Springfield Nursing Home

Updated 11 October 2023

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 completed by 2 inspectors, a regulatory co-ordinator and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Springfield Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Springfield Nursing home is a care home without nursing care. CQC have requested the provider changes their name to avoid confusion as to the regulated activity they provide. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 3 months and was in the process of registering with the Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed all the information we held about the service and looked at information in the public domain. We sought feedback from stakeholder groups and other professionals. We also looked at information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 17 staff including the home manager, clinical lead, senior care staff and care staff, domestic and catering staff. We spoke with 9 people who lived in the home and 2 visiting relatives. We reviewed 6 staff personnel files, 13 people’s care records and governance information for medicines management, quality assurance, staff support and risk management.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 11 October 2023

About the service

Springfield nursing home is a residential care home providing accommodation and personal care to people. The provider has been requested to change their name to avoid confusion as they do not provide nursing care. The home accommodates up to 40 people and during the inspection there were 35 people living in the home. The home has a large lounge/dining room on the ground floor and a smaller one on the first floor. There is a lift and stairs making each floor easily accessible to all people in the home.

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

Everyone we spoke with told us they felt safe. However, upon reviewing practice we identified potential concerns that could place people at risk of harm. This included concerns around medicines, risk management, staff recruitment and training, protection from potential abuse and governance procedures.

During the inspection there were enough staff to meet the needs of people living in the home, however, some told us this was not always the case. We have recommended this is regularly reviewed. The home was clean and good procedures were in place for the management of infection.

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 did not always support this practice and we have made a recommendation about this.

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. We considered this guidance as there was one person using the service who had a learning disability and or who were autistic. The required learning in this area was yet to be completed by staff in the home and we have made a recommendation about this and the completion of other key training.

Staff support had recently improved and team meetings had begun to take place. People’s nutritional and hydration needs were met and everyone told us they enjoyed a varied and good standard of food. When people needed additional support referrals were made to specialist professionals as required.

Everyone we spoke with told us staff were kind and caring. People’s privacy was respected and information was gathered about people’s preferences, likes and dislikes. People’s independence was promoted and respected.

Good information was collected for the delivery of a person-centred approach to people’s care and support and people told us they had everything they needed. There was an available complaints procedure which people told us they knew how to access. End of life care had been considered in people’s care plans and people’s views on the discussion around the end of their life was respected.

Governance systems were starting to develop and this would allow better oversight of service delivery. Systems were not yet in place to measure and monitor continuous improvement. Recent notifications were sent to the Commission as required and the last inspection ratings were on display in the home and on the provider’s website. The culture in the home had much improved over recent months and staff and people all told us they liked the new manager and found them approachable.

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 13 July 2021).

Why we inspected.

The inspection was prompted in part due to ongoing concerns received about an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risk to people. This inspection examined 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.

You can see what action we have asked the provider to take at the end of this full report.

Some action had been taken to mitigate risk but more action was required. The new manager had begun to take steps to introduce and implement the required changes.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Springfield Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to medicines, risk management, protection from abuse and good governance. We have also given 4 recommendations around staffing levels, monitoring and application of staff training, timely assessment including those relating to the Mental Capacity Act and measuring improvement based on people’s feedback.

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.