About the service: Springfield House is a care home that provides accommodation and personal or nursing care for up to four people with a learning disability, mental health issues and behaviours that challenge. The home is situated in Penistone, South Yorkshire near local shops and public transport. It is a detached house with a separate secure rear garden accessed through the house. There were four people living at the home on the day of this inspection.

People’s experience of using this service:

• The service had improved since the last inspection. Staff supervision had increased, and these improvements had been embedded. People who used the service and staff were now being asked to provide feedback on the service. This feedback was sought through questionnaires and/or meetings on a one to one basis or in groups.

• People told us they ‘liked’ the staff and they were positive about how they were treated by staff. People told us they were in control of their day to day routines and staff supported them to remain independent and access and participate in activities in the home and in the community. Staff asked people for consent before providing support.

• People felt safe whilst residing at Springfield House. Recruitment processes were robust and thorough checks were completed before staff started working in the home. We saw there were sufficient numbers of staff on duty to make sure people’s care needs were met. Staff supported people safely with their medicines.

• Risks to people receiving care at Springfield House were assessed and kept under review. People’s needs were assessed and support plans were developed to guide staff in how to support each person. People were involved in monthly reviews about their support with their key worker at Springfield House.

• Staff had received training and supervision to ensure staff had the knowledge to provide people with appropriate care.

• People had access to health professionals as required. Community health professionals provided positive feedback about the service commenting particularly about the person centred information contained in people’s support plans.

• The service was consistently well-led. People felt able to raise any concerns with the registered manager or provider and were confident they would be addressed. Staff felt well supported by the registered manager and we observed the staff team work well together.

• The registered manager and provider coordinated a wide range of quality checks and audits of the service to make sure the care and support provided was of high quality. This supported the continuous improvement of the service.

• The service met the characteristics of good in all key questions.

• More information is in the full report.

Rating at last inspection: At the last inspection the service was rated requires improvement (published 3 March 2018).

Why we inspected: This was a planned inspection based on the rating awarded at the last inspection.

Follow up: We will continue to monitor this service. We plan to complete a further inspection in line with our re-inspection schedule for those services rated good.

The inspection of Springfield House took place on 18 and 20 December 2017. We previously inspected the service on 21 September 2015; we rated the service as Good, at that time we found the registered provider was not meeting the regulations relating to staffing. The registered provider sent us an action plan telling us what they were going to do to make sure they were meeting the regulations. On this visit we checked to see if improvements had been made.

Springfield House is registered to provide accommodation and personal care for up to four people with learning disability, mental health issues and behaviours that challenge. The home is situated in Penistone, South Yorkshire near local shops and public transport and is a detached house with a separate secure rear garden accessed through the house. There are four private bedrooms with en-suite facilities, a communal lounge, a small lounge/craft room, a communal kitchen/dining room, a communal bathroom and a separate laundry/domestic room. There were three people living at the home on the day of inspection.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service had a registered manager in place. 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.

During this inspection, we found measures had been put in place to rectify and address previous concerns relating to staff and a programme for supervision and appraisal was in place.

We found the service was safe. Staff had received safeguarding training and knew how to recognise the signs of abuse. Risk assessments and risk reduction plans were in place to support staff and minimise the risk of avoidable harm.

Appropriate recruitment processes and checks were made to ensure suitable staff were employed. There were a sufficient number of staff to keep people safe and meet the needs of the people who used the service.

Medicines were administered and stored safely. People were encouraged to manage their own medicines where they had the capacity to do this. PRN (as required) protocols were in place and regular medicine audits were undertaken.

Staff received training to carry out their roles effectively. Some staff required their training to be refreshed and we found this had been identified by the registered manager and actions were already in place.

People were supported with their hydration and nutritional needs. People were encouraged to participate in menu planning and food shopping.

People were supported to have maximum control and choice of their lives and staff supported them in the least restrictive way possible. Policies and systems in the service supported this practice.

Staff understood the requirements of the Mental Capacity Act 2005. Capacity was assumed. Where people lacked capacity decision mental capacity assessments had been completed and best interest meetings held.

Staff were caring and very kind. Staff treated people with respect and were extremely knowledgeable how to support the people who used the service. Staff supported people to maintain their privacy and dignity.

Care plans were person-centred and included people’s likes and dislikes. Staff supported people to retain their independence.

People who used the service were encouraged to participate in a wide range of activities and interests and included in the day to day activities within the home. A car was provided by the service to enable people to have an ease of access to a wide choi

Springfield House is registered to provide accommodation and personal care for up to four people with a learning disability, mental health issues and behaviours that challenge. The home is situated in Barnsley, South Yorkshire near local shops and public transport.

There was a manager at the service who was registered with CQC. 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 and associated Regulations about how the service is run.

