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Inspection Summary


Overall summary & rating

Requires improvement

Updated 16 July 2019

This inspection took place on 4 December 2018 and 7 January 2019 and was unannounced on both days.

Spring Mount 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. The care home can accommodate up to 25 people and specialises in the care of people living with dementia. The home offers care to younger people living with dementia. At the time of our inspection there were 22 people using the service.

Following the last inspection in September 2016 the overall rating for the service was ‘good’. During this inspection we found improvements were needed and the overall rating has changed to ‘requires improvement’.

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 told us they felt the service was safe. However, we found risks to people’s safety and welfare were not always managed effectively.

We found the home was clean and free of unpleasant odours. However, we found the registered providers quality monitoring systems had not been effective in identifying and dealing with risks such as those posed by radiators with hot surface temperatures.

There was an ongoing programme of refurbishment and some evidence the needs of people living with dementia had been taken into consideration. For example, the grounds were secure and people could go outside whenever they wanted. However, we found there was scope for improvement and made a recommendation about this.

People’s medicines were not always managed safely.

There were enough staff and safe recruitment procedures were followed. This helped to protect people from the risk of being supported by staff unsuitable to work in a care setting. Staff received training for their roles and told us they felt supported by the management team.

People told us the food was good.

People were not always supported effectively to access the full range of NHS services. We made a recommendation about this.

We found the service was acting in people’s best interests but this was not always reflected in their care records. Similarly, we found that although people’s relatives told us they were consulted about care this was not evidenced in the records. We found people’s care plans were not always up to date and accurate. However, staff could tell us about people’s current needs.

The service aimed to provide an enabling environment where people living with dementia were supported without the use of tranquilising or sedating medication. We observed many positive interactions between staff and people who used the service. However, we also saw examples of interactions which did not promote people’s privacy and dignity.

People were supported to take part in a range of activities inside and outside the home. However, some people felt this was an area which could be improved.

People spoke positively about the management team. They told us they felt confident any concerns they raised would be dealt with and said they would not hesitate to recommend the service to family or friends.

However, we found the registered providers systems for monitoring the quality and safety of the services provided were not always operated effectively. The management team acted quickly to address the concerns we identified during our inspection. From our discussions we were assured they were committed to making the required improvements to ensure people experienced consistently good outcomes.

We found the provider was in breach of two regulations. These were Regulation 12 (Safe care and treatmen

Inspection areas

Safe

Requires improvement

Updated 16 July 2019

The service was not consistently safe.

Risks to people’s safety and welfare were not always managed properly.

People’s medicines were not always managed safely.

There were enough staff to meet people’s needs.

The home was clean, tidy and odour free.

Effective

Requires improvement

Updated 16 July 2019

The service was not always effective.

People said the food was good.

The service was acting in people’s best interests but this was not always reflected in the records.

Improvements were needed to the way people were supported to meet their health care needs.

Staff were trained and supported to carry out their duties.

The grounds were secure and accessible to people. There was an ongoing programme of refurbishment. More could be done to create a dementia friendly environment.

Caring

Requires improvement

Updated 16 July 2019

The service was not consistently caring.

We observed at lot of positive interactions between staff and people who used the service.

However, we observed some practices which did not promote people’s privacy and dignity.

People were supported to maintain their independence and there were no restrictions on visiting.

Responsive

Requires improvement

Updated 16 July 2019

The service was not consistently responsive.

People’s care plans were not always up to date and person centred.

People were not supported to plan for their end of life care.

People were supported to take part in a range of activities, some people felt this was an area which could be improved.

People told us they felt confident any concerns they raised would be dealt with.

Well-led

Requires improvement

Updated 16 July 2019

The service was not always well led.

Quality monitoring and assurances systems were not always operated effectively.

The management team were clearly committed to providing good quality care and responded quickly to address the shortfalls we found during the inspection.

People and staff spoke positively about the management team and relatives told us they would have no hesitation in recommending the home to friends and family.