Archived: Springfield Retirement Home Limited

We found the following examples of good practice.

The registered manager had worked in partnership with other agencies to ensure processes were implemented to stop the spread of infection. This included attending local authority webinar, clinical commissioning group advisory meetings and working in partnership with another nearby home. Virtual meetings with another registered manager took place on a weekly basis to ensure both homes were up to date with good practice. We saw COVID-19 policies had been introduced which were in line with guidance. Additionally, the business continuity plan had been updated to include COVID-19.

The registered manager had implemented comprehensive processes to minimise the risk to people, staff and visitors from catching and spreading infection. People being admitted into the home were required to have a COVID-19 test before moving into the home and were subjected to a period of isolation. The home had signed up to a ‘whole home’ approach to testing for COVID-19. This meant that all people and staff had agreed to be screened on a regular basis for COVID-19, so timely action could be taken to minimise the spread of infection.

There was a focus on maintaining relationships between people, friends and family. Risk assessed family visits were encouraged and welcomed. Relatives and friends hoping to visit people who lived at the home, were sent letters before their planned visit detailing processes they were expected to follow at the visit. Visitors were screened before they were allowed to enter the home to ensure they were fit and well and not displaying any signs of COVID-19. Visitors were restricted to specific visiting areas within the home and appointments were time limited and restricted.

The registered manager understood the importance of protecting and promoting well-being during challenging times. They told us they had an open door policy and made themselves available to provide reassurance and support to people and staff. People who lived at the home told us they were happy with current arrangements in the home. Staff looked relaxed and happy in the working environment. The registered manager told us they had introduced risk assessed entertainment within the home. This included having a singer visit the home and entertain people from the garden.

Staff had received training and guidance in infection control processes. We observed staff going about their duties and saw they wore personal protective equipment, (PPE) in line with guidance.

The physical environment had been reviewed and adapted to meet good practice guidance. Subtle changes had been made within the environment to balance risk and people’s well-being. This included reviewing areas within the home to make them easier to clean and introducing additional hand washing facilities throughout the home. Consideration had been taken as to how the house could be divided into separate areas, should an outbreak occur within the home. There were posters in the home to promote best practice guidance on how to put on and take off gloves, aprons and masks.

Further information is in the detailed findings below.

Springfield Retirement Home 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, both of which we looked at during this inspection.

There was a registered manager in place. 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 December 2015, the service was rated ‘Good’. At this inspection, we found the service remained ‘Good’.

During the inspection visit we observed staff provided support for people in a sensitive and caring way. For example one person who lived at the home said, “Very caring and respectful they treat everyone so well.” A relative wrote in a survey ‘Excellent care’.

Risk assessments in care records of people who lived at Springfield had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records showed they were reviewed and any changes had been recorded.

We looked around the building and found it had been maintained, was clean and a safe place for people to live. We found equipment had been serviced and maintained as required. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. We found supplies were available for staff to use when required. Medication documentation in care plans provided staff with a good understanding about specific requirements of each person who lived at Springfield. Also staff had relevant training to assist them in the safe administration of medicines. This was confirmed by talking with staff.

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

We confirmed people who lived at the home had access to healthcare professionals and their healthcare needs had been met. Care records seen confirmed visits to and from General Practitioners (GP’s) and other healthcare professionals had been recorded.

People who lived at the home spoke positively about the standard of food provided. People only made positive comments about the quality of meals and food provided. They included, “Food is very good. We are fortunate to have a very good cook.”

Staff knew people they supported and provided a personalised service in a caring way. This was confirmed by talking with people who lived at the home and relatives. Care plans were organised and had identified care and support people required. We found by conversations with staff they had a good understanding of protecting and respecting people’s human rights. They were able to describe the importance of respecting each person as an individual. One staff member said, “The culture at this home is everyone is treated the same way with compassion and care no matter what background or religion they are.”

People who lived at the home told us there were a variety of activities which were organised for their entertainment. These included exercise classes, dominoes, entertainers from the community and film afternoons with refreshments. One person who lived at the home said, “Sometimes if I come in the afternoon they have all sorts of activities going on.”

We found there was information available with regards to support from an external advocate should this be required by them.

Springfield had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they had no complaints.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included regular audits and resident/staff meetings to seek their views about the service provided.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

Care and support was provided in a way that was intended to ensure people's safety and welfare. We saw there were enough staff on the inspection to support people as they needed. People were treated with respect and dignity with staff assisting people in a sensitive manner. People had the choice of spending time on their own or in the communal areas. One person said, 'The staff are really good. They deal with us beautifully. Staff give us support just as we request and they answer any bells quickly.'

Systems were in place to make sure that provider and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.

The home had policies and procedures in relation to the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Relevant staff had been trained to understand when an application should be made and in how to submit one.

