We carried out a comprehensive inspection of Springhill Care Home on 8 and 9 August 2016. The first day of the inspection was unannounced.

Springhill Care Home provides accommodation, personal care and nursing care for up to 116 people, including people living with dementia. At the time of this inspection there were 107 people living at the home.

The service is a mainly purpose built care home. There are three dementia units over three floors and an additional residential unit and nursing unit. Accommodation is provided mainly in single en-suite rooms. There are a small number of double occupancy rooms. The grounds and gardens have accessible seating areas for people living at the home. The home is situated close to the small town of Oswaldtwistle in East Lancashire.

At the time of our inspection the service had a registered manager, who had been registered with the Commission as the manager of the service since October 2015. 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.

As part of our inspection we have made a recommendation about the management of medicines at the service.

There were appropriate policies and procedures in place for managing medicines. However, we found that medicines were not always stored safely.

People living at the home told us they received safe care. Most people living at the home felt that staffing levels were sufficient to meet people’s needs.

We saw evidence that staff had been recruited safely. The staff we spoke with understood how to safeguard vulnerable adults from abuse and what action to take if they suspected abuse was taking place.

People told us they were happy with the care they received and felt that staff could meet their needs. We found that staff received an appropriate induction and effective training when they joined the service. Staff told us they received regular supervision.

Staff understood the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). The service had taken appropriate action where people lacked the capacity to make decisions about their care.

The people we spoke with told us they were involved in decisions about their care and their care needs were reviewed regularly.

People living at the home and their relatives were happy with quality of the food provided. They told us they had lots of choice.

We received positive feedback about from community healthcare professionals who were involved with the service.

We observed staff communicating with people in a kind and caring way. People told us staff respected their privacy and dignity and encouraged them to be independent.

Activities were provided by dedicated activities co-ordinators and people told us they were happy with the activities available at the home.

We saw evidence that the registered manager requested feedback about the service from people living at the home and acted on the feedback received.

People told us they thought the home was well managed. They felt that the management team were approachable.

Many aspects of care at the home were audited regularly to ensure that appropriate standards of care and safety were maintained.

People using the service told us they were treated with respect and involved in making decisions about their care and support needs. One person said, “I’m so glad I’m here.” Another person said, “I love it here, the staff are excellent.”

We saw that members of staff were courteous and attentive to people’s needs. One person said, “I’m looked after incredibly well, the staff are angels.” Another person said, “They are very good at looking after you.” The relative of one person said, “I cannot speak highly enough of the care.”

We found that the home was clean, tidy and free from offensive odours. Procedures and training for all members of staff was in place for the prevention and control of infection.

We noted that recruitment procedures were thorough in order to protect people from the employment of unsuitable staff.

We saw that systems were in place to monitor the quality of the service provided. There was evidence to demonstrate that people were regularly consulted about the care and facilities provided at the home.

People using the service told us they liked living at Springhill House and were satisfied with the care provided. Members of staff explained what they were doing before they carried out care tasks so that people could give their consent. One person said, “I’m happy with everything, the staff are marvellous, really caring and they will do anything for you”.

We found that suitable arrangements were in place for the safe keeping and handling of medicines.

We saw that members of staff were usually available to assist people when necessary and supervise people with a dementia.

