We carried out a review of the data available to us about Springfield House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Springfield House, you can give feedback on this service.
Springfield House is a residential care home providing accommodation and personal care for up to 69 people across three floors. The service provides support to people living with dementia and those requiring support with personal care. At the time of our inspection there were 42 people using the service.
People’s experience of using this service and what we found
The service has experienced a period of change in management over the last year. There is now a new registered manager in post. Improvements have been made to governance/quality checks since the last inspection however there are still areas for improvement. We have made a recommendation about this. Most quality assurance checks were effective.
Medicines were managed safely however there were some issues with paperwork relating to medicine patches and topical medicines. We have made a recommendation about this.
People were safe from the risk of abuse. Risks were assessed and regularly reviewed when people's needs changed. The building was well maintained with appropriate décor, including dementia friendly decorations.
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.
Care records were person centred. People were supported to eat and drink a balanced diet. There were enough staff to care for people safely. Staff were trained appropriately and recruited safely.
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 7 May 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 improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that care records were reviewed with a view to making them more person-centred. At this inspection we found the provider had made improvements to care records.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 21 January 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve medicines, staffing levels and governance processes.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions Safe, Effective and Well-led which contain those requirements.
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 requires improvement to good. This is based on the findings at this inspection.
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, which will help inform when we next inspect.
Springfield House is a residential care home providing personal care to up to 69 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 44 people using the service.
People’s experience of using this service and what we found
The service did not always manage medicines safely. Appropriate documentation for ‘as and when’ medicines and topical medicines were not in place; some medicines were not stored correctly. This meant people may not have received medicines at the right time, or may have received out of date medicine. Since the inspection the management team have improved the documentation.
Visitors’ COVID-19 tests and vaccination status (for professionals) were not checked on arrival. Deep cleaning was not being carried out due to staff shortages. This put people at risk of catching infections.
There were not enough staff on duty to safely care for the needs of people living at the service. Some non-care staff were helping with caring duties, and not carrying out their own duties which were also important, such as activities. Since the inspection staffing has been increased.
Quality assurances checks were not always effective meaning a number of issues had been missed in relation to medicines management, staffing and care records.
Care records were not always in line with best practice guidance as some information was not consistent. We have made a recommendation about reviewing care records.
The management team were working to develop a more open culture at the service. Staff felt able to approach the manager for help or to raise issues.
Systems and processes were in place to safeguard people from the risk of abuse. Accidents and incidents were investigated, and staff had learned lessons from things going wrong. Risk assessments were in place, the building was well maintained, and regular safety checks were carried out.
Staff were trained appropriately and recruited safely. Staff told us that the manager was supporting them to improve their skills.
People were supported to maintain a balanced diet and people were supported with specialist diets. Staff worked with other agencies to ensure people had access to the right care and support. The service was adapted to suit people’s needs and there were regular opportunities for people and their relatives to give feedback.
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
The last rating for this service was good (published 27 November 2017)
Why we inspected
We undertook a targeted inspection due to information we had received about the service including an outbreak of COVID-19 and the visiting processes.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
The inspection was expanded due to concerns about staffing levels.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of the full report.
You can see what action we have asked the provider to take at the end of the full report. The provider has already taken steps to mitigate the risks which we have taken into account.
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.
Enforcement and Recommendations
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 monitor the service and will take further action if needed.
We have identified breaches in relation to the management of medicines, infection control, staffing levels and quality assurance checks.
Please see the action we have told the provider to take at the end of this report.
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.
At the last inspection in August 2015, the service was rated Good. At this inspection we found the service remained Good.
People and relatives gave positive feedback about the care provided at the home and the caring approach of the staff team. We saw staff supported people with kindness and understanding.
People, relatives and staff told us they felt the home was a safe place. They also felt sufficient staff were deployed in order to meet people’s needs.
Staff demonstrated a good understanding of safeguarding and whistle blowing including how to report concerns.
There were effective recruitment procedures in place. This included pre-employment checks to ensure new staff were suitable to work at the home.
Medicines were managed safely. Trained staff administered people’s medicines. Records accurately accounted for the medicines people had been given.
Regular health and safety checks were carried out and up to date procedures were in place to deal with emergency situations.
Incidents and accidents were logged and investigated. Records confirmed appropriate action had been taken to prevent recurrence and help keep people safe.
Staff said they were usually well supported and were able to access the training they needed.
People were supported to meet their individual nutritional and healthcare needs.
