Springbank

Springbank is a 'care home' that provides care and support for up to 11 people. All the people who lived at the home had a learning disability. There were 11 people living there at the time of the inspection.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted.

Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

People's experience of using this service and what we found

The home was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this. Staff focused on people's strengths and supported people to take part in activities and pursue their interests.

Right Care:

People received kind and compassionate care. People's support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff understood how to protect people from poor care and abuse. They had training on how to recognise and report abuse which was regularly updated. There were sufficient skilled staff to meet people's needs and encourage them to develop their life skills and independence. People received care that supported their needs and aspirations. They focused on their quality of life and followed best practice.

Right Culture:

People were supported by staff who understood best practice in relation to the wide range of strengths, impairments or sensitivities people with a learning disability and/or autistic people may have. People received compassionate and empowering care that was tailored to their needs. Staff turnover was very low, which supported people to receive consistent care from staff who knew them well. The registered manager and deputy had both worked at the home for many years. The staff team were passionate in ensuring people's rights were upheld and that each person's voice was heard or on their behalf through advocates. The staff were keen for people to live a life of fulfilment and supported people to live freely which included taking positive risks where possible.

Rating at last inspection and update

The last rating for this service was good (published 10 January 2018). At this inspection we have rated the home good.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding. We inspected the key questions of Safe and Well led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the home remains good based on the findings of this inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for

Springbank on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Springbank provides accommodation for up to 11 adults with a learning disability. At the time of our visit there were 11 people living at the service. 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.

There was 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.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

People were treated in a dignified, caring manner, which demonstrated that their rights were protected. Where people lacked the capacity to make choices and decisions, staff ensured people’s rights were protected by involving relatives or other professionals in the decision making process. Information was accessible to help people make decisions and express their views about the service. Staff recognised the importance of effective communication enabling them to respond to people in a person centred way. People were very much involved and included in the running of the service with resident forums being organised. They were consulted about activities and involved in the recruitment of staff. There was a strong emphasis this was people’s home.

People remained safe at the home. There were sufficient numbers of staff to meet people’s needs and to spend time socialising with them. Risk assessments were carried out to enable people to receive care with minimum risk to themselves or others. People received their medicines safely.

People were protected from the risk of abuse because there were clear procedures in place to recognise and respond to abuse and staff had been trained in how to follow the procedures. Systems were in place to ensure people were safe including risk management, checks on the equipment, fire systems and safe recruitment processes.

People continued to receive effective care because staff had the skills and knowledge required to effectively support them. People's healthcare needs were monitored by the staff. Other health and social care professionals were involved in the care and support of the people living at Springbank. Staff were proactive in recognising when a person was unwell and liaised with the GP and other health professionals.

The home continued to provide a caring service to people. People, or their representatives, were involved in decisions about the care and support they received. Staff were knowledgeable about the people they supported and very committed to providing care that was tailored to the person. People were treated with kindness and compassion.

People received an exceptionally responsive service. Care and support was personalised and person led. People were supported to take part in a variety of activities and trips out based on their interests and aspirations. End of life care was co-ordinated based on their wishes of the person.

The service was well-led. Relatives and health and social care professionals spoke extremely positively about the commitment of the registered manager and the team in supporting people. The registered manager and provider had monitoring systems, which enabled them to identify good practices and areas of improvement. It was evident they strived to provide the best experience for people and were creative and innovative in developing care that was tailored to the person.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well-led?

Below is a summary of what we found. The summary is based on our observations during the inspection, talking with four people using the service, the staff supporting them and examining records.

Is the service safe?

The evidence that we saw confirmed that there were systems in place to gain and review consent from people or their advocates; and that their decisions were respected. Where people lacked the capacity to make complex decisions then appropriate others, such as relatives and social and healthcare professionals were involved to ensure people's best interests were considered. The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. While no applications have needed to be submitted by Springbank, proper policies and procedures were in place. Relevant staff had received training in relation to DoLS, mental capacity and safeguarding.

We looked at how the home managed medicines and our findings confirmed that systems were in place that ensured people received their medicines when they needed them and in a safe way. We found that people benefited from safe care, treatment and support, due to effective management of risks to their health, welfare and safety.

Is the service effective?

People living at Springbank had varying degrees of learning disability and were not all able to communicate their needs verbally. Staff had got to know people well, how they communicated and the things that they liked to do. People's individual health and care needs were assessed and recorded in support plans, which were regularly reviewed to ensure that they were a current reflection of their needs. Staff were appropriately trained and received good support from the management team in order to carry out their role effectively.

People were supported to access the local community and attend social activities. One person was supported to maintain employment. People were able to access the home's communal areas in order to experience a degree of social interaction.

Is the service caring?

We saw that people were relaxed in the company of staff, who appeared respectful and supportive. One person told us ''Yes, it's alright here'' and a visiting healthcare professional had recorded the comment 'The staff really care about the residents.' A relative had written 'Very friendly staff, lovely homely atmosphere.'

One person was receiving end of life care and staff had been trained in a specialised clinical procedure to meet the person's nutritional needs and provide appropriate support. This meant that the person could remain in their home and be cared for by familiar staff who were aware of their needs.

Is the service responsive?

Staff were aware of changes in people's health and welfare and supported them to access health and social care professionals when needed. One visiting therapist had written 'In a recent situation, staff have been brilliant in staying on top of necessary paperwork and liaison with outside professionals.'

Regular audits were carried out in order to monitor the quality of the service provided. We found that action had been taken in response to the findings of these audits, such as providing extra staff training. The home had a complaints policy and procedure, which included an easy read version. Questionnaires were also sent to advocates in order to gain feedback and where one relative had raised a concern, the manager had responded promptly and had resolved the issue.

Is the service well-led?

The home has a full time manager in place who is registered with CQC. Staff members told us that they felt supported by the manager and her deputy. We spoke to staff members and looked at training records and found that appropriate training was provided that enabled staff to provide support to those living in the home.

Annual appraisals and formal supervision sessions were held, although the latter were infrequent; however staff told us that they were able to speak to the manager at any time in order to discuss issues. Regular staff meetings were held and staff told us that they felt they were able discuss issues openly.

Comments received from advocates and visiting professionals indicated that they were happy with the way the home was managed.

Care was planned and delivered in a person centred way and risks were assessed to ensure people's safety and wellbeing. People were protected from the risks of abuse because staff were trained and knowledgeable about safeguarding and told us they would feel able to act on any concerns if they had them. Information was available for people using the service on what to do if they were unhappy or concerned.

Staffing levels were sufficient to meet people's needs, and staffing levels meant that people were able to be supported to access the community regularly. We viewed rotas to check that expected staffing levels were met.

There were systems in place to monitor the quality and safety of the service and this included providing opportunity for people and their representatives to provide feedback on the support they were receiving.

During our visit, we saw people being offered choices, for example about how they wanted to spend their time and where they wanted to have their meals. One person told us that they liked going out to get a newspaper each day and they also went to a local hairdresser. Staff had got to know people at the home well and knew how individuals liked to be supported.

People received support from staff so that their medication was kept safely and they received it at the right times. Staff worked in conjunction with health care professionals to ensure that people's individual needs were met.

There was a recruitment process which helped to ensure that new staff were suitable for the work.