Service contracts were in place. Maintenance records we looked at showed that regular safety checks were carried out. Any repairs were completed quickly and safely. These measures ensured equipment in the home was maintained.

Is the service effective?

People confirmed that they were able to see their visitors in private and that friends and relatives could visit whenever they wished. We saw one person was supported by staff to visit their home and family frequently. Relatives said they were always made welcome when they visited their family member. One person told us, 'The staff make sure we have privacy with our visitors if we want it.' A relative told us, 'Mum has a key to her own room so she can lock her personal things away. It makes her feel secure.'

The care records seen were person centred and informative. They showed the health needs, care and support needs and the likes, dislikes and routines of the person.

Risk assessments were in place and had been regularly updated to reflect the changes in support needed. We saw evidence that changes in health were noted, records updated and the advice of other professionals sought. This assisted staff in providing appropriate care and support.

The individual needs of people were taken into account with the layout of the home enabling people to move around freely and safely. The premises were suitable to meet the needs of people with physical impairments.

Is the service caring?

People told us that the staff were kind and willing. They said they responded quickly to any requests for help and supported them as they wanted. One person said, 'I am happy here. The staff here are kind and help us when we need it.' A relative said about the care of their family member, 'The staff have been really great with her. She is very settled.'

We saw lunch and the evening meal being served. The mealtimes were relaxed and unhurried. Staff were attentive and supported people appropriately as they assisted them with their meals.

Care plans were being maintained, and regularly updated, recording the care and support people were receiving. People and their relatives had been involved in collecting and updating this information. This helped all involved to have clear and detailed information on how to support people effectively.

Staff checked in residents meetings and also informally whether people were satisfied with the care provided and if they had ideas for any changes.

Is the service responsive?

Staff respected the diverse needs of people. Religious, cultural, sexual orientation and other diverse needs were taken into account when planning care and these were met as people wanted. Staff assisted people with personal care discretely and sensitively and in a timely manner. We observed people involved in daily living activities, social and leisure activities or chatting with staff. People said that they enjoyed the activities.

Any extra hours of staffing needed were covered with the staff team quickly and safely, even in an emergency. Staff told us that they were always willing to change shifts to make sure there were enough staff to look after people well. One member of staff said, 'The manager will put extra staff on if resident's needs change.'

People and their relatives said they were asked their opinion about their care and the home. One person told us, 'We have our meeting to talk about things we like and anything we are not happy with. The staff always ask our opinion and they listen to us.' A relative told us, 'I have spoken to the staff if not happy with things. Things are dealt with very quickly.'

Is the service well-led?

The service had a quality assurance system in place. Records showed that any identified problems were addressed.

Staff had a good understanding of their roles and responsibilities and of the ethos of the home. They felt that they worked together effectively. Staff had regular meetings so were involved in decisions about the home. There were also regular residents meetings where people could discuss their view of the home and any changes they would like in care or routines.

We were notified of any incidents or issues relating to the home in a timely manner.

The service demonstrated good practice that ensured people were cared for in a supportive and dignified manner. One person told us, 'I'm happy as I can be here. I miss my home, but know I have to be here where I get cared for properly'. Another person said, 'I'm very glad I came here, the staff are extremely kind and caring'.

Additionally, care records were of a good standard. Care plans and risk assessments were signed and regularly reviewed. Daily records demonstrated where other providers had been involved in people's care. This showed good communication within the home.

The home had thorough practices in place to maintain secure premises for the safety of people living and working there. People were recruited appropriately because the home had followed its procedures. One staff member told us, 'I'm very happy here'. Springfield Retirement Home additionally had appropriate processes in place to monitor the quality of its service.

The manager completed an action plan that demonstrated how the provider intended to address the non-compliance. This highlighted the introduction of a consent form and Mental Capacity training for all staff.

We received Springfield Retirement Home's newly introduced consent form and were told that all residents, or their appropriate representatives, had signed and completed them. We were also informed that the completed forms were stored in the individual's care records.

We received a record detailing that all staff at the home had received Mental Capacity Act training. Staff had signed this record stating that they understood Mental Capacity and its impact upon care. The information included an outline of the training and how staff understanding was ensured. The training included Deprivation of Liberty information.

People who used the service felt staff were supportive and listened to them. One person said, "Whenever I need support the staff are there. They are so kind". Another person told us, "I get embarrassed, but they put me at ease and help me".

We observed the interaction between the staff and the people who used the service. We observed that staff were respectful of people and treated them with dignity. We saw staff knocking on people's bedroom doors before entering. We also saw staff talking with people in a courteous manner.

We looked at three people's care records. Although these contained individualised care plans, we were told that people who used the service initialled them. There were no signatures or formal identification of people consenting to their treatment.

Most staff explained how they obtain consent verbally, but acknowledged that this was not recorded. Additionally, staff had not received Mental Capacity training that would assist in better understanding consent.