People were supported to have maximum 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.
The home had been specially adapted to suit the needs of people living with dementia.
People’s needs had been assessed and personalised care plans developed. Care plans were evaluated to check they reflected people’s needs. People had the opportunity to be involved in the review.
There were opportunities for people to participate in activities. This included crafts, reminiscing, sing a longs, chats, snakes and ladders, bingo and chair aerobics.
Although people and relatives gave us positive feedback, they also knew how to make a complaint if needed. Previous complaints received had been investigated in accordance with the provider’s policy.
The service had a registered manager. They had been re-located temporarily to support another home. The provider advised they were due to return to Springfield House imminently. People and staff told us the registered manager was supportive and approachable.
The provider had a structured approach to quality assurance. Regular audits were carried out to help ensure people received good support. These were up to date at the time of this inspection.
People and relatives had given very positive feedback during the last consultation carried out. Where minor issues had been raised, evidence was available to show action had been taken to make improvements.
Further information is in the detailed findings below.
The inspection took place on 18 and 20 August 2015 and was unannounced. This means the provider did not know we were coming. We last inspected Springfield House in August 2013. At that inspection we found the service was meeting the legal requirements in force at the time.
Springfield House provides personal care for up to 69 older people, including people with dementia related conditions. Nursing care is not provided at the home. At the time of our inspection there were 70 people living at the home.
A manager was in post who had applied to become the registered manager. 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 found that care was delivered safely and appropriate steps were taken to protect people from being harmed. Staff were trained in and understood the importance of their duty of care to safeguard people against the risk of abuse.
People living at the home confirmed they felt safe with the staff who cared for them. The home was clean, comfortable and well equipped. Safety checks were conducted to ensure people received care in a safe environment.
People were supported to meet their health needs and access health care professionals, including specialist support. Medicines were managed safely to promote people’s health and well-being.
There was a varied menu with choices and people told us they enjoyed the food. Nutritional needs and risks were closely monitored and people were supported with eating and drinking where necessary. A new process had been introduced to provide people who had a pureed diet with more appetising meals.
New staff were suitably checked and vetted before they were employed. There were sufficient numbers of staff to provide people with continuity of care and to support the running of the home. The staffing ratio had been increased to enhance the care of people living at the home.
Staff were well supported in their roles and met people’s needs effectively. Further training was being undertaken and staff were given regular supervision to support their personal development.
People were consulted about and were able to direct their care and support. Formal processes were followed to uphold the rights of those people unable to make important decisions about their care, or who needed to be deprived of their liberty to receive the care they required.
Staff knew people well and the ways they preferred their care to be given. People and their relatives told us the staff were kind, caring and respectful in their approach. Our observations confirmed this and we saw people were cared for with dignity and treated as individuals.
A range of methods were used that enabled people and their families to express their views about their care and the service they received. Any concerns or complaints were taken seriously and properly investigated.
Care was flexible and responsive to people’s needs. Assessments of needs and risks were carried out and care plans were in place and regularly reviewed. Recording standards were being addressed to ensure care plans consistently reflected the personalised care provided. A variety of activities were made available to encourage stimulation and help people meet their social needs.
The management arrangements ensured good leadership and the home had an open and inclusive culture. Robust systems were operated to monitor and develop the quality of the service, including acting on feedback and checking the care that people experienced.
We spoke with 12 people who received care and support. We found people were given all the information they needed to make an informed decision about their care and were asked to provide their consent to such care.
We saw people were cared for effectively and care was planned for the individual.
We saw people were safe and protected from abuse.
We saw there was sufficient staff to provide care and support.
The provider had an effective system in place to record and monitor complaints. Complaints were taken seriously and responded to appropriately.
One person said; "There isn't anything I'm not happy with."
Two visitors were sitting in the coffee area. They said they enjoyed visiting the home and they had enrolled as members so they could use facilities such as the restaurant and health and well being facilities. They were anxious to book for Christmas lunch.
People said it was a lovely environment. They said they were given appropriate information and were involved in making decisions about their care and treatment. People told us staff treated them with respect and courtesy. One person said, "They always ask me my opinion and explain what is happening."
People told us they were well cared for. One person said, "The staff are very good." We found that care was planned and delivered in a way that ensured people's safety and welfare.
Staff received professional development and people told us staff were well trained.
We saw the provider had systems in place to gather feedback from people, who used the service, and to regularly assess and monitor the quality of service people received.