Springbank House Care Home

Springbank House Care Home is registered to accommodate 41 people. At the time of our inspection 32 people were using the service. The service accommodated people in one building over two floors and had adapted facilities to meet people’s needs. This included several lounges and a conservatory. A courtyard garden was also available that people could access.

This inspection was conducted to consider Infection Prevention and Control (IPC) practice in the service.

We found the following examples of good practice:

The registered manager kept staff informed of the most current guidance for Covid-19, including vaccination requirements and visiting in care homes.

The environment was clean and hygienic throughout. Attention was given to frequently touched surfaces and facilities in use by multiple people such as bathing suites, toilets, dining areas and lounges.

The environment in communal areas of the home were arranged in a way to promote social distancing and were set up effectively to avoid people feeling isolated within these spaces. New flooring had been installed in the dining room to allow for easier and more effective cleaning. Further environmental improvements were underway.

The registered manager had implemented a system to have emergency supplies ready in case of an outbreak of an infection within the home. This system included an emergency box with personal protective equipment (PPE), hand sanitiser and cleaning supplies to put into use on an immediate basis should a person require isolation due to infection.

Staff were clear about their responsibilities in respect of how to control the risk of infection to people. All staff were current with training including IPC, the use of PPE, health and safety and Covid-19 preparedness.

There were a sufficient number of staff deployed in the service to meet people’s needs.

We observed staff use different levels of PPE depending upon the task they were completing. There was a sufficient supply of PPE available for staff to use.

All staff and people using the service were current with vaccinations for Covid-19.

Springbank House Care Home is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Springbank House Care Home is registered to accommodate 41 people. At the time of our inspection 37 people were using the service. The service accommodates people in one building over two floors and had adapted facilities to meet people’s needs. This included four lounges and a conservatory. A courtyard garden was also available that people could access.

The service had a registered manager in post. 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.

Our last comprehensive inspection was undertaken in October 2015 and the service was meeting the regulations that we checked and was rated as good.

At this inspection we found that some improvements were needed to people’s meal time experience; to ensure they enjoyed the meals available and in a comfortable way. People were supported to eat meals that met their dietary requirements.

There was enough staff to support people in a timely way. People felt safe and staff knew about people’s support needs to enable the staff to provide this in a safe way. Staff felt supported by the management team and received the relevant training to ensure people’s needs could be met.

Staff were clear about what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People received their medicine in a safe way and when they needed it.

Recruitment checks were done before staff started working at the home to check they were suitable to support people. Risks to people’s health and safety were assessed and care plans directed staff on how to minimise identified risks. Staff had the equipment needed to assist people safely and understood about people’s individual risks. The provider checked that equipment was regularly serviced to ensure it was safe to use.

Staff understood the importance of gaining people’s verbal consent before supporting them and helped them to make their own decisions when required. Where people were unable to do this; decisions were made in people’s best interests. People were supported to access healthcare professionals to maintain their health and wellbeing.

People liked the staff and their dignity and privacy was respected by the staff team. Visitors were made welcome by approachable and friendly staff. People and their representatives were involved in decisions related to the planning of their care. Opportunities were provided for people to socialise and take part in activities to promote their wellbeing. People and their representatives were supported to raise any concerns they had.

People and their representatives were supported to express their views and opinions about the service provided and felt the home was managed well. There registered manager and provider understood their responsibilities around registration and systems were in place to monitor the quality of the service, to enable them to drive improvement.

Below is a summary of our report. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. If you want to see the evidence that supports our summary please read our full report.

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. All of the staff we spoke to during our visit were familiar with safeguarding procedures and told us they would report any concerns to their manager. Staff had a good understanding of the needs of people living in the home. They were able to describe different people's needs and what care they required.

We saw that people had a medication administration record (MAR) chart which recorded what medication people were having. We looked at four MAR charts which had information on; the person's name, frequency of the medication, allergies to medication, codes if medication had been omitted, and, the reason why. All of the MAR charts were signed and demonstrated that medication had been given at the appropriate times.

CQC monitors the operation of the Deprivation of Liberty Safeguards, which applies to care homes to ensure that proper legal processes are in place if a person lacks capacity to make decisions and their liberty is being restricted in some way. While no applications have needed to be submitted, policies and procedures were in place. Staff had been trained to understand when an application should be made.

Is the service effective?

We saw that people's needs were assessed and care and treatment was planned in line with their individual care plan. We looked at four care records and saw that care records had information on assessments being carried out in areas such as personal care, mobility, eating and drinking and maintaining a safe environment. We saw that risk assessments had been carried out and covered areas such as moving and handling, nutrition, tissue viability and falls.

We saw information on involvement from other healthcare professionals such as GPs, District Nurses, speech and language therapy (SALT) and dieticians, which demonstrated that people were getting the care they needed from other healthcare professionals.

Is the service caring?

We observed staff speaking to people in a kind and caring way and supporting people to be as independent as possible. We observed staff being respectful to people by talking to them in a kind and caring way and knocking before entering people's rooms. We observed that people were comfortable in the presence of staff.

People said they were very happy with the care they received. One person said 'It's very good here I get well looked after'. Another person said 'I am happy here. I have a bit of fun with the staff'.

Is the service responsive?

People's needs had been assessed before they moved into the home. Records included information on people's preferences, interests and the care they required. People had access to activities that they enjoyed and had been supported to maintain relationships with their family and friends.

We saw that some people had to wait a significant amount of time before call bells were answered. We saw that staff had discussed the high incidents of accidents which had been occurring during the evening and had felt that a twilight shift with extra staff would help reduce this number. This however, had not been agreed because it was felt it would impact on staffing levels at other times of the day.

Is the service well led?

Quality assurance processes were in place and we saw that actions had been implemented where necessary. Staff told us they were clear about their roles and responsibilities and that they felt supported by their manager. We saw that management had consulted with people who used the service and their families. We saw that changes had been made after these consultations. For example, menus were changed to reflect people's preferences.

We saw that audits were carried out across areas such as nutrition, falls, infections and pressure damage. We saw that action plans were completed when areas for improvement were noted. For example we saw that the falls team had been requested when it was identified that the number of falls people were having was increasing.

We saw that people were asked for their consent to their photo being taken and for how it could be used by the provider. Where people did not have the capacity to consent, their best interests were considered and this was recorded appropriately.

People's care plans showed input from a multi-disciplinary team including, primary and secondary care and specialist services such as psychiatrist and the speech and language therapy team (SALT). Staff were following advice given by the health care professionals.

People were being care for in a clean, hygienic environment. We did observe however that some areas of the home were cluttered and untidy.

A satisfaction survey was underway at the time of our visit and a survey of the catering service in the home had been completed in January 2013. The results of the survey were generally positive. We saw that additional food items had been added to the menu and two people were receiving different portion sizes following feedback from the survey.

We looked at the medicine administration records for eight people living in the home and one care plan. All medicines prescribed for people in the home were available on the day of our visit. Appropriate arrangements had been introduced to ensure that medicines were consistently available and that guidance was available to staff so they that could obtain medicines more easily.

We spoke with four members of staff and they told us arrangements for medicines in the home had improved since our last visit and they had had been more able to access medicines for people. Staff told us new systems for the ordering of medicines were working well.

We found that medicines were kept safely and stored at the right temperature. We also found that procedures were in place for giving people medicines. However we found that some people were not getting the medicines they needed because they were not available in the home. Medicines were not properly recorded and accounted for, which meant it was not possible to check if people were getting their medicines as needed.