CQC report explained · a nursing home
What the CQC found at Springfield Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, August 2021
Springfield Nursing and Residential Care Home was rated Good; inspectors found safe, effective and well-led care, with some records and medicines checks needing improvement.
This was an unannounced focused inspection on 02 June 2021. Inspectors spoke with people, staff and relatives, and checked care records, medicines records, recruitment files, training information and quality checks.
The home was rated Good for Safe, Effective and Well-led. People and relatives generally said they felt safe and happy. Inspectors found enough staff, suitable care plans, trained staff, good support with food and fluids, and positive leadership.
Inspectors found some shortfalls. Some recruitment files did not include complete employment dates. Some topical medicines were not dated when opened, and there were two infection control concerns. The home acted promptly during the inspection to address these issues.
The previous rating was Requires Improvement, with three breaches of regulations. The report says the home had improved and was no longer in breach. The Caring and Responsive areas were not inspected during this visit, so their previous ratings were carried forward.
People felt safe
People and relatives generally said they felt safe and well supported. Staff knew how to recognise and report abuse, and safeguarding incidents were clearly recorded.
“People and their relatives told us that they felt safe and happy with the provider.” from the report
Good care planning
Care plans covered people's physical, mental health and social needs. They were person-centred, regularly reviewed and updated when people's needs changed.
“Care plans were detailed, person-centred and regularly reviewed.” from the report
Food and fluids
People were offered choices, regular drinks and snacks. Inspectors saw staff checking people's comfort and supporting them with meals in a respectful way.
“We observed people being supported with regular fluid and nutrition throughout the inspection, with particular awareness for the weather and the hot day.” from the report
Positive leadership
People, relatives and staff described the management as approachable and listened to. The home used feedback, meetings and audits to improve care.
“The registered manager promoted an inclusive, positive and open culture.” from the report
Partnership working
The home worked with GPs and other health and social care professionals. Inspectors saw evidence that professional advice was recorded and acted upon.
“The provider had developed close links with external agencies, and we saw evidence of successful partnership working.” from the report
Topical medicines
needs fixingSome creams and other topical medicines did not show when they were opened or their new expiry dates. The home replaced them during the inspection and planned extra spot checks.
“We found no evidence that anyone had been harmed by this but there was a concern that it increased people's risk of skin breakdown.” from the report
Infection control details
needs fixingInspectors found damaged sealant in one bathroom and a shower chair covering that had not been cleaned effectively. The home repaired and cleaned these areas during the inspection and introduced a cleaning record.
“However, we did observe two areas where there were concerns in relation to IPC.” from the report
Time for emotional support
minorSome relatives said staff were sometimes too busy to spend enough time with people on their emotional wellbeing, even though physical and nursing needs were met.
“There were times of the day where staff were too busy to be able to spend time with people to support their emotional wellbeing and they felt this could be improved.” from the report
Admission communication
minorRelatives said they would have liked more information about what to expect at the start of an admission and a more formal review process.
“Relatives said that they would have liked more communication and information about what to expect in the early stages of the admission and a more formal structured review process.” from the report
- 01How do you now check that every recruitment file includes a complete employment history and explanations for any gaps?
- 02What checks are now in place to make sure topical medicines are dated when opened and replaced before they expire?
- 03How do you make sure people receive emotional support and time with staff when the home is busy?
- 04What information and review meeting will families receive when someone is first admitted?
- 05What are the current ratings for Caring and Responsive, which were not reassessed in this inspection?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 20 August 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2019
Springfield Nursing and Residential Care Home was Rated Requires Improvement; inspectors found kind care but serious weaknesses in consent, records and management oversight.
Inspectors visited the home without warning on 20 and 21 March 2019. They spoke with people, relatives, staff and health professionals. They reviewed care records, medicines records, recruitment files, training records and quality records.
People generally said they felt safe and were treated kindly. The home was clean, food was well regarded, people had access to healthcare and activities were available. Inspectors rated caring and responsive care as Good.
However, medicines records were not always complete. Some risk information and care plans lacked enough detail or were out of date. Records about mental capacity were sometimes conflicting, and the Mental Capacity Act was not always followed.
The home was rated Requires Improvement overall, as well as for Safe, Effective and Well-led. This was the second consecutive Requires Improvement rating. The provider was asked for a clear action plan and CQC said it would continue to monitor the service.
Clean and safe environment
The home was clean, free from bad smells and had well-maintained equipment. Emergency plans were in place for fires.
“The environment was clean and free from bad odours.” from the report
Food and healthcare
People received a choice of meals and drinks, including food prepared for medical or swallowing needs. They also had access to relevant health professionals.
“People were provided with a choice of meals and drink” from the report
Activities and complaints
The home offered daily activities and had a complaints process. Inspectors found complaints were investigated and responses were given.
“Activities were available every day and planned by the social carers.” from the report
Mental capacity and consent
seriousRecords about people's mental capacity were sometimes conflicting. Best interest decisions were made without the required assessment in one example, and this was a breach of Regulation 11.
“The failure to work within the principles of The Mental Capacity Act was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Incomplete medicines records
needs fixingThere were gaps in records for topical creams. This meant inspectors could not be sure that creams had always been applied as prescribed.
“some people had topical creams applied and gaps were identified on the topical Medication Administration Records (MAR).” from the report
Out-of-date care information
needs fixingSome risk guidance and care plans did not contain enough detail or had not been updated after people's needs changed. This could affect unfamiliar staff's ability to provide the right support.
“Where people's needs had changed, care plans were not always updated.” from the report
Weak management checks
seriousThe provider's audits did not identify all the problems found by inspectors. The provider had also failed to notify CQC about an allegation of abuse.
“Quality assurance systems were in place but these did not always pick up on the concerns identified at inspection.” from the report
Language about people
minorInspectors found that some words used about people were not positive or person-centred. The manager put measures in place during the inspection, but CQC recommended continued monitoring.
“improvements were required to ensure that there was a positive and person-centred approach to the language being used when staff were referring to people.” from the report
- 01What has been done to make sure topical medicines administration records are complete every time?
- 02How are mental capacity assessments and best interest decisions now recorded and checked?
- 03How are care plans updated when a person's health or support needs change?
- 04What checks now make sure safeguarding incidents are notified to CQC and other agencies when required?
- 05How are people's individual interests, such as art or photography, included in their activities?
This was an unannounced comprehensive inspection of the care, premises and management of the home, covering all five CQC questions. This explanation was written from the published report of 25 May 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Springfield Care Home
4 rated inspections over 6 years: the service has held its Good rating throughout.
- August 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- July 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 21 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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