About the service Springfield House is a residential care home providing personal care to up to 69 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 44 people using the service.
People’s experience of using this service and what we found
The service did not always manage medicines safely. Appropriate documentation for ‘as and when’ medicines and topical medicines were not in place; some medicines were not stored correctly. This meant people may not have received medicines at the right time, or may have received out of date medicine. Since the inspection the management team have improved the documentation.
Visitors’ COVID-19 tests and vaccination status (for professionals) were not checked on arrival. Deep cleaning was not being carried out due to staff shortages. This put people at risk of catching infections.
There were not enough staff on duty to safely care for the needs of people living at the service. Some non-care staff were helping with caring duties, and not carrying out their own duties which were also important, such as activities. Since the inspection staffing has been increased.
Quality assurances checks were not always effective meaning a number of issues had been missed in relation to medicines management, staffing and care records.
Care records were not always in line with best practice guidance as some information was not consistent. We have made a recommendation about reviewing care records.
The management team were working to develop a more open culture at the service. Staff felt able to approach the manager for help or to raise issues.
Systems and processes were in place to safeguard people from the risk of abuse. Accidents and incidents were investigated, and staff had learned lessons from things going wrong. Risk assessments were in place, the building was well maintained, and regular safety checks were carried out.
Staff were trained appropriately and recruited safely. Staff told us that the manager was supporting them to improve their skills.
People were supported to maintain a balanced diet and people were supported with specialist diets. Staff worked with other agencies to ensure people had access to the right care and support. The service was adapted to suit people’s needs and there were regular opportunities for people and their relatives to give feedback.
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 supported this practice.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
The last rating for this service was good (published 27 November 2017)
Why we inspected
We undertook a targeted inspection due to information we had received about the service including an outbreak of COVID-19 and the visiting processes.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
The inspection was expanded due to concerns about staffing levels.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective and Well-led sections of the full report.
You can see what action we have asked the provider to take at the end of the full report. The provider has already taken steps to mitigate the risks which we have taken into account.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Springfield House on our website at www.cqc.org.uk.
Enforcement and Recommendations
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 and will take further action if needed.
We have identified breaches in relation to the management of medicines, infection control, staffing levels and quality assurance checks.
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 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.