Springfield House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Improvements had been made since the last inspection regarding managing risks and medicines. There were process in place to help protect people from the risks of abuse and neglect. Staff understood their responsibility to keep people safe and knew how to raise concerns. Individual risk assessments were completed to guide staff on how people should be supported in order to mitigate risks. We observed staff following risk assessments during our site visit. People were supported to engage in activities both in and outside the service. There were enough staff to meet people’s needs. There was a consistent staff team who knew people well. Regular agency staff were used to cover shortfalls and they also knew people well.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us or indicated with a thumbs up that they felt safe living at Springfield House. Relatives spoke positively about the service. They said, “[My loved one] does receive good safe care; the staff are tuned into their needs and treat them well” and “I do feel [my loved one] is safe. They are very happy at the home I have no concerns, nor have I had to raise concerns.”

People were protected from the risks of abuse, harm and discrimination by staff who completed safeguarding training and understood how to put their learning into practice. Staff told us, “I have done safeguarding training which tells you about the different types of abuse and how to report it. I feel I know how to protect people here” and “If I was concerned at all, I would go to the senior on shift, the deputy manager or the manager, and then escalate to the CQC or the local authority, it depends on the situation and the response.”

We observed staff making sure people were protected against abuse as much as possible. Staff noticed when people were becoming anxious and knew the best way to support people. For example, when a person became anxious and wanted to go out, staff encouraged them to find a ball so they could take it to the beach as this was the person’s preferred way of reducing anxiety.

People told us or indicated with a thumbs up that they felt safe living at Springfield House. Relatives spoke positively about the service. They said, “[My loved one] does receive good safe care; the staff are tuned into their needs and treat them well” and “I do feel [my loved one] is safe. They are very happy at the home I have no concerns, nor have I had to raise concerns.”

Risks to people’s health, safety and welfare were assessed, managed, monitored and reviewed. When people needed specialist equipment to help keep them safe this was provided. Staff knew people well and understood their different communication needs. A member of staff told us, “You let the person know the reason why something needs to be done, for example, wearing a helmet, and ask them if they know about the consequences of not wearing it and explaining it to them gently and simply. It’s all about communication and patience.”

Staff recognised when people might be becoming anxious and provided reassurance. Relatives told us, “I do feel [my loved one] receives good safe care. They are very happy at the home. I have no concerns, nor have I had to raise concerns” and, “We are involved in all decisions for [our loved one]. Staff do understand their needs but due to staff turnover I feel things can slip.”

People lived safely and free from unwarranted restrictions. Staff involved people, when possible, in managing risks and spoke with them about keeping safe. People’s health and support plans included detailed risk assessments. These included risks around people’s physical and mental health, finances, medicines and nutrition and hydration. People had a personal emergency evacuation plan which identified the level of support a person may need in an emergency, such as a fire.

We observed staff following people’s risk assessments in order to keep them safe. For example, when a person was at risk of being unsteady on their feet at times, we saw staff offer their arm to the person to ensure they were able to move safely. Staff gently prompted and encouraged the person. When a person wore a helmet to protect their head, staff made sure they were wearing it correctly.

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

During the on-site assessment there were enough skilled and knowledgeable staff to provide people with the support they needed in the way they preferred. Throughout the days of the site visits people were supported to go out and enjoy various activities of their choice.

People told us or indicated that they liked the staff team. For example, one person gave a thumbs up pictorial sign for staff, being helped, shopping, feeling comfortable, getting medical help, trips out, using money and going out for a drink. Relatives told us that staffing levels had improved. They said “[Our loved one] doesn’t receive one to one support but there are always plenty of staff to look after them and the other residents” and “I do feel there is enough staff currently.”

The service had enough staff, including for providing people with one-to-one support to take part in activities how and when they wanted. People were supported by staff who had been recruited safely. Staff had the induction, training and support they needed to provide people with the support they needed in the way they preferred. The registered manager monitored staff training to make sure staff kept their knowledge up to date. Staff confirmed they received regular supervision and were given the opportunity to discuss their development.

There were enough skilled and knowledgeable staff on each shift. Staff received effective support, supervision and development and worked together to meet people’s needs. Staff told us, “I have had supervision. I was able to say what I wanted to say. I felt listened to and I felt reassured” and, “Staffing is a lot better now, really no agency unless there is sickness. I have supervision every 3 months. It gives you a chance to speak and raise any thing you need to.”

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People were supported with their medicines according to their individual preferences. Information for staff in relation to medicines used ‘when required’ (PRN) to calm, sedate or restrain did not make it clear that they must only be used as a last resort. However, we did not see these medicines being used inappropriately. We saw that documents relating to the management of seizures for one resident contained conflicting information that could be confusing to staff.

Fridge temperature readings were outside of the recommended range and had been for over a year. No medicines requiring refrigeration were in use at the time of this inspection. We raised this issue with the provider who said they would take immediate action to rectify this. There was minimal risk of harm to people, however we are unable to establish the level of historic risk. The provider had systems to manage medicines incidents and we saw evidence of actions taken to minimise the risk of them reoccurring. For example, staff had implemented additional MAR chart checks to reduce the risk of medicines errors.

Staff were trained and assessed as competent to administer medicines. There was always a member of staff available that could administer emergency medicines for the management of seizures. Staff understood and implemented the principles of STOMP (stopping over-medication of people with a learning disability, autism or both) and ensured that people’s medicines were reviewed by prescribers in line with these principles. However, information for one ‘when required’ medicine to calm, sedate or restrain did not make it clear that it must only be used as a last resort. We did not see these medicines being used inappropriately.