Dimensions Somerset Spring View

Updated 23 December 2021

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 Care Act 2014.

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 two adult social care inspectors, one pharmacist inspector and an Expert by Experience. An Expert by Experience is someone who has personal experience of using or caring for someone who uses this type of service.

Service and service type

Spring View 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 last registered manager left the service in October 2021. A registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. A new manager started working in the home on 1 November 2021.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed all information we had received about the service and took this into account when we inspected the service and made judgements in this report. We also used this information to plan our inspection

During the inspection

Most people were not able to tell us about their care or life in the home. We therefore spent time observing care and support in communal areas throughout the first day of our visit. We did communicate with one person who lived at the home using a picture-based communication system so they could share their views with us. We spoke with two visiting relatives and five members of staff about living and working at the home. We also spoke with the newly appointed manager, the provider’s local operations director, the provider’s good practice lead and with an experienced locality manager who was also supporting the service.

We viewed a range of records. These included three people’s care plans and medicine records, staff rotas, staff training records and two staff supervision records.

Following the inspection

An Expert by Experience contacted three relatives by phone to gain their views on the quality of care provided to their family members. We also requested a range of records from the provider including examples of good practice, quality audits and action plans, compliments, complaints, staff meeting minutes and staff rotas.

Updated 23 December 2021

Dimensions Somerset Spring View is a residential care home registered to provide accommodation and personal care for up to six people. The home specialises in the care of people with a learning disability and a physical disability. At the time of the inspection there were four people living at the home.

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

People were supported by enough staff to ensure they were safe, however safe staffing levels were being reassessed due to people's changing care needs.

There were vacancies in the staff team; recruitment was ongoing. Staff spoke of often feeling under pressure due to staffing issues and not always being able to provide the quality and consistency of care people needed. Relatives did express some concern about staff turnover and the use of agency staff; they though people were not always cared for by staff they knew well. Staff supervisions and appraisals were not being carried out regularly to support staff in their roles and professional development.

People received their medicines in a safe way. However, there were improvements needed to some aspects of the way people’s medicines were managed and recorded.

Risks to people had been assessed. There was ongoing work to improve risk analysis and risk assessments. Not all staff were familiar with or were following all safe eating and drinking plans which could place people at risk.

Staff training on core subjects was good. Training on some service specific topics needed completion by some staff. Agency staff did not always have a thorough induction into the service.

People were supported to make choices, although accessible information and communication systems were limited in the home. Relatives told us they were involved in decisions about their family member's care. People were supported to eat meals of their choice.

The last registered manager left the service the week before the inspection process commenced. A new manager had started work in the home and was involved in the inspection process. Some relatives were concerned that the manager had changed again; there had been a number of changes over recent years.

People were protected from abuse and avoidable harm. Staff knew how to identify and report any concerns.

Accidents and incidents were reviewed both within the home and by the provider to try to prevent recurrence. Infection control policies and procedures were up to date, including COVID 19 measures.

Staff were dedicated and committed to providing the best care for people they could. They had clearly worked very hard throughout the pandemic. Kind and caring interactions were witnessed between staff and people throughout the inspection visits. Relatives commented on the kindness and dedication of staff.

People were supported by a wide range of health professionals to meet their complex needs. People were supported to maintain contact with their friends and relatives. Relatives thought their family member was supported to take part in activities both inside and out of the home.

Relatives told us they knew who to speak to if they were unhappy of if they needed to complain. No complaints were raised with us during the inspection.

The auditing of the service identified the improvements which were needed. There was a clear improvement plan and there was good support from senior staff within the organisation to help improve the service. The service worked in partnership with other agencies and professionals to help meet people’s needs.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture, although further improvements were needed.

Right Support: Spring View is a small care home, based in the community. People had their own rooms, but shared communal areas appeared popular, with people enjoying spending time together. Some people had lived at the service for many years and clearly felt comfortable and relaxed living there. When a new person had moved to the home, this had been well planned to make sure it was suitable for them and they were happy with the move. People were supported to make choices and to take risks.

Right Care: People received personalised care, although staffing shortages impacted on the quality and consistency of care. There was a reliance on temporary staff who did not always have the opportunity to get to know people well or provide all of the care people needed.

Right culture: There was a positive culture at the service. Staff were committed to the provider's values, aims and objectives. People, staff and relatives were involved in the running of the home and ideas for improvement were welcomed. There was an honesty and openness about things which needed to improve.

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

Why we inspected

We carried out a focused inspection of this service on 6 August 2020. We only inspected the safe and well led key questions at this inspection. This was therefore the first inspection of all five key questions of this service since its registration.

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 identified a breach in relation to staffing numbers and staff not receiving regular supervision to support them in their professional development.

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.