We inspected Springbank Nursing Home on 13 October 2015. The inspection was unannounced. At our last inspection on 30 May 2013, we found that the provider was meeting the required standards. During this inspection we identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the Care Quality Commission (Registration Requirements) Regulations 2009. You can see what action we told the provider to take at the back of the full version of the report.
The service is registered to provide accommodation and personal care for up to 42 people. People who used the service were over 65 years old and have physical and/or mental health diagnoses. At the time of our inspection there were 39 people who used the service.
The service had a manager but they were not registered with us (CQC). 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 and associated Regulations about how the service is run. We requested that the manager registered with immediate effect.
Risks to people’s health and wellbeing were not consistently identified or managed to promote their safety. We found there were not always enough staff available to deliver people’s planned care or keep people safe.
Effective systems were not in place to ensure medicines were administered in a consistent and safe manner at a time when people needed them.
People did not always get the support they needed to eat and drink. Systems to monitor people were receiving sufficient amounts to eat and drink were not always in place. This meant some people’s nutritional needs were not met.
People were not always supported to have their care in an environment that protected their privacy and dignity.
People and their relatives were not always involved in planning their care. Staff had a varied knowledge of people’s care preferences. This meant that people were at risk of receiving inconsistent care.
The provider did not have effective systems in place to consistently assess, monitor and improve the quality of care. This meant that poor care was unable to be identified and rectified by the manager and provider.
People were not always protected from potential abuse because staff did not recognise some incidents that may be considered as alleged abuse.
People told us they were treated with care and given choices. However, improvements were needed to the way the provider gave choices at lunchtime.
People’s health and wellbeing needs were monitored and advice was sought from health and social care professionals when required. However, we saw that the advice received was not always followed to ensure their health needs were met effectively.
When people did not have the ability to make decisions about their care, the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were followed. These requirements ensure that where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves.
Staff received training. However, we found that improvements were needed to ensure that the quality of the training followed the correct guidelines. There were no systems in place to ensure that staff understood and followed the training supplied.
People were given the opportunity and supported to be involved in social and leisure based activities.
People knew how to complain about their care and complaints were managed in accordance with the provider’s complaints policy.
People and their relative’s feedback was gained and we saw that systems were in place to address feedback to improve people’s care experiences.