Spring Mount

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people's outcomes were consistently good, and people's feedback confirmed this.

This service scored 63 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Care plans were not always updated following incidents such as falls or injuries, and associated documentation was sometimes missing. Additionally, where people had clearly identified risks, the required risk assessments were not consistently in place or reflected within care plans. As a result, in some cases, care plans did not fully reflect people’s current risks or support needs.

However, most relatives reported that they were involved in contributing to the care planning for their loved ones. Most care plans were up to date and generally reflected people’s assessed needs.

Information gathered during the pre-assessment process was used to inform the development of care plans. This supported continuity of care and ensured staff had clear guidance on how to meet people’s individual needs from the outset of their placement

Overall, while care planning generally supported people’s needs, improvements were required to ensure that care plans consistently reflected up-to-date risks and incidents.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Clinical monitoring tools were not always consistently in place where required. This meant staff did not always have clear, up-to-date guidance about people’s current clinical risks, which could affect how care was planned, monitored, and delivered.

We saw nationally recognised assessments were completed to monitor nutritional risks for people. However, 2 people with pressure wounds did not have risk assessments in place. Without these assessments, there was limited evidence staff had a clear understanding of the level of pressure ulcer risk or that preventative measures were consistently guided, reviewed, and adjusted. Despite this, we observed the district nurse team were involved in the care and treatment of the wounds.

We observed that people were provided with plenty of food, drinks, and snacks. People had regular access to fluids through hydration stations, and snack trolleys were routinely offered between main meals. Meal choices, including puddings, were available, and good-quality, home-made food was provided, supporting people’s nutrition, enjoyment, and wellbeing.

Overall, care was generally responsive to people’s nutritional needs, but improvements were needed to ensure clinical monitoring and risk assessment tools were consistently applied to support safe, evidence-based care.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

We observed positive examples of effective team working between staff and external professionals, and feedback from visiting professionals reflected this well. Staff worked collaboratively, sharing information to support the implementation of changes, and weekly staff meetings took place, which supported communication and shared learning.

Handover records on the electronic care system were not always robust or sufficiently detailed. As a result, important updates or changes were not clearly captured in written records. Despite this, we observed the changes implemented between day 1 and day 2 of assessment were shared verbally with staff on shift, demonstrating responsive communication in practice. Strengthening the quality and consistency of handover documentation would further support safe, well-coordinated care and continuity between staff teams.

People were supported well to maintain healthy lifestyles.

We observed a good variety of meals being provided, including a balance of meats, carbohydrates, and vegetables, with higher-calorie options available where required. This supported people’s nutritional needs and overall physical health. People were also able to freely access outdoor spaces and fresh air whenever they wished, promoting both physical health and mental wellbeing.

People and their relatives reported that they felt individuals were empowered to make their own choices throughout the day. They described being supported to access outdoor areas and to go out into the community, which helped maintain independence and social inclusion. One relative commented, “They do themed parties for everyone where they dress the home up and staff get dressed up too. They sometimes get entertainers in. There is always something for [person] to do. [Person] can go outside whenever they want; [person] is an outdoor person.”

There was also evidence of effective involvement from a range of health professionals, including dentists, chiropodists, GPs, and district nurses, supporting people to maintain their health and wellbeing.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive andconsistent, or that they met both clinical expectations and the expectations of people themselves.

We identified gaps in clinical monitoring and care planning in relation to emerging healthcare needs, particularly where people were experiencing complex behaviours. For 1 person under observations, staff were recording episodes of aggression and agitation, sometimes directed towards staff. However, entries were often vague and lacked sufficient detail to understand triggers, patterns, or impact. There was no clear evidence this information was being reviewed or analysed, or what actions were being taken to reduce risks to the person or to staff.

Additionally, for people requiring ‘as and when required’ medication to manage agitation, care plans did not clearly outline strategies, such as distraction or de-escalation techniques, to be used prior to or alongside medication. This limited assurance that care was delivered in a proactive, person-centred way and that medication was used as a least restrictive option.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We observed staff consistently seeking people’s consent before providing care and offering choices and options in everyday life. Care plans included specific information about how to communicate effectively with people who spoke a different language or who experienced barriers to communication, such as dementia, supporting people to understand and consent to their care.

Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) records were in place where required, and people and their relatives told us they felt their views had been taken into account regarding care and treatment decisions. They described feeling involved and supported to make decisions in line with the person’s wishes. One relative told us, “We are much more involved in [person’s] care now. We feel free to make changes and suggestions and we do feel listened to.”

Sensor mats and crash mats, which may constitute a restrictive practice, were in use without documented Mental Capacity Act assessments or best interest decision records. We did not consider these were being used in a way that restricted people, as they were needed to maintain safety. This was addressed immediately during our assessment by the provider.

Staff demonstrated a good understanding of consent, ensuring people were supported to make informed choices about their care and treatment.