The Springs Care Home

Safe – this means we looked for evidence that people were protected from avoidable harm. At our last inspection this key question was rated requires improvement. At this assessment this key question remains at requires improvement. We identified continued shortfalls with medicines, infection prevention control and safe environments. Where people's needs had changed, this was not always reflected in their care plans. People’s daily care records did not always show how their risks were being monitored in line with their assessed needs. For example, fluid, bowel and weight monitoring, and repositioning charts were not always completed consistently. We found the environment was not always safe on 1 unit and some risks were identified around infection prevention and control (IPC), medicines and effective staffing. The service internal audits did not always identify the risks we found during our onsite visit, however, the provider had started to take actions during our visit.

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last inspection we rated this key question good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection. Staff demonstrated good knowledge of people and their support needs, however this was not always reflected in people's care plans. For example, 1 persons communication information was not up to date with the support they required and they did not have the appropriate external support available to ensure their choices and preferences could be heard. Another person's care plan did not have all of the relevant guidance for staff on how to provide consistent approach to support their anxious behaviours.

Caring – this means we looked for evidence that the service involved people and treated them with compassion, kindness, dignity and respect. At our last inspection we rated this key question good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection. People told us they were supported by kind and caring staff and had choice and control to make decisions about how their care and support was provided. The majority of our observations confirmed this, however our observations on 1 unit demonstrated improvements were required to ensure people had positive lunchtime experiences and were able to communicate their choices and preferences. People had to wait longer when requesting support with transitioning and personal care.

Responsive – this means we looked for evidence that the service met people’s needs. At our last inspection we rated this key question good. At this assessment we did not assess all quality statements within this key question. The overall rating for this key question remains good based on the findings at the last inspection. The service gathered feedback from relatives and staff. The latest results had improved. 89% of people and 92% of relatives were happy and would recommend the service. Staff we spoke with mostly demonstrated they knew people well and understood their support needs and how these may have changed. However, people and families were not always involved in their care planning and decision making. Care plans were not always accurate and did not always reflect peoples current support needs. This had been identified by the peripatetic manager who told us, people and families were not as involved as they could be with care planning, this was due to be actioned through the resident of the day process. People and their relatives did not know how to make a formal complaint if they needed to, however the majority stated they would speak to staff or a manager about any concerns.

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last inspection this key question was rated requires improvement. At this assessment this key question remains at requires improvement. We identified improvements were needed in management oversight and governance. The service had a newly appointed peripatetic manager in post at the time of our site visit. They were committed to improve the safety and quality of care being delivered and the provider had an action plan in place. However, these were not yet embedded. The systems for governance and oversight had not always been effective in identifying the service’s shortfalls. People and families spoke positively about managers.