The Springs Care Home

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection. The service gathered feedback from relatives and staff. The latest results had improved. 89% of people and 92% of relatives were happy and would recommend the service. Staff we spoke with mostly demonstrated they knew people well and understood their support needs and how these may have changed. However, people and families were not always involved in their care planning and decision making. Care plans were not always accurate and did not always reflect peoples current support needs. This had been identified by the peripatetic manager who told us, people and families were not as involved as they could be with care planning, this was due to be actioned through the resident of the day process. People and their relatives did not know how to make a formal complaint if they needed to, however the majority stated they would speak to staff or a manager about any concerns.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives were unaware of care plans and some said they had not heard of them. This demonstrated people and relatives had not been involved in how they would like their care to be delivered. This was recognised by the new peripatetic manager when delivering feedback who told us this had been identified and they would be now involving people and families as care plans are currently being reviewed. People told us, “I’ve never heard of a care plan. No review that I know of” and “Don’t know about care plans it’s never been discussed”. Relatives told us “There was a care plan yonks ago. I haven’t seen one for a long time’ and “We haven’t seen a care plan since (relative) came in. They do discuss their needs ongoing and update us continually".

Staff told us about people's needs and how these may have changed, however this was not always accurate in people's care plans. During feedback the management team shared they had already identified people and families were not as involved as they could be with care planning, this was due to be actioned through the resident of the day process. This process focuses on a different person each day, where staff and families members should review peoples current care needs, choices and interests.

We observed staff to have good knowledge of people’s individual needs and preferences. For example, on 1 unit the host knew people's nutrition and hydration needs well, they had knowledge of where the person liked to sit and who with. On another unit staff were able to respond effectively when a person declined their meal, having good awareness the person preferred something sweet before their main meal when they became anxious.

We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

People told us they had not needed to make a complaint, and were unsure of the service’s formal process. One person said "I've not raised a concern or a complaint no need to. I've no idea who I would talk to if I did" Another person told us, "Never a concern no. If I did I’d tell my carer. ‘No complaints at all if there were I would talk to speak to staff". We spoke with 5 family members, the majority said if they had any concerns or complaints they would raise with staff, managers or the nurse on duty.

Staff told us they were motivated to listening to people about their choices. The provider told us they completed surveys with people to gather information about what improvements can be made to ensure people's voices are heard. We reviewed these as part of our assessment. People shared what activities they would like to do in the future, the provider had advertised for 2 additional staff to support and told us they recognised this required improvement.

We reviewed the last 12 months of the provider’s compliments and complaints processes. Actions had been taken when people had complained and the provider had apologised to families and informed them of what lessons had been learnt and what actions had been taken as a result of the complaint. We asked the provider to review the complaints log and consider adding additional information to ensure they have an overview of the complete process.

Staff shared knowledge with inspectors on people's culture and equality. However, this was not always reflected in people's care plans. 1 person did not have the communication support and tools in place to support their diverse needs. This was shared with the provider during our assessment. Some staff told us, they felt the service could improve by providing additional activities for residents. Some staff felt there was a risk the service was not providing enough staff to interact meaningfully with residents.

Not all people were able to access care, support and treatment when they needed to. The provider worked with a number of external professionals who visited the service on a regular basis, but this did not always meet people’s needs. The provider supported people with communication barriers, however we did not see any additional communication tools to support their decision making. Some people who were nursed in bed did not have access to meaningful interaction and activities. However, people’s care plans contained information about their wishes in relation to their social, cultural and spiritual needs. These included people's sexuality and preferred daily lifestyle choices.

We did not look at Equity in experiences and outcomes during this assessment. The score for this quality statement is based on the previous rating for Responsive.