This inspection took place on 10 May 2018 and was unannounced.

Springfield is a residential care home for 20 people with dementia. There were 20 people living at the home at the time of this inspection. Springfield House 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.

At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

There was a registered manager in post. 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.

People living in the home told us they felt safe and that staff support and guidance made the home safe. People told us that staff assistance maintained their safety and staff understood how they were able to minimise the risk to people’s safety. We saw staff help people and support them by offering guidance or care that reduced their risks. Staff understood their responsibilities in reporting any suspected risk of abuse to the management team who would take action. Staff were available for people and had their care needs met in a timely way. People told us their medicines were managed and administered for them by staff. Infection control measures were in place to prevent the spread of infections and where incidents or accidents had happened the provider had reviewed and made changes where needed to ensure that learning from these events took place.

Staff knew the care and support needs of people and people told us staff were knowledgeable about them. Staff told us their training courses and guidance from the registered manger helped to maintain their skills and knowledge. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had a choice of where they ate their meals, and enjoyed the meals offered. Where people needed support to eat and drink enough to keep them healthy, staff provided assistance. People had access to other healthcare professionals that provided treatment, advice and guidance to support their health needs.

People were seen talking with staff and spent time relaxing with them. Relatives we spoke with told us staff were kind and friendly. Staff told us they took time to get to know people and their families. Family members were updated about their family member’s well being from staff. People’s privacy and dignity was supported by staff when they needed personal care or assistance. People’s daily preferences were known by staff and those choices and decisions were respected. Staff promoted a people’s independence and encouraged people to be involved in their care and support.

People’s care needs had been planned, with their relative’s involvement where agreed. Care plans included people’s care and support needs and were reviewed and updated regularly. People told us activities were offered in the home which were of interest to them.

People and relatives were aware of who they would make a complaint to if needed. People told us they would talk though things with staff or if they were not happy with their care.

The manager provided leadership for the staff team and people had the opportunity to state their views and opinions. The provider worked in partnership with other local agencies to promote people’s wel

This was an unannounced inspection carried out on 14 and 17 March 2017.

The provider of Springfield House is registered to provide care for up to 18 older people, including people with dementia. There were 17 people living at the home at the time of our 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.

At our previous inspection visits the provider was required to make improvements to evidence risks to people’s safety and wellbeing were identified with risks reduced. We found the provider had taken action to implement preventative measures to identify and reduce the likelihood of similar incidents from happening. Improvements had been made so people had their prescribed medicines available to them and these were administered by staff who had received the training to do this. People had their prescribed medicines available to them and these were administered by staff who had received the training to do this.

Staff knew how to protect people against the risk of abuse or harm and how to report concerns they may have. Risks to people's health and wellbeing were assessed and measures put in place to meet people's needs with safety in mind. This included the staffing arrangements which took into account the care and support people required in order to reduce risks to their safety and wellbeing.

People were supported by staff who showed they were kind and had developed positive relationships with people who appreciated the tactile approaches of staff showing they cared. However, staff practices did not always reflect a personalised approach to meeting people’s care needs and at times this showed a lack of respecting people’s dignity and privacy.

People’s care and support needs were met by staff who had their backgrounds checked before they started work at the home to provide assurances they were suitable to work with people who lived at the home. Staff had a planned induction to prepare them for their role and training and support to ensure they understood and met people's needs effectively. The registered manager had increased staffs' opportunities to gain support through more practical training to effectively carry out their caring roles. Staff appreciated the registered manager’s approach to training and the support they provided to staff so they were confident in their caring roles.

Staff understood the importance of seeking people’s consent to care and how to support people whose liberty was restricted. Training in the requirements of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS), was planned to support staff understanding.

People were supported to access health and social care services to maintain and promote their health and well-being. People’s changing needs were monitored and reviewed by staff who acted upon these where required so these could be met by the most appropriate healthcare professionals. The monitoring and recording of what people ate and drank was completed. Staff took additional advice from a healthcare professional to ensure this was achieved in the best way to monitor risks to people from not eating and drinking sufficient amounts to stay well.

People were supported to access planned and spontaneous activities. The registered manager told us further work was in hand to improve the regularity of fun and interesting things for people to do which were personalised to meet their individual recreational interests.

People knew the registered manager and they felt they were approachable and visitors to the home felt they were welcomed. The registered manager had introduced more opportunities for people and staff to make suggestions about the services people received. Staff u

Springfield House is registered to provide care and accommodation to up to 18 people who need personal care. At the time of our inspection 15 people were living at the home.

The inspection took place on the 23 and 29 February 2016 and was unannounced. Two inspectors were involved in the inspection.

At the time of our inspection a manager was in post. 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 carried out this inspection because we received information of concern and were also aware of incidents which had taken place at the home.

People we spoke with and their relatives felt people were kept safe however this was not always the case. People did not always receive their medicines safely and as prescribed and at times medicines were not available for staff to administer. Staff were not aware of whether healthcare professionals wished people to remain on a medicine and creams and gels were not always applied as prescribed.

Risks to people’s safety were not always assessed and staff failed to recognise potential risks in the care and support people were receiving. Care plans were not always provided or reviewed to reflect the care people needed. This placed the health and welfare of people at risk.

Management systems were not always effective and did not always fully follow up on shortfalls identified as part of audits. Agencies such as the Care Quality Commission and the local authority were not always informed in a timely way about incidents which had an effect on people’s health and welfare.

Staff were aware of the how to report signs of abuse as well as of other agencies who may be involved. Staff told us they received training and support to provide them with the skills to support people who lived at the home. Staff sought people’s consent prior to providing care and support and ensured people’s privacy and dignity was maintained.

People had a choice of food and drink they enjoyed available to them. People were provided with help and assistance as needed to maintain their independence while ensuring their dietary needs were met. People has access to healthcare professionals to maintain their well-being. People told us they felt listened to and were aware of the provider’s complaints procedure.

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