The inspection took place on 15 and 21 May 2018 and was announced. This meant we gave the provider 24 hours’ notice of our intended visit as this was a small home and we wanted to ensure there would be someone home. This was the first inspection of the service since registering in April 2017.Springwood 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. Springwood accommodates 6 people in one adapted building.
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.
During this inspection we found medicines administration was not always recorded correctly and policies in place for staff were not available on the day of our inspection. When people were administered ‘as and when required’ medicines directions were not clear and the records to support this type of administration were not adequate.
Medicines were audited regularly but issues were not always found or addressed. Staff competencies were monitored by senior staff but this also didn’t highlight issues found regarding recording.
Care plans were not always sufficiently detailed or clear in giving members of staff relevant information to provide care and support to people. Care plans were reviewed regularly and with the involvement of people who used the service and their relatives.
A programme of audits was carried out by the registered manager these were not always effective at improving the service.
People who used the service were asked for their views about the support through an ongoing exercise, however this wasn’t always recorded. Peoples relatives and other healthcare professionals were not asked for their views via questionnaires or feedback forms, however this was to commence.
The home was clean and well presented however there were no hand washing facilities in the laundry or separate clean and dirty areas to minimise the risk of cross infection.
People were supported to take risks safely and personalised risk assessments were in place to ensure people were protected against a range of risks.
Staff had received safeguarding training and were able to describe types of abuse and what they would do to report concerns and protect people.
The service had a registered manager in place. A registered manager is a person who has registered with the CQC 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 registered manager had extensive experience of working in the social care sector.
Staff recruitment was carried out safely with robust safety checks in place for new staff.
New staff received induction training and were supported by other staff members until they could work alone.
Support for people was person centred this meant their preferences and dislikes were respected at all times. People had planned goals and were supported to achieve them.
People were supported to have choice and control over their own lives from being supported by person centred care. Person centred care is when the person is central to their support and their preferences are respected.
There were sufficient staff to meet people’s needs safely and in an individualised way.
Staff were trained in safeguarding, first aid, Mental Capacity Act and infection control. Additional training was in place or planned in areas specific to people’s individual needs.
Staff had a good knowledge of people’s likes, dislikes, preferences, mobility and communicative needs. People we spoke with gave us positive feedback regarding staff and how their needs were met.
People were supported to maintain their independence by staff that understood and valued the importance of this.
Notifications of significant events were submitted to us in a timely manner by the registered manager.
The registered manager displayed a sound understanding of capacity and the need for consent on a decision-specific basis. Consent was documented in people’s care files and people we spoke with confirmed staff asked for their consent on a day to day basis.
Health care professionals, including GP, dietitians or specialist consultants were Involved in people's care as and when this was needed and staff supported people with any appointments as necessary.
Staff, people who used the service, relatives and other professionals agreed that the registered manager led the service well and was approachable and accountable. We found they had a sound knowledge of the needs of people who used the service and clear expectations of staff. They had plans in place to make further improvements to service.
People and their relatives were able to complain if they wished and were knowledgeable of how to complain or raise minor concerns.
Assistive technology was in use at the home and people were supported to use this for communication.
People were supported to access information in a variety of formats to suit their needs and adaptations were made to suit individuals.
People were supported to take part in a wide range of activities at home and in the wider community as active citizens and to suit their individual preferences.
We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment and good governance. You can see what action we told the registered provider to take at the back of the full version of the report.