Springfield Nursing Home: Chorley care home where resident died receives ‘Requires Improvement’ rating after visit from CQC Watchdog

Springfield Nursing Home, 191 Spendmore Lane, Coppull, was visited by the Care Quality Commission (CQC) in August and was given an overall requirement of requiring improvement.

The death of a resident at the nursing home, on March 5 of this year, in part prompted the inspection which found effective systems were not in place to protect people from the risk of potential abuse

Although the CQC did not examine the circumstances of the death, information they obtained 'indicated potential concerns around the management of risk to people within the home'.

As a result, the August inspection focused on these risks.

Is the service safe?

Although rated good at the last inspection, it had now changed to inadequate.

The recent inspection found that effective systems were not in place to protect people from the risk of potential abuse and care staff including seniors had not completed basic safeguarding awareness training. Records showed up to 50 per cent of staff had not completed this training in the last 12 months.

Documentation designed to protect people from basic risks, for example constipation, were ineffective. Inspectors noted that three people suffered serious impacts to their health and welfare as a consequence of this, with two hospital admissions.

Inspectors also found that two members of staff did not receive a Disclosure and Barring Service (DBS) check, which ensures individuals are suitable to work with vulnerable people. Other files also had DBS checks that were over eight years old, but the manager did arrange action on this as soon as it was highlighted by the CQC.

People at Springfield Nursing Home were also restricted without required authorisation under the Mental Capacity Act. Despite this, additional training around the Act had been arranged. When people had accidents or were involved in an incident that caused harm, the home did not review these in a timely way. Risk assessment updates did also not routinely capture risks to people living in the home, including around epilepsy, falls, choking and skin integrity.

Fire drills had not been completed and each shift did not have a trained fire marshal. In terms of medication, inspectors found poor practice in terms of medicine security, with staff administering medicines and leaving the trolley unlocked when they weren’t present.

Medicines were not managed safely with two people informing the CQC that their medicines were left with them. A person said, "They [staff] leave them [medicines] for me

to take, they have no need to watch me, I can take my painkillers any time."

Medicine bottles and creams did not always have an opening date recorded which meant no assurance could be sought as to whether they were even in date.

Is the service effective?

The health watchdog 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 the last inspection this key question was rated good. At this inspection the rating changed to requires improvement. This meant the effectiveness of people's care, treatment and support did not always achieve good outcomes or was inconsistent.

Staff support had recently improved with the start of the new manager, however, some training had not been completed including training that had been identified as required to improve staff competence.

There was not an easy-to-read training matrix in place to identify when staff last completed training and when it was next due. As a consequence, some training had not been completed for some time. Some staff had no recorded dates as to when they last completed mandatory training, including night seniors who were the responsible person in charge through the night.

Is the service caring?

This was rated as good at the last inspection and remained the same at the most recent inspection. This meant people were supported and treated with dignity and respect; and involved as partners in their care.

People were asked how they wanted to be addressed. One person said, "I am called by my first name, not a pet name."

A patient’s privacy and dignity was respected at all times. Peoples' independence was promoted and people had the autonomy to spend their day as they choose.

A spokesperson for Springfield Care Home said: “It is important to stress that this Requires Improvement report describes our workforce as responsive, kind and caring, and the inspector noted that our care home has a good standard of cleanliness, provides a varied menu of quality food, and has all the right procedures in place to manage infection.

"The report does flag helpful concerns over governance and aspects of our procedures and record keeping. The people we care for, and their loved ones, can be assured that we are addressing these as a matter of priority. An action plan has already been prepared. For every point raised there is a clear and reasonable explanation, with assurance that the appropriate measures are being taken."

Follow up measures

The CQC will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. They will work alongside the provider and local authority to monitor progress and will continue to monitor information received about the service, which will help inform when they next inspect.

"It is encouraging to read that the inspector already feels that the culture in our care home has much improved and that staff and people interviewed all said they liked the new management and found them approachable.”