This comprehensive inspection took place on 17 and 18 December 2018; the first day of the inspection was unannounced. The service was last inspected in December 2017 when it was rated as requires improvement. This was because we identified two breaches of regulations; these related to the fact that people’s care records contained contradictory information and the provider had failed to ensure people’s nutritional needs were properly assessed, monitored and met.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of is the service safe and is the service well-led to at least good. The provider submitted the requested action plan which showed they would complete all required actions by January 2018.

Springfield Cottage 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.

Springfield Cottage is registered to provide accommodation and personal care for up to 26 older people; there were 25 people living in the home at the time of the inspection. The home is situated in a residential area in Blackburn. Accommodation is provided over two floors in 24 single and one double room, a number of which have en-suite facilities. There is both a passenger lift and stairlift to provide access to the first-floor rooms. Communal space is provided in two lounges and a dining room.

The service was managed by a registered manager who had been appointed since the last 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.

During this inspection, we identified four breaches of the regulations. This was because people were not provided with the equipment required to support them to mobilise safely in the home, medicines were not always safely managed, staff were not always safely recruited and governance systems were not always effective. This has led to the service again being rated as required improvement. This is the second consecutive time the service has been rated as required improvement since December 2017. You can see what action we told the provider to take at the back of the full version of the report.

Our observations during the inspection showed that staff did not always ensure people had the appropriate equipment necessary for them to mobilise safely in the home. We saw that people were transferred in wheelchairs which did not belong to them. In addition, we saw staff support an individual to walk using a frame which was inappropriate for their height. One person had to ask the inspection team to find their walking frame to enable them to mobilise safely. We found this equipment had been placed behind another person in the communal dining room.

Staff had not always been safely recruited. Checks were not always made to ensure applicants had documented a full employment history on their application form or CV. One person had started employment prior to any references being received. The registered manager told us this was standard practice in the home but recognised this meant they could not be certain employees were of good character and suitable to work with vulnerable people before they started work. They told us they would cease this practice with immediate effect and ensure references were always received before people commenced employment.

Medicines were not always safely managed. Records we reviewed showed that on one occasion, a person had received a dose of a medicine which was four times the prescribed dose. Although the person did not appear to have su

This inspection took place on 11 and 12 December 2017. The first day of the inspection was unannounced. The service was last inspected in September 2015 when it was rated Good.

Springfield Cottage 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. The care home is a detached property and accommodates up to 26 older people on two floors. At the time of the inspection there were 23 people accommodated in the home.

The home 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. At the time of this inspection the registered manager was on maternity leave. The provider had arranged for a relief manager to be appointed until the registered manager’s return; they had only been in post for three days at the time of this inspection. Prior to this arrangement the provider had organised for the registered manager from another of their services to oversee the running of the home.

During this inspection we found two breaches of the regulations. This was because some people’s care records contained contradictory information which could lead to a risk of them receiving unsafe care or treatment. In addition, the provider had failed to ensure that people’s nutritional needs were properly assessed, monitored and met. You can see what action we told the provider to take at the back of the full version of the report.

This is the first time the service has been rated Requires Improvement.

Although people told us they felt safe in the home, care records did not always consistently record the care people required. This meant there was a risk people might receive unsafe or inappropriate care. In addition the systems in place to assess, monitor and meet people’s nutritional risks were not sufficiently robust. People gave us mixed feedback about the quality of the food.

Staff had been safely recruited. They had received training in safeguarding adults and understood their responsibilities to protect people from the risk of harm. Records showed staff were provided with the induction, training and support required to help ensure they were able to deliver safe and effective care. People who used the service were generally complimentary about staff. Although two people told us they felt new, younger staff needed more training, one person with particular medical needs told us they felt all staff were competent to care for them.

We received mixed feedback about staffing levels in the home. While some people who lived in the home felt there were sufficient staff to meet their needs, a number of people felt staffing levels were not sufficient to respond to people’s needs in a timely manner. On the first day of the site visit, the inspection team had to intervene on five occasions to ensure people received the care they needed; this was mainly due to a member of domestic staff being off sick. A full complement of staff was in place on the second day of the inspection; this meant staff were more visible and therefore better able to respond to people’s needs.

People told us they had no concerns about the way their medicines were administered by staff. However, we noted that improvements needed to be made to the systems for monitoring and recording when prescribed topical creams had been administered.

People were cared for in a safe and clean environment. On-going plans were in place to improve the décor of the home. Procedures were in place to prevent and control the spread of infection. Regular checks were made to help ensure the safety of the equipment

This was an unannounced inspection which took place on 8 July 2015. This was the first inspection since a change to the partnership which owns the service.

Springfield Cottage is registered to provide accommodation for up to 26 older people who require support with personal care. At the time of our inspection there were 25 people using the service.

There was a registered manager in place at Springfield Cottage. 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. The registered manager was on maternity leave at the time of the inspection but arrangements had been put in place for the deputy manager to assume responsibility for the day to day running of the service; they were supported by an acting deputy manager.

People who used the service told us they felt safe in Springfield Cottage and that there were enough staff available to meet their needs in a timely manner. Staff had been safely recruited and received the induction, training and supervision required to deliver effective care.

People spoke positively about the caring nature of staff. Our observations during the inspection showed staff were kind and respectful in their interactions with people who used the service.

Systems were in place to ensure people received their medicines as prescribed.

We saw there were risk assessments in place for the safety of the premises. All areas of the home were clean and well maintained. 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 good 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 and plans were in place to help reduce or eliminate the risk. People were involved in and consulted about the development of their care plans. This helped to ensure their wishes were considered and planned for.

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.

People made mostly positive comments about the food provided in Springfield Cottage. We saw systems were in place to help ensure people’s nutritional and health needs were met.

A programme of activities was provided in the service. The acting manager had plans to involve people who used the service in an activity committee to help decide what future events and activities should take place.

Records we reviewed showed people who used the service and their relatives had opportunities to comment on the quality of care provided. All the people we spoke with told us they would feel confident to raise any concerns with the staff and managers in Springfield Cottage.

Staff told us they enjoyed working at Springfield Cottage and received good support from colleagues and managers. We saw staff had regular opportunities to provide feedback on the service provided.

To help ensure that people received safe and effective care, systems were in place to monitor the quality of the service provided.