Our last inspection at Springfield House took place on 3 January 2013. The home was found to be meeting the requirements of the regulations we inspected at that time with the exception of Regulation 10, Assessing and Monitoring the Quality of Service Provision. We undertook a follow up inspection on 28 March 2013 and found improvements had been made to reach compliance with this regulation.

This inspection took place on 21 September 2015 and was unannounced. This meant the people who lived at Springfield House and the staff who worked there did not know we were coming. On the day of our inspection there were two people living at Springfield House.

We spoke with both people living at Springfield House and their comments were positive. We saw people freely approach staff and have conversations and interactions with them. People commented, “I like it” and “It’s good here, staff are nice.”

We found systems were in place to make sure people received their medicines safely.

Staff were provided with relevant induction and training to make sure they had the right skills and knowledge for their role. Staff understood their role and what was expected of them. They were happy in their work, motivated and confident in the way the service was managed.

Staff supervision and appraisal meetings were not taking place on a regular basis to ensure staff were fully supported.

The service followed the requirements of the Mental Capacity Act 2005 (MCA) Code of practice and Deprivation of Liberty Safeguards (DoLS). This helped to protect the rights of people who may not be able to make important decisions themselves. Staff had a clear understanding of the MCA and DoLS so that they had the knowledge needed for their role and to make sure people’s rights were upheld.

People had access to a range of health care professionals to help maintain their health. A varied and nutritious diet was provided to people that took into account dietary needs and preferences so that health was promoted and choices could be respected.

People living at the home said that they could speak with staff if they had any worries or concerns and they would be listened to.

We saw people participated in a range of daily activities both in and outside of the home, according to their choice, which were meaningful and promoted independence.

There were systems in place to monitor and improve the quality of the service provided. Checks and audits were undertaken to make sure full and safe procedures were adhered to.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. The manager and staff told us where people were unable to make decisions they would consult people’s representatives or advocates to gain consent.

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Care was planned and managed by staff with the help of regular reviews. On the day of our inspection one of the people complained of not feeling well and staff contacted the GP without delay.

There were effective systems in place to reduce the risk and spread of infection. We saw communal areas were kept clean and tidy. Care staff on duty said they had received training on infection prevention and control.

People were cared for and supported by staff who had been appropriately checked for their fitness before staff began work.

Although from time to time different quality audits were carried out by different senior managers from the company, the provider may find it useful to note that the manager and staff commented they were not supported by the senior managers to make the required improvements.

The complaints procedure was produced in a suitable format so that people knew how to make a complaint. Comments and complaints made by people were listened to and acted on by the manager without people fearing that they would be discriminated against for making a complaint.

We carried out an unannounced inspection on 3 January 2013 where we found that the provider was not fully meeting the essential standards relating to the quality monitoring of the service. We found the quality assurance system was not effective. The provider submitted an action plan. This inspection was to check that the provider had taken action to address the non-compliance.

During this inspection we spoke with staff on duty, the manager and their locality manager. We also reviewed the systems in place and the outcomes of the audits carried out by the service.

The provider had improved the system in place to identify, assess and manage risks to the health, safety and welfare of people using the service and others. The format of the surveys for people had been changes to ‘easy read’ to suit the needs of the client group.

Staff had been provided with access to hard copies of the company policies so that they were able to refer to them.

The manager and the locality manager said that they had reviewed the systems for reporting, managing and analysing incidents. The amended arrangements gave care workers opportunities to get involved and give their views.

Regular staff meetings had taken place and staff had requested the locality manager be present so that they could discuss service development. This was acknowledged by the locality manager. Following our inspection we were informed that they had met with staff at the Springfield House.

On the day of our inspection three people lived at Springfield House. People who lived at the home understood verbal communication. Some were unable to verbally engage in conversation. Staff were familiar with people and understood individual’s body language, general mood and the modified sign language they used to express themselves.

One of the people welcomed us when we arrived. Another asked us whether we wanted a cup of tea. We explained to them why we were there.

The provider acted in accordance with legal requirements where people did not have the capacity to consent to care. We observed staff explaining to people why they needed to take their medication. People said ‘no’ if they did not want to do something without worrying about the consequences.

Care was planned and delivered in a way that was intended to ensure people's safety and welfare. We observed staff escorting a person for an external appointment. The manager ensured staff escorting the person had a good understanding of their conditions, knew the person well and of the risks involved and how they would manage them.

The provider had carried out audits of the service regularly and recommended actions by the manager. There were several actions the home had not achieved. There had not been any follow up from the provider to monitor progress against the action plan. This meant the system for monitoring quality of service was not effective. Therefore we have imposed a compliance action.

People who lived at the service looked comfortable. Some people were unable to verbally communicate but their body language and gestures demonstrated that they liked the care workers and generally enjoyed living at Springfield House. The other people said that they were “OK”.