CQC report explained · a nursing home
What the CQC found at Springfields Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found safe recruitment, enough staff with an appropriate mix of skills, regularly reviewed risk assessments and systems for managing medicines. One medicine record discrepancy was identified, although the manager said the weekly audit would find it.
- Effective?
- Good
- Staff had training, supervision and support. People received suitable food and drink, had access to healthcare and were supported in line with the Mental Capacity Act.
- Caring?
- Good
- People and relatives gave positive feedback about staff. Inspectors saw respectful interactions and found that privacy, dignity, independence and people's views were supported.
- Responsive?
- Good
- Care plans reflected people's preferences and routines. The home had improved its activities, supported community links and discussed and recorded end of life wishes.
- Well-led?
- Good
- People, relatives and staff described management as approachable. Inspectors found improved oversight, regular audits, open communication and a focus on continuous improvement.
What inspectors found, December 2018
Rated Good; inspectors found safe, kind care and clear improvements since 2016, with a few minor issues including one medicines-record discrepancy.
Inspectors visited over two days in November 2018. The first day was unannounced. They spoke with people living in the home, relatives, staff and a health professional. They observed care and checked care records, staff files, medicines systems and safety records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough suitably trained staff, safe recruitment, appropriate risk assessments and systems for giving medicines. People were supported with food, drink, healthcare, consent, activities and end of life care.
The report says the home had improved from Requires Improvement in Safe, Effective, Responsive and Well-led since the November 2016 inspection. Caring remained Good. Inspectors found stronger management oversight, better activities, improved care records and better quality checks.
People felt safe
People and relatives said they felt safe and staff knew how to report abuse or concerns. Recruitment checks were in place.
“People told us they felt safe in the care of staff and were happy living in the service.” from the report
Kind and respectful care
Staff supported people's dignity, privacy and independence. Inspectors observed natural and meaningful interactions between staff and people.
“Staff were respectful and caring, supporting people to maintain their dignity and independence.” from the report
Choice and consent
People were offered choices and supported to make decisions. Staff understood their responsibilities under the Mental Capacity Act.
“People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.” from the report
Activities and involvement
The range of activities had improved and included support for people who stayed in their rooms. People's feedback was used to shape activities.
“People's care records and minutes of residents' meetings, showed that people were being asked their views on the activities, which were being listened to and acted on.” from the report
Improved management checks
Inspectors found better management oversight and regular checks on quality and safety. Feedback from people, relatives and staff was being used to make changes.
“Audit and quality assurance systems were in place to ensure that the quality of care was consistently assessed, monitored and improved.” from the report
Medicines record discrepancy
minorInspectors found one discrepancy in a person's medicines record. Weekly audits were intended to identify and address such issues, but families may want to ask how this is checked now.
“Where we identified one discrepancy in a person's medicine record the registered manager was confident that it would have been picked up in the forthcoming weekly audit check.” from the report
Supervision was not consistent
minorSome staff found supervision helpful, while another described it as more of a tick-box process. The manager said further training for supervisors would be arranged.
“Feedback from staff showed that some staff gained more out of the experience than others, depending who was carrying out their supervision.” from the report
A radiator was too hot
needs fixingOne corridor radiator was hot to touch because its setting had been too high. No people or visitors were using that area, and management acted immediately by updating the risk assessment and adding warning signs.
“Although they had been risk assessed, one of the radiators which was on, was hot to touch.” from the report
- 01How do you now check medicines records, and what action is taken if a discrepancy is found?
- 02What training has been given to staff who provide supervision, and how do you check that supervision is useful?
- 03What further protection was put in place for the radiator and its heat control?
- 04How are activities adapted for people who prefer to stay in their bedrooms?
- 05How are people's current end of life wishes recorded and reviewed?
This was a comprehensive inspection covering all five key questions, including care, medicines, staffing, records, the premises and management systems. This explanation was written from the published report of 29 December 2018 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, March 2017
Springfields Nursing Home was rated Requires Improvement; inspectors found kind care but gaps in consent, risk checks, medicines records and management oversight.
The inspection was unannounced and took place on 29 November 2016. Inspectors spoke with people living in the home, visitors and staff. They observed care and reviewed care, staffing, maintenance and quality records.
The home was caring, with staff described as kind, respectful and attentive. People had enough staff, food and access to healthcare. However, records and checks were not always reliable. Inspectors found problems with medicines stock records, bed rail risks, capacity assessments, daily records and activities.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were also Requires Improvement. Caring was rated Good. The report says the provider had to send CQC an action plan, and CQC would check that action was taken.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw kind, compassionate interactions and staff who took time with people.
“We observed interactions between staff and people to be kind and compassionate.” from the report
Enough staff
Inspectors found staffing levels were based on people’s needs. Staff responded promptly and did not appear rushed.
“We saw that staff were attentive to people's needs and any requests for assistance were provided in a timely manner.” from the report
Personalised care
Staff knew people’s histories, preferences and needs. Care plans included guidance about areas such as mobility and communication.
“People and their relatives told us that staff knew them well and cared for them according to their preferences.” from the report
Consent and capacity records
seriousThe home did not consistently assess or record people’s capacity. Best-interest decisions were not always recorded, creating a risk that people’s choices or consent were not properly respected.
“This placed people at risk of not being supported to make their own decisions or of receiving care and support that they did not consent to.” from the report
Medicines stock checks
seriousFor four people, inspectors could not reconcile the medicines stock. This meant the home could not effectively check whether medicines had been given as prescribed.
“Without this information, the service were unable to carry out effective checks to ensure that people had received their medicines as prescribed.” from the report
Bed rail safety
seriousRequired bed rail bumpers were not in place for two people. The home also did not have a completed bed rail policy covering the checks staff needed to make.
“The risk assessment for two people regarding bed rails stated that bumpers should be in place to prevent arms and legs from becoming trapped, however we saw that bumpers were not in place on these beds.” from the report
Activities and daily records
needs fixingActivities took place, but inspectors saw little activity on the inspection day. Records did not always describe people’s feelings, social activities or how staff responded to distress.
“Full consideration needs to be given to how people cared for in their rooms can be supported with meaningful activities.” from the report
Quality monitoring
needs fixingAudits did not always identify problems, including concerns about bed rails, daily records and capacity information. It was not always clear that identified actions had been completed.
“There were some gaps in how the service assessed and monitored the quality of its provision.” from the report
- 01What has been done to make sure medicines stock is counted and reconciled for every person?
- 02How are bed rail risks checked now, and how do you make sure required bumpers remain in place?
- 03How do you assess capacity and record best-interest decisions before using restrictions such as bed rails?
- 04What meaningful activities are available for people who spend much of their time in their rooms?
- 05What action-tracking system is now used to make sure problems found through audits and feedback are fixed?
This was an unannounced comprehensive inspection covering all five CQC questions, with observations, discussions and reviews of care, staffing, maintenance and quality records. This explanation was written from the published report of 3 March 2017 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 Springfields Nursing Home
2 rated inspections over 2 years: the service has improved, from Requires improvement to Good.
- December 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 17 December 2010.
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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