Springbank Rest Home is based in Heywood, Greater Manchester. The home is registered to provide residential care and support for up to 20 elderly people. The home is on a local bus route and has garden areas for people to use in good weather. There were 19 people accommodated at the home on the day of the inspection, with one person in hospital.

A registered manager was in post. 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. The manager had been in post since the service first registered in October 2010 but had managed the service for over thirty years.

At the last inspection of March 2016 the service were found to be in breach of two regulations. Regulation 15 HSCA RA Regulations 2014. Premises and equipment because of an absence of window restrictors on three upstairs windows and Regulation 19 HSCA RA Regulations 2014 Fit and proper persons employed. The recruitment of staff was not safe because satisfactory and suitable references had not been obtained. The service sent us an action plan to show how they intended to meet the regulations. We looked at both breaches during this inspection and found restrictors had been fitted to all windows and the staff files we looked at showed recruitment was safe.

People who used the service and family members said staff were consistently kind, caring and supportive.

The views of people who used the service were sought in meetings and surveys to help their wishes be known and we saw the registered manager responded to them.

There were safe systems in place for the storage and disposal of medicines. Staff received training in how to administer medicines and had their competency in this area assessed.

There were safe systems in place to protect people from abuse. Staff we spoke with said they would take action if they saw any poor care or support.

There were robust recruitment procedures to ensure new staff were safe to work with vulnerable adults.

Equipment was maintained regularly to meet the health and welfare needs of staff and people who used the service.

The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and worked to ensure people's rights were respected.

People were given a choice of nutritious food and they told us they enjoyed the meals

People were able to attend activities of their choice which were suitable to their age, gender, culture, ability and religion.

There was an accessible complaints procedure for people to raise any concerns if they needed to.

Policies procedures and audits helped the registered manager maintain and improve the service if possible.

This was an unannounced inspection that took place on 15 February 2016. We last inspected Springbank Rest Home on 23 May 2014. At that inspection we found the service was meeting all the regulations that we inspected against.

Springbank Rest Home is a residential care home registered to provide personal care and accommodation for up to 20 older people. There were 18 people using the service at the time of the inspection. The home is situated in Heywood and is on a bus route leading to both Bury and Rochdale towns. It is a large detached property situated in its own grounds. There is off- road parking to the side and back of the home. Bedroom accommodation is provided on the ground and first floors and access to the first floor is via a passenger lift. The communal areas of lounges, conservatory and dining room are situated on the ground floor.

The home had a manager registered with the Care Quality Commission (CQC) who was present on the day of the inspection. 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.’

We found two breaches in the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulation 2014. We found that the premises were not as safe as they should have been because three of the upstairs windows were without restrictors. This placed the health and safety of people at risk of harm. The recruitment system did not ensure the safety of people because suitable references were not obtained for one person who had been employed by the service.

You can see what action we have told the provider to take at the back of the full version of the report.

We found people were cared for by sufficient numbers of suitably skilled and experienced staff. Staff received the essential training and support necessary to enable them to do their job effectively and care for people safely. People who used the service told us they felt the staff had the skills and experience to meet their needs. People were happy with the care and support they received and spoke positively of the kindness and caring attitude of the staff.

Staff we spoke with had a good understanding of the care and support that people required. We saw people looked well cared for and there was enough equipment available to promote people’s safety, comfort and independence.

We saw that suitable arrangements were in place to help safeguard people from abuse. Guidance and training was provided for staff on identifying and responding to the signs and allegations of abuse. Staff were able to demonstrate their understanding of the whistle-blowing procedures (the reporting of unsafe and/or poor practice).

The system for managing medicines was safe and we saw how the staff worked in cooperation with other health and social care professionals to ensure that people received timely, appropriate care and treatment.

All areas of the home were clean and procedures were in place to prevent and control the spread of infection. Systems were in place to deal with any emergency that could affect the provision of care, such as a failure of the electricity and gas supply.

People’s care records contained enough information to guide staff on the care and support required. The care records showed that risks to people's health and well-being had been identified, such as the risk of pressure sores and poor nutrition.

We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and treatment. We found the provider was meeting the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

Food stocks were good and peopl

Our inspection of Springbank Rest Home was made up of a visit to the home by an inspector.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and looking at records. We also obtained a report produced after a quality monitoring visit from Rochdale Local Authority commissioning team in October and November 2013.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

We were able to speak with five of the people who used the service and two family members. All of whom told us that they were happy with the service being provided and had no complaints. One of the people who lived at the home told us, "The home has a good reputation in the area and that was one of the reasons I chose to come and live here". Another person who lived at the home told us, "I can't fault it at all". They also went onto say that they were always given a choice at meal times and could choose when they got up and went to bed. Their family member told us that they had been waiting for a bed at the home to become available.

We spoke with a family member whose relative had lived at the home for over two years. They told us, “The staff can’t do enough for you and they keep ‘on top’ of things. They also said that the staff ‘are lovely’, ‘work hard’ and "I looked at quite a lot of homes but as soon as I walked in I liked it; it was homely and I was made to feel welcome".

Everyone we spoke with said that they were happy with the care they received and had no complaints.

We were able to observe during our visit that the staff team were friendly and spoke to people in a caring and friendly manner.

Is the service effective?

