CQC report explained · a residential care home
What the CQC found at Springfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. There were enough suitably trained staff, but inspectors found some medicines paperwork problems involving patches, topical medicines and thickened fluids.
- Effective?
- Good
- Care records were person-centred and staff had the training and support needed. People were supported with food, drink, healthcare and decisions about their care.
- Caring?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Responsive?
- Good
- This key question was not inspected during this visit. Its rating was carried over from the previous inspection.
- Well-led?
- Requires improvement
- Management and quality checks had improved, but they did not always identify problems. Some improvements had also not been made quickly enough.
What inspectors found, March 2023
Rated Good overall; inspectors found safe care and improvements, but the home still requires improvement in how it is managed.
This was an unannounced focused inspection on 10 January 2023. Inspectors spoke with people living in the home, relatives and staff. They observed care and checked care records, medicines records, staff recruitment files and management records.
The home was rated Good for Safe and Effective. Inspectors found enough suitably trained staff, safe recruitment, appropriate risk assessments and improved care records. Medicines were generally managed safely, although some records for patches, topical medicines and thickened fluids were not complete or clear.
The home was rated Requires Improvement for Well-led. Quality checks had improved and the home was no longer in breach of regulations, but some checks did not identify problems quickly enough. The overall rating changed from Requires Improvement at the previous inspection to Good.
This inspection only assessed Safe, Effective and Well-led. The Caring and Responsive ratings were not inspected and were carried over from the previous inspection.
Staffing
Inspectors found enough suitably trained staff to support people safely. People, relatives and staff said staffing levels had improved since the previous inspection.
“There were enough suitably trained staff to provide support to people who use the service.” from the report
Risk management
Risks to people and the building were assessed and reviewed. The home also looked for patterns in incidents such as falls and shared lessons with staff.
“Risks were assessed, and actions were put in place to keep people safe.” from the report
Positive culture
Inspectors found a positive, person-centred culture. Staff felt supported by the new registered manager.
“There was a positive, person-centred culture in the service.” from the report
Medicines paperwork
needs fixingRecords did not always show that instructions were being followed for medicinal patches, topical medicines and thickened fluids. The provider addressed the shortfalls during the inspection, but the medicines audit had not found them.
“Records did not always assure us that guidance was being properly followed in relation to medicinal patches, topical medicines and food and fluid thickeners.” from the report
Quality checks
needs fixingSome quality checks were not fit for purpose and did not identify problems. Inspectors also found that some improvements had not been acted on promptly.
“Quality assurance checks were in place however they did not always identify issues.” from the report
Complaints and response
needs fixingOne person said complaints about being left in bed, the buzzer not being answered and an unsuitable bed had not led to changes. This suggests the home should check how it responds to individual concerns.
“I've made several complaints to the organisation, about being left on my bed and not having my buzzer answered.” from the report
Food quality
minorSome people felt the food was not always good quality. The issue was fed back to the registered manager.
“Some days it's very good and sometimes not so good.” from the report
- 01What has been done to make sure records for medicine patches, topical medicines and thickened fluids are complete and accurate?
- 02How has the medicines audit tool been changed so it identifies problems found during this inspection?
- 03How quickly will issues found by quality checks be acted on and checked again?
- 04How are complaints about unanswered buzzers, being left in bed and unsuitable equipment recorded and resolved?
- 05What is being done to improve the consistency of food quality?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their ratings were carried over from the previous inspection. This explanation was written from the published report of 7 March 2023 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 2022
Rated Requires Improvement; inspectors found risks in medicines, infection control, staffing and quality checks.
This was an unannounced targeted inspection on 21 and 24 January 2022. Inspectors looked first at infection control and visiting arrangements during a COVID-19 outbreak. They expanded the inspection because of concerns about staffing.
Inspectors found problems with medicines records and storage, visitor COVID-19 checks, deep cleaning and staffing levels. Some care records were inconsistent, and management checks had missed several of these issues. The home was told to improve its care records.
The home was rated Requires Improvement overall, and also Requires Improvement for Safe, Effective and Well-led. This was a fall from the previous Good rating, published in November 2017. The report says staffing was increased and medicines documentation was improved after the inspection.
Safeguarding
The home had safeguarding systems, investigated accidents and incidents, and used lessons learned to reduce risks such as falls.
“Systems and processes were in place to safeguard people from the risk of abuse.” from the report
Food and drink
People were supported with balanced diets, food and fluid targets, and specialist diets.
“People were supported to maintain a healthy diet. People met their daily targets for fluid and food intake.” from the report
Healthcare support
Staff worked with other professionals and made referrals, including to occupational therapy and speech and language therapy.
“The management team worked effectively with other agencies.” from the report
Staff training
Staff received an induction and refresher training. Inspectors found that recruitment checks were carried out safely.
“New staff received a detailed induction and regular refresher training was carried out for all staff.” from the report
People's involvement
People and relatives were involved in care planning and were given opportunities to comment on the service.
“People using the service were given opportunities to give their views on all aspects of their care and support.” from the report
Medicines
seriousRecords for medicines given when needed did not contain important guidance. Some medicines were stored incorrectly, and patch locations were not recorded.
“Medicines were not always managed safely.” from the report
Infection control
seriousSome visiting professionals and a relative were not asked for vaccination or negative test evidence. Deep cleaning was not taking place during the outbreak.
“This meant people were at risk of infection from visitors.” from the report
Staffing levels
seriousThere were repeated occasions when staffing fell below the required number. Non-care staff had to help with care and could not complete their usual duties.
“The service did not always have enough staff on duty to care for people safely.” from the report
Care records
needs fixingSome records gave conflicting information about risks and dependency levels. This could have led to people receiving the wrong level of support.
“Care plans were not always person centred.” from the report
Quality checks
seriousManagement checks had not identified several problems. Similar medicines concerns raised by the local authority seven months earlier had not been addressed.
“Quality assurance checks did not always identify issues.” from the report
- 01What evidence can you show that medicines given when needed, medicine patches and liquid medicines are now recorded and stored safely?
- 02How many staff are now planned for each shift, and how do you adjust this when people have higher needs or there is an infection outbreak?
- 03How are visitor vaccination or negative test checks and deep cleaning being carried out now?
- 04How do you check that care records give consistent information about choking, dependency, risks and people's choices?
- 05How have your quality checks changed so that medicines, staffing and care record problems are found and acted on promptly?
This was a targeted inspection of Safe and infection control, expanded to staffing and related concerns; the report gives ratings only for Safe, Effective and Well-led, while Caring and Responsive are not rated. This explanation was written from the published report of 7 May 2022 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 House
4 rated inspections over 7 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- May 2022Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2018Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- March 2012
Registered with the Care Quality Commission on 5 March 2012.
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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