Springfield Court Nursing Home

Updated 3 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 13 November 2018 and was unannounced. The inspection team consisted of three inspectors and an Expert by Experience who had personal experience of caring for an older family member. An Expert by Experience is someone who has experience of using services.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed previous reports and notifications that are held on the CQC database. Notifications are important events that the service must let the Commission know about by law. We also reviewed safeguarding alerts and information received from a local authority.

During the inspection we used observation to gain feedback on people's experience at the service. We sat with people in communal areas and observed the care and support people received.

During our inspection, we spoke with eight people, two relatives, two of the providers the registered manager, the clinical nurse lead, an external compliance contractor, two care workers, two senior care assistants and two registered nurses. We also spoke with two visiting healthcare professionals.

We carried out a pathway tracking exercise. This involved us examining the care records of people who lived at the service closely to assess how well their needs and any risks to their safety and wellbeing were addressed. We carried out this exercise for six people who lived at the service.

We looked at a sample of records including three staff files, staff rotas, training and supervision records, minutes from meetings, complaints and compliments records, medication records, maintenance records and certificates, policies and procedures and quality assurance audits.

Updated 3 January 2019

Springfield Court is located in the village of Aughton, Ormskirk. Accommodation is provided on one level for up to 60 adults requiring support with personal or nursing care needs. Single occupancy and shared rooms are available with ensuite facilities. Pleasant lounges and dining areas are provided. A variety of amenities are close by including pubs, a restaurant, shops, a post office and churches. There is a car park to the front of the premises. There were 51 people living at the service when we visited.

Springfield Court 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.

At the last inspection in May 2016 the service was rated overall good. At this inspection we found that the service had improved to outstanding.

Why the service was rated outstanding.

The registered manager had been in place for 15 years and was supported by a clinical lead who had also been in place for 12 years. The management team shared a thorough understanding of people in their care and the combination of business and clinical management contributed to the exceptional service delivery. 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.

The service had built on its sustained good rating and demonstrated outstanding qualities across two domains: responsive and well-led. Springfield Court had an inclusive ethos throughout service delivery and this created exceptional positive outcomes for people that lived at the service, people's relatives and staff.

We saw examples of outstanding person-centred care which enabled people who lived at the service to maintain their identity and independence. The team at Springfield Court were confident in positive risk taking and showed how they helped people who lived at the service to achieve their goals and aspirations.

The providers and registered manager worked in a united way to continually review the quality of care and support provided. Staff told us that they thoroughly enjoyed their work and felt included and valued. The providers invested in staff wellbeing and an inclusive family approach was embedded throughout.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. We saw good examples of people being assessed in line with the Mental Capacity Act and when a person lacked capacity staff fully considered their best interests in a person-centred way.

Springfield Court is a passionate provider of social care and this was led from the senior management team. The providers live on site and have owned the service for 30 years. They know the needs of all service users and consider them to be family.

In 2010 the providers built an extension to the service initially with the intent to increase the number of bedrooms available. However, the providers decided to turn the extra space into a ‘Theatre of Dreams’. The theatre of dreams is a large communal area for people to access social activities and enjoy time with visitors. Six to eight times each year, the theatre was turn into an extravagant venue and the providers organised West End acts to perform. The elegant dinner evenings were enjoyed by people who lived at the service, their relatives, staff and the wider community. In excess to this the providers told us that they did not want people who were unable to leave their bedroom to miss out and therefore used innovative technology to live stream each event to people’s bedroom televisions. This showed an exceptional level of responsive and considerate work achieved and sustained by the service.

We found that the service had sustained and built on its exceptional links with the community. Springfield Court was a community hub and this enabled people who lived at the service to engage in exciting and creative social activities on a frequent basis. The service showed great ingenuity to ensure that its service users had access to their community.

Staff had a very good understanding of medicines management and how to assess individuals' risk in a person-centred way. The environment was clean and well maintained. We found that the providers continually invested and took pride in the building.

There were high staffing levels and a work force with the required skill mix to ensure people's wellbeing, safety and security were protected. A robust recruitment and selection process was in place. This ensured prospective new staff have the right skills and were suitable to work with people living at the service.

The service provided personalised, caring and excellent end of life care. The sensitive team approach meant they could obtain a wealth of information about each person’s end of life preferences. We saw staff showed genuine sensitivity and compassion.

Staff engaged with people who lived at the service on a very frequent basis to obtain their feedback and provide them with opportunity to express any need for change. We found that the registered manager was extremely passionate about enabling people to feel involved and listened to. There was a complaints procedure and this was accessible for people who lived at the service and visitors. The manager maintained robust records to show how people's concerns had been dealt with.

The service understood the importance of facilitating positive communication and showed great initiative around the Accessible Information Standard, including treating each person as an individual to ensure that their needs were assessed and facilities provided to enable them to be fully engaged.

We found that the service wholly considered people's equality, diversity and human rights. A non-discriminative workforce meant that the service embraced change and welcomed diversity.

Further information is detailed in the findings below.