We saw notes on the care plans when other healthcare professionals had been contacted such as the GP, district nurse or chiropodist. One of the people we spoke with told us, "They always get the GP when necessary and tell the family".

We saw in the care plan for one person guidance notes regarding their treatment. We were told by the person that the care workers were assisting them daily with their treatment which had been prescribed by the physiotherapist.

We saw that the district nurse attended people who lived at the home as and when someone required nursing care such as vaccinations or medical dressings.

We saw that a mental capacity assessment had been completed to ensure that people’s best interests were being met.

People we spoke with said that if they had any concerns they were comfortable with talking to the manager or the care workers.

A passenger lift assisted people to reach the upper floor. There was equipment available such as hoists and assisted baths to help the care workers meet people's care needs.

We saw that activities were organised and people took part in crafts; which were displayed throughout the home.

Springbank Rest Home was clean, and apart from one bedroom, was free from unpleasant odours. The manager told us that carpets were cleaned regularly, monitored and replaced when necessary.

There were hand wash dispensers and paper towels available in all bedrooms and toilets in the interests of infection control.

We also saw that various safety checks had been completed. These included gas, electricity and passenger lift safety certificates. Some work had been required after the electric inspection which had been completed.

Is the service responsive?

We saw that people's health, personal and social care needs were assessed before they were admitted to the home to ensure that they could be met. We saw that risk assessments and care plans were in place that reflected their needs to ensure that they received appropriate care. The care plans and risk assessments were reviewed regularly by the manager.

The two family members we spoke with told us that they were kept informed of their relative’s health and that the GP was contacted straight away if they were not well.

We were told by people who used the service, their family and the staff team that they could talk to the manager if they had any concerns about the care being provided.

We saw that an audit had been undertaken in October 2013 by a member of the Rochdale Local Authority Quality Monitoring team. There had been a number of recommendations made within the action plan. We saw from the action plan that recommendations had been completed by December 2013.

An infection control audit had also taken place by Rochdale Council. The recommendations such as replacement of some of the chairs in the lounge, replacement of some of the mattresses and mattress covers had been actioned.

Is the service well-led?

The registered manager had worked at the home for 28 years; 19 of which had been as the manager. The manager had a National Vocational Qualification Level 4 in Management.

Training was in place to protect the people who lived at Springbank Rest Home such as moving and handling, safeguarding adults and first aid.

Training was provided through Rochdale Local Authority, distance learning training companies and in house by the manager. This helped to ensure that the staff team had the qualifications and skills to meet people's needs.

We saw that National Vocational Qualifications (NVQ) in Health and Social Care had also been obtained by the staff team.

We were told by the manager that questionnaires were distributed to the people who used the service in order to obtain their views and opinions about the service. The last survey held was in 2012 and a small number in 2013. The responses received were positive. Comments received were, “The staff are very caring and compassionate”; “The home is clean and homely”; “People are always dressed nicely”.

We spoke with four people using the service and with two relatives. Comments made to us included; “The best place ever, it is wonderful” and “They are all very good and so patient”. We were also told, “I am so lucky to be here, it’s lovely”.

Arrangements were in place to help ensure people were treated in a respectful, dignified way and were involved in the making of decisions about their care, support and treatment.

People's care records contained enough information to show how they were to be supported and cared for.

We saw that appropriate arrangements were in place to help safeguard people from abuse. People we spoke with told us that they felt safe and trusted the staff.

People were cared for by staff that were properly trained, supported and supervised.

Regular monitoring of the services and facilities provided was in place to help protect people against the risks of inappropriate or unsafe care.

During the visit, we spoke with three people who use the service. They told us the staff were very helpful and always explained what they were doing.

The people we spoke with told us they were very happy at the home. One person told us they enjoyed the food and liked to read a newspaper. Another person told us the staff were excellent and the home was clean.

The people we spoke with told us they always received their medication on time. They told us that the staff were always around when they needed them.

The people we spoke with told us they were happy with the staff at the home.

They also told us that they had no concerns about the care they received and would speak to the Registered Manager is they had any concerns

We spoke with people living in the home and asked them for their views and experiences of staying there. We heard that people felt contented living at the home. One person said staff looked after them “Better than their own family.” Another person said they were “Looked after very well.” They said it was “Lovely” and “Homely” living in the home and that “Staff were fine.” We heard that people felt safe.

People told us that there was “Always something happening such as music or daft games.” One person said “We can have some fun.” People also told us that a church service was held regularly at the home and they looked forward to this.

We heard that people’s wishes were respected and that meals were “Quite good” and there were choices available.

We spoke with a visitor to the home. They said, “I find it brilliant.” We heard that they visited at different times and that there was always something going on. We were told that people were “Treated with great respect.” The visitor said they were always made welcome and care staff were friendly. They said they had “Peace of mind” that their relative was cared for properly.

The manager had sent out questionnaires in January 2012 to people living in the home and their relatives to ask for feedback about the quality of the service provided. The returned questionnaires from people living in the home and relatives rated all aspects of the service and staff as either good or excellent.

Comments from people living in the home included:

“The staff are pleasant and helpful. Always willing to help.”

“I can’t ask for anymore, we are so happy with everything.”

Comments from relatives included:

“I am totally happy with mum’s care.”

“The manager is a very caring lady and this shows in how things are run.”

“The home itself is clean and homely.”

“I am made to feel welcome every time I visit.”

“Wonderful care from staff.”