Springfield House

Springfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager. 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 our last inspection in March 2016 we rated the service as good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good.

People enjoyed living at Springfield House and staff practices helped to keep people safe. Positive interactions between the people at the home and staff were observed during our inspection.

Staff received the training and support, through supervisions and team meetings, to effectively meet people’s needs. Annual observations of staff competencies were completed.

Staffing levels varied depending on the needs of the people and their preferred daily routines. We saw that the registered manager identified occasions when additional staff might be required and approached commissioners if additional funding was needed.

Person centred care plans and risk assessments were in place to guide staff on the support people needed and how to reduce any identified risks. Where applicable, care plans were in place to support specific health conditions, for example autism and epilepsy. Medicines were administered as prescribed.

At this inspection all equipment was maintained and serviced in line with national guidelines. The home was well maintained and clean throughout. Personal emergency evacuation plans (PEEPs) were in place for each person living at Springfield House.

People’s health and nutritional needs were met by the service. People were involved in choosing the varied meals that were cooked and served by staff.

Information about people’s preferences, culture, likes and dislikes was recorded. A description of people’s preferred daily routines was held on their support plans. Staff recognised the importance of routines and how deviating from these might negatively affect people living at Springfield House. They explored new ways of working with people to try and meet their changing needs.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible.

The registered manager had an auditing system in place to monitor the quality of the service provided. All incidents and accidents were reviewed to reduce the likelihood of a re-occurrence.

The service demonstrated examples of working in partnership with people, their relatives, commissioners, and health professionals. The service engaged with people where possible and used all forms of feedback to continuously improve the service to ensure people living at Springfield House were appropriately supported and had a good quality of life.

Springfield House is registered to provide residential services for a maximum of four adults who have a learning disability. Some people may also have a mental or physical disability. At the time of our inspection four people were using the service. People were using the service in different ways depending on need and other personal circumstances. Some people visited daily and then stayed for 1 or 2 nights each week, others stayed in the service on a residential basis but spent time away from the service with immediate family or other relatives.

There was a registered manager in place at the service. 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.

Due to the unique communication styles of the people living at Springfield House we were not able to speak with everyone using the service. We made observations and spoke with people’s relatives, the home’s staff and other visiting healthcare professionals involved with the service to understand their experience of the service.

We saw the measures that the service had put in place to protect people and keep them safe from harm. Relatives told us that they thought that the service was safe. The service had a safe system in place for the recruitment of staff. Staff had received training in safeguarding vulnerable adults and could clearly describe the action they would take if they suspected any abuse had taken place.

People’s medicines were well managed by the service. Support staff administering medicines had been trained, assessed for competence and told us they felt confident in doing so. Medicines were safely administered with clear guidelines in place for any ‘as required’ medication that had been prescribed.

The home undertook risk assessments for all aspects of people’s care and support. People’s support plans and risk assessments contained personalised information about an individual’s needs and provided guidance for staff as to the support people needed and the routines they followed. Equipment used to support people was well maintained and regular health and safety checks of the premises were made.

If people’s needs changed a system was in place to liaise with the person, their family and other professionals to update care plans and risk assessments. People’s health and medical needs were met by having access to GP’s and health professionals on a regular basis.

The home was clean and tidy throughout and staff used personal protective equipment (PPE) such as gloves and aprons when necessary. We identified a small infection control concern around limited hand washing facilities when people using the upstairs bathroom did so independently and brought this to the registered manager’s attention.

An induction programme was in place for new staff to complete required mandatory training courses and shadow existing staff. Staff training was available and staff confirmed that they had completed training courses relevant to their role. The training matrix was up to date and reflected all mandatory elements plus any additional training undertaken by staff.

We found that the service was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). These provide legal safeguards for people who may be unable to make their own decisions. People’s support was assessed and agreed with the person, their families and the respective commissioning team prior to a referral being made to Springfield House. Support workers had a good working knowledge of the MCA and how it affected the people using the service. The home was compliant with both the MCA and DoLS.

People were supported to eat a healthy diet. They were involved in choosing meals, shopping for food and meal preparation. Meals were cooked from scratch using natural ingredients as opposed to giving people ready meal options.

Relatives we spoke with and other healthcare professionals involved with the service said that the support staff were caring. Staff we spoke with knew people well as individuals and understood their routines. We observed staff interacting with people with warmth and humour but were firm in their approach when they needed to be. Each staff member adopted a consistent approach with people in the service so that boundaries were not crossed and routines were upheld.

During our inspection we could see that staff members respected the privacy and dignity of people using the service. Staff we spoke with could provide examples of how they did this. There was a relaxed and friendly atmosphere at the home. Staff acted with the person’s best interests in mind.

Staff promoted people’s independence by giving them choices. People were encouraged to take part in domestic tasks so that Springfield House felt like their home. The service acknowledged different cultures and beliefs. One person using the service was of the Islamic faith and practiced muslim traditions in their own home. We saw that family were happy for the person to participate in other traditions whilst at Springfield House and staff supported them in making informed choices about their participation.

People’s care plans contained information about their likes, dislikes and personalities, and were very much person-centred. They contained details about how people liked to communicate and be supported in all aspects of their care. Technology to aid communication between people and the staff had been fully explored and adopted by those who wanted to use it. Care plans were up to date and reviewed regularly by people’s keyworkers and the registered manager. People received support as it was described in their support plans.

There were enough staff on duty to meet people’s support needs and to provide activities for them. People’s access to activities was very good; we saw that they were supported to get out and about in the community and to pursue hobbies they enjoyed. Families were kept up to date of all activities undertaken by way of a communication book and photographs emailed to them.

Staff told us that they felt supported by the registered manager. Formal supervisions took place and staff we spoke with valued these sessions. Regular team meetings were also held and staff were able to raise any issues or concerns at these meetings.

A system was in place for responding to complaints. We were told by relatives and staff that the registered manager was approachable and would listen to their concerns. We saw evidence of how the manager pro actively dealt with concerns or issues raised by family members and how they kept people informed of actions taken by the service.

All aspects that could influence people’s care was reviewed and evaluated monthly, including accidents and incidents, individuals’ health and well-being, and health and safety.

At the time of our visit, four members of staff were on duty and all three service users were at home. Although due to presenting conditions communication was difficult, they were friendly and welcoming. One of the people who used the service was able to talk to us about their experiences at the home, although not in detail. They were positive about the home and the staff and said they liked being at Springfield House. They said their choices were listened to and they were able to do the things they wanted to do. We also spoke to two members of staff. They were knowledgeable and understood the needs of the people using the service.

The atmosphere at Springfield House was relaxed and homely; we observed staff interacting with services users and engaging in conversations and activities. The staff clearly understood their needs and had good relationships with all of them.

The person named as registered manager was unavailable on the day of the visit having been redeployed elsewhere but we were able to speak to the new manager whose registration was pending. He confirmed that the person named as registered manager was acting as his supervisor pending registration.