Springfield House

Updated 12 March 2022

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 inspectors.

Service and service type

Springfield House 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 service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service about their experience of the care provided. We spoke with six members of staff including the area manager, senior care workers, care workers and agency staff.

We reviewed a range of records. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two relatives and the registered manager.

Updated 12 March 2022

About the service

Springfield House is a residential care home providing personal care to 10 people with a learning disability at the time of the inspection. The service can support up to 10 people in one adapted building.

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

People and their relatives told us they were happy with the support they received at Springfield House. However, we identified shortfalls with medicines management, which included not having sufficient numbers of medicines trained and competent staff on duty. Staffing levels did not always meet the assessed needs of people, and people were not always able to take part in the activities they wanted to. Risks to people had not been acted on; staff did not complete the necessary checks for people who were at risk of constipation, and checks to the environment, including fire safety had not been completed.

There were not robust systems in place to ensure that actions were taken when the registered manager was not at the service. Staff failed to escalate concerns relating to unexplained bruising in a prompt manner. Training for staff had expired or not been completed in a number of different areas. When we identified issues, they were resolved quickly however, the providers governance systems had failed to identify the shortfalls.

People and their relatives told us they felt safe living at Springfield House. One relative told us, “They would relay back to me if there was a problem the fact that they are always happy to go back says to me there’s no problem.” People were supported by core staff who knew them well and were kind and caring towards them. People were supported to be involved in the planning and delivery of their care. Staff encouraged people to be as independent as possible; people made decisions about what they wore, how they spent their time and what they ate. People were involved in meal planning and preparation.

The service was clean and personalised to the people that lived there. Relatives and staff told us it felt homely.

People were supported by a range of health care professionals including the GP, dentist, epilepsy specialists and a chiropodist. People’s needs were continually reviewed and re-assessed.

Relatives told us they felt well informed about their loved one’s care. There had been no recent complaints. Relatives told us they understood the complaints process and felt they could approach the registered manager with any issues.

People were supported to have maximum choice and control of their lives and staff mostly supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

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.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. For example, some of the language used within care plans was not respectful. Staff had placed restrictions on people, although this had been identified and acted on by the registered manager, staff showed a lack of understanding of people’s rights.

Right support:

• Model of care and setting mostly maximises people’s choice, control and independence.

Right care:

• Care is mostly person-centred and promotes people’s dignity, privacy and human rights.

Right culture:

• Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

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

Rating at last inspection

This is the first rated inspection of this service under the new provider.

Why we inspected

This was a planned inspection due to the length of time the home had not been inspected since the change of provider. The service had been under the new provider since September 2020.

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 found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

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 to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to risks to people, staffing and governance at this inspection. 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 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.