Archived: The Springs Community

The Springs Community provides care and accommodation for up to 25 younger adults who have autism, Asperger's syndrome, mental health difficulties and learning disabilities. There were 15 people using the service at the time of our inspection.

We considered our inspection findings to answer questions we always ask:

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found. This summary is based on our observations during the inspection, discussions with people using the service, staff supporting people and the management team and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

The service was generally safe because people's individual needs were assessed but there were some gaps in how some of the support needs were managed. This was both in practice and there was a lack of detail in care plans for guidance. Risk assessments did not always address the issues and the management of risk was sometimes prevention or avoidance of an activity rather than facilitating people's self-management and learning.

People's medicines were handled safely.

Staff had completed essential training.

There were systems to monitor the safety of the building and equipment but they were not always effective. The hot water in one of the hand wash basins was very hot and people were at risk of being scalded. Staff told us they had previously reported this risk.

Is the service effective?

The service was not effective.

Staff knew people well, they responded to people's requests and offered them choices.

People were supported with their physical health. Checks were made, like monitoring people's weight and blood levels for medicines to make sure people were healthy and to pick up any issues quickly. Other health professionals were involved in people's care and people were able to access health services to get the support they needed.

People's mental health was affected by the current management culture and staffing levels because changes to people's routines, a lack of meaningful activity and lack of structured support to develop independence led to frustration and anxiety.

Policies and systems were in place but there was insufficient monitoring and analysis to make sure these were workable and effective.

Is the service caring?

The service was caring.

People were treated with dignity and respect. People had their own private space and their privacy was respected.

Staff spent time with people and supported people with their daily activities. Staff treated people with respect and understanding. People told us they liked the staff. One comment was 'X sorts out any problems, helps me with trips out. They are really great.' Another person commented, 'All very nice, good staff.'

Staff listened to people and were approachable. Despite the shortage of staff and long hours some staff were working they gave people the time they needed to reassure them when they became anxious.

People could talk about the home and their needs in individual meetings with their key worker and in house meetings.

Is the service responsive?

The service was responsive.

It was clear from observations and from speaking with staff that they had a good understanding of people's care and support needs. Staff sought extra help and advice from other health and social care professionals when required.

Staff were attentive to people using the service and responded promptly when needed but there were some difficulties in being able to respond to each person's individual needs due to the shortage of staff.

Activities were on a turn taking basis and there were more small group activities than individual activities in order to make sure people were able to get out. Some activities were delayed due to staff being in meetings with the manager and this caused anxiety.

Is the service well-led?

The service was not well led.

There was no clear leadership in the service. The management of the service was at a distance. The manager and deputy manager were based in office buildings separate from the homes. The culture was that management staff did not work alongside care staff. If an incident occurred then staff reported it to the manager or deputy manager so it was managed after the event. This did not build confidence in the staff's roles and meant that management of the service was not proactive.

Policies were in place but there was no monitoring to make sure these were workable. Staff were given responsibilities but they were not supported sufficiently to carry these roles out effectively. There was no evidence of learning from incidents.

There was no development plan for the service. Improvements were mainly driven by the relative's complaints.

Our last inspection of 4 July 2013 found that the supervision of staff had not always taken place when it was supposed to or had not been recorded. This meant that the service could not show that staff were fully supported.

At this inspection we found that staff had received supervision and annual assessments when due.

We spoke with staff and some of the people who lived at the service. Staff told us they felt effective supervision and appraisals were in place. People that we spoke with told us that they were confident that the staff had the skills and support required to provide effective and safe care. One person commented 'I trust staff'.

Visitors to the service spoke positively about the staff, facilities and the quality of care provided. One person said 'I can't fault the staff or the care'.

Our last inspection of 29 March 2013 found that complaints were not recorded and the complaints procedure in place did not tell people who else they could complain to.

At this inspection we found that the complaints procedure had been revised. It was accessible to anybody who may need it, contained suitable information and any concerns raised were recorded and replied to.

We looked at other areas during this inspection to make sure that people had consented to the care and treatment they received and that it met their needs. We also checked to make sure that the quality of the service provided was monitored and looked to see how the staff working there were supported.

We found that people had been asked about the care and support they wanted, it met their needs and people had agreed to it. The quality of the service was monitored and people's views were listened to. Staff had received appropriate training, but we found that staff supervision and appraisal had not always taken place when it was supposed to. This meant that the service could not show that staff were fully supported.

A person told us that staff; 'are always there to help you if you need them'.

We spoke with six relatives. Everyone, except one relative, told us that the care staff provided was of a very high standard.

One relative said; 'staff are really excellent. They do everything possible to try to encourage independence. The facilities here are excellent'.

We received a small number of comments of concern: Three relatives said that staff sometimes appeared to accept what their relatives told them, rather than trying to encourage them to be more independent, or to make sure that personal care tasks were carried out. The manager explained that people are encouraged to be more independent. She said she would review people's care plans and try to resolve such issues with relatives.

This was largely a positive inspection. People living in the home were satisfied with the care that staff supplied. Relatives said that they were satisfied or generally satisfied with the care supplied by staff. Some essential standards were fully met. Others, such as ensuring care plans were fully sufficient, and that complaints were always recorded and responded to, needed to have contained more detail in order to have fully met people's needs.