1 August 2023
During a routine inspection
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.