Springfield Care Centre

The service took an individual and person centred approach to visiting. We saw visitors were facilitated where this was safe and appropriate. Relatives were supported to adhere to Personal Protective Equipment (PPE) guidance. As garden visits were no longer suitable the service had designated a lounge for visitors which could be accessed without passing through other areas of the home. Floor tape had been used to facilitate social distancing and family members could book visiting slots to see their relatives. The manager wrote to relatives regularly to update them about whether or not visiting was possible depending on the advice of the local director of public health. At the time of our inspection visiting restrictions were in place due to local risk levels.

Staff and people living in the home accessed testing in line with government guidance. Where people refused testing there were risk assessments in place to mitigate the risks of this. Staff adherence to testing was high.

The manager told us they were investigating and sourcing alternative face covering that would enable people to see staff faces. They recognised the impact wearing face coverings was having on the communication of people living with dementia.

All staff, and people living in the home, had personalised covid-19 risk assessments. The covid-19 care plans for people living in the home included step by step guidance for staff to follow in the event of diagnosis.

The home had separated and segregated a specialist area to use as a designated setting. There was a separate entrance with robust procedures in place to ensure risks were minimised. This area would be staffed separately to minimise risks to other areas of the home.

We were assured that this service met good infection prevention and control guidelines as a designated care setting

Further information is in the detailed findings below.

We found the following examples of good practice.

The provider had developed new ways of recording observations about people’s health which were shared with healthcare professionals in advance of appointments. This had reduced the need for external visitors to the home, and had facilitated smooth virtual consultations with healthcare professionals. The templates used had been shared with other homes in the local area.

The provider was following best practice guidance in terms of ensuring visitors to the home did not introduce and spread Covid19. Information and instructions for visitors were clearly displayed and explained in person by the receptionist. Staff were adhering to PPE and social distancing guidance. People were supported to see their visitors in the garden, or when this was not possible people were support to speak to their families on the phone or via video call.

The provider had designated a 15 bedroom area as an isolation area for people who were infected with Covid19, or for people who had been admitted to the home from hospital or the community. There was clear information and increased restrictions on staff movement in this area of the home. This effectively reduced the risks of transmission of Covid19 within the home.

The provider had ensured staff who were more vulnerable to Covid19 had been risk assessed, and where it was not safe for staff to be at work they had utilised furlough schemes to protect staff and people.

Further information is in the detailed findings below.

Springfield Care Centre can accommodate 80 older and younger adults who may have dementia in a purpose built three storey building. People were accommodated across six units on the ground and first floor. At the time of this inspection, 72 people were using the service.

This inspection took place on 28 and 29 August and 5 September 2018. The inspection was unannounced. This was the first inspection since the service was registered under the provider Bondcare (London) Limited in July 2017.

The service did not have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (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. At the time of this inspection there was a manager in position who had applied to become registered with CQC.

There were enough staff on duty to meet people’s needs but occasionally the service was short staffed. Recruitment checks were carried out before new staff began working at the service. People had risk assessments carried out to mitigate the risks of harm they may face and were protected from the risks associated with the spread of infection. There were systems in place to manage medicines safely. Building safety checks were carried out in line with building safety requirements. The provider used accidents and incidents to make improvements to the service.

People’s care needs were assessed before they began to use the service to ensure the provider could meet their needs. Staff received training and were supported with supervisions and appraisals to help them to carry out their role effectively. The provider had systems in place for staff to be updated on people’s well-being and changes in care needs. The layout and décor of the building could be confusing for some people to find their way around. The provider was in the process of refurbishing the building. People were supported to eat a nutritionally balanced diet and to maintain their health. The provider understood their responsibilities under the Mental Capacity Act (2005). Staff understood the need to obtain consent before delivering care.

Staff described how they developed caring relationship with people. People and their relatives were involved in decisions about the care. The provider had a system in place where each person had a named nurse and care worker who had overall responsibility for the person’s care. There was a ‘resident of the day’ system where each person had a day dedicated to them to make them feel special. Staff were knowledgeable about equality and diversity. People were supported to maintain their independence and their privacy and dignity was promoted.

Care plans were personalised, contained people’s preferences and were reviewed monthly. Staff knew how to deliver a personalised care service. People were offered a variety of activities and their communication needs were met. Complaints were dealt with appropriately and compliments were recorded. People’s end of life care preferences were recorded.

People, relatives and staff gave positive feedback about the leadership in the service. The provider had a system to obtain feedback about the service in order to make improvements. People, relatives and staff had regular meetings so they could be updated on service development and make suggestions for improvements. The provider had quality audit systems in place to identify areas for improvement. However, call bell response times and care plan checks were not taking place at the time of inspection.

We have made two recommendations in relation to the refurbishment of the building and quality assurance systems.