This inspection took place on the 8 and 9 December 2014 and was unannounced. Springfield House provides personal care to up to 36 older people. On the day of this inspection there were 23 people accommodated at the home.
There had not been a registered manager in post since January 2014. 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.
At the last inspection in June 2014 we asked the provider to take action to make improvements to people’s care and welfare, record keeping and the monitoring of the quality of care. Action had been taken but improvements were still needed.
People told us they felt safe. Staff knew the signs that may indicate people were abused and were clear of the action to take. They were aware of their responsibility to protect people from harm or abuse. They told us they were confident that any concerns they reported would be acted upon.
Risks to people were identified. Plans were in place and acted upon to minimise risk to people.
There were sufficient staff to provide people’s care in a safe way. The staffing levels were regularly monitored and adjusted to take account of people’s needs. The provider had a robust recruitment process that ensured people were supported by staff whose suitability had been checked. Staff were supported and trained to provide people with care to an appropriate standard.
People had an individual plan of care that detailed the support they needed and how they wanted this to be provided. However, we found that some people’s support was task based and was not provided in the way people wanted. We also saw that some people including those living with dementia did not have sufficient things to do. People were left for periods with no interaction or stimulation. Activities were not consistently taking account of people’s wishes.
Appropriate systems were in place to store, record and administer medicines. This supported people to have their medicines at the right time and in the right way.
Care staff were not consistently following the provisions of the Mental Capacity Act 2005. Mental capacity assessments were not always completed. When people did not have capacity there was no information to show that decisions were made in their best interest. This meant that people’s rights may not always be upheld.
People were supported to have sufficient to eat and drink. People could choose from a selection of meals and drinks. Where people needed support to eat and drink this was provided. The health care needs of people were addressed. People were supported to access health care services. When people were ill the doctor was called and when they needed specialist support this was provided.
People told us they found the staff caring and compassionate. People were able to see their friends and families as they wanted. There were no restrictions on when people could visit the home. All the visitors we spoke with told us they were made welcome by the staff in the home.
We observed and people told us that there were occasions when people’s dignity was not fully promoted. Some people were not able to wear their own clothes due to problems with the laundry facilities.
The provider had a range of checks and audits in place but these were not always effective. The checks had identified some shortfalls we saw and when actions were taken to address concerns these were not always effective.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which correspond with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.