We carried out an unannounced inspection of this service on 28 October 2014. Breaches of legal requirements were found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the cleanliness and infection control, people’s consent to care and treatment, assessing and monitoring the quality of the service, how people were cared for and respected, requirements that related to the recruitment of staff and how staff were supported.
We undertook this inspection to check that they had followed their plan and to confirm that they have now met legal requirements. This report covers our findings in relation to those requirements and additional any other areas that we looked at on the day of the inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Springfield Manor Nursing Home on our website at www.cqc.org.uk.
Springfield Manor Nursing Home is a privately owned care home for people who require long
term and respite care, nursing, or palliative care for up to 30 older people some of whom were living with dementia.
The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. This was because a new manager had been recruited to work at the service who was submitting their application to the CQC.
There were not enough suitably skilled staff deployed around the service. One person said “I don’t feel there are enough staff as I always have to wait for staff to come and answer my call bell.” We found that the nurse on duty only had time to complete their medicine rounds and undertake wound care on the day of the inspection. They told us that they feel they do not have time to be more pro-active in the clinical care that they wanted to provide. Some care was not being provided in a timely way.
We found during this inspection that there had been sufficient improvements to the cleanliness and infection control at the service. Staff had received updated infection control training to improve their understanding and knowledge. People and visitors said the service was a lot cleaner now.
On this inspection we found that the recruitment practices had been addressed. Recruitment files contained a check list of documents that had been obtained before each member of staff started work and these were all present.
The provider and the manager have contacted us since the inspection. They have provided us with a dependency tool to assess the needs of people living at the service and are looking to recruit additional staff including a nurse.
Assessments were undertaken to identify risks to people. When clinical risks were identified appropriate management plans were developed to reduce the likelihood of them occurring.
We reviewed people’s medicine charts and found no gaps or discrepancies. All medicines had been recorded appropriately. All medicine was stored, administered and disposed of safely.
Staff had knowledge of safeguarding adult’s procedures and what to do if they suspected any type of abuse. One said “I have never seen abuse here, but if I did then I would inform the manager and the nurse.”
In the event of an emergency such as a fire each person had a personal evacuation plan and at each handover staff discussed these.
Arrangements were now in place in relation to Mental Capacity Act 2005 (MCA). There were mental capacity assessments present in people’s care plans. These included care being provided and the use of bed rails.
People confirmed that consent was sought from them before care was given. We saw examples of staff gaining consent from people throughout the visit.
CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS). This aims to make sure that people are looked after in a way that does not inappropriately restrict their freedom. We saw that where people’s liberty may have been restricted applications had been submitted to the local authority.
At this inspection staff told us that training had improved. We saw that all staff were up to date with the service’s mandatory training.
People were happy with the care that they were receiving at the service. One person said “I’ve been here a while. It’s wonderful, no problems.”
People had access to a range of health care professionals, such as the GP, nutritionist and physiotherapist.. One health care professional said they worked well with the staff at the service and felt that people were receiving the health care they needed.
We found on this inspection that all people that wanted to were sitting in new lounge chairs which were arranged in little clusters around the service to promote privacy and independence.
When asked if they thought staff were caring one person said “Yes, staff help me with my make-up and finish getting me ready”. Another person told us that staff were kind and considerate. We saw staff took the time to acknowledge people either with a smile and there was plenty of laughter between staff and people.
People’s family and friends were able to visit at any time and we saw this happening throughout the visit. Health care professionals said that the staff were caring. One said “It’s a lovely home, think the care is excellent.”
Residents and relatives meetings took place regularly. This was a way of involving people and family’s in the running of the service.
Staff showed they were knowledgeable about people in the service and the things that were important to them in their lives.
People’s care plans detailed what people need to support them. The equipment provided to people was appropriate and up to date and where specialist needs had been identified support was given
Since the last inspection activities have increased in the service. An activities coordinator had been recruited. There were CD’s, various jigsaws and games. There were areas of interest for people around the service including large pictures, sensory items and hamsters which we saw people enjoying.
People were also able to access the community. One member of staff said “I’ve organised an outing to Wisley (gardens)” and a Father’s Day barbeque had been arranged on the Sunday following our inspection.
People said they would know how to make a complaint but had not needed to. There was a service policy available for people and staff said they would support people who wanted to make a complaint.
People who used the service and relatives said the management of the service had improved recently. Comments included “Things are a lot better since the new manager started, there is still a way to go” and “A lot of work has been done on the home, they are in the process of redecorating.”
The provider gained staff feedback through periodic meetings and surveys. The survey completed in 2015 identified that staff were generally happy and identified a few areas they felt could be improved. An action plan had been devised to address areas needing improvement.
The manager said “Springfield remains upon the top of my priorities; I am actively working towards improving things.”
We saw various audits had been used to make sure policies and procedures were being followed and to improve the quality of the service provided. This included health and safety, care records, accidents and incidents, falls and medication practices.
Services that provide health and social care to people are required to inform the Care Quality Commission (CQC) of important events that happen in the service. The manager had informed the CQC of significant events in a timely way. This meant we could check that appropriate action had been taken.
During the inspection we found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.