent considerable time observing care to help us understand their experience of people. We also spoke with two healthcare professionals and completed various observations throughout our inspection. We spoke with the registered manager, service manager, the deputy manager and five members of staff. We also contacted the local safeguarding team. We reviewed six care records of people using the service, obtained information about safe recruitment practices, audits and other records about the management of the service, including policies and procedures.

Updated 17 August 2022

About the service

Spring Lake is a residential care home providing care to nine people with learning disabilities at the time of our inspection. The service can support up to 11 people.

Summary

We expect¿health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right¿support, right care, right culture’ is the guidance CQC¿follows to make assessments and judgements about services supporting¿people with a learning disability and autistic people and providers must have regard to it.

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

The service did not fully demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support:

People were not supported to have the maximum possible choice, control, independence and have control over their own lives. Whilst we saw features of positive support, including choice, participation, and inclusion, these were not consistent.

Right care:

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. The provider had enough appropriately skilled staff. Staff understood people’s individual communication needs.

Right culture:

Whilst people and those important to them, including advocates, were involved in planning their care, people did not lead fully inclusive and empowered lives. Reasonable adjustments were required to meet people’s needs, more so for those with sensory sensitivities. The provider did not have effective strategies to help people predict, understand and control their environment effectively.

We have made two recommendations for an enabling environment for autistic people and person-centred approaches.

There were no effective risk assessments for people at risk of scalding. During the inspection we found some shower outlets discharged water hotter than safe temperatures.

The incident investigation process was not adequate. We noted underlying and organisational factors were not considered. We judged there were limited opportunities for organisational learning because there was a focus on individual errors, as opposed to root causes.

People were not always supported to have maximum choice and control of their lives and the provider did not always assist them in the least restrictive way possible.

People’s medicines were safely stored and well recorded. There were protocols for medicines prescribed ‘as required’ (PRN) in relation to reduction of behaviours and anxieties. The provider took immediate action to correct a gap in the management of PRN medicines. The provider must continue to manage these arrangements.

Staff received regular supervision. Staff training records showed they had completed mandatory training.

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 Good (published on 4 July 2018)

Why we inspected

We received concerns in relation to the management of risk relating to hot water. 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.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe, effective, responsive and well-led sections of this full report.

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 Spring Lake 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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in regulation in relation to safe care and treatment, unnecessary or disproportionate restraint and good governance. Please see the action we have told the provider to take at the end of this report.

At the time of the inspection the service had enlisted input from a party contractor, and we noted an improvement plan had been developed which broadly mapped ways to address identified risks. The provider must invest sufficiently in the service to deliver improvements required in the water system. Our inspection of the provider in 2018 identified faults with the water system.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow-up

We will request an action plan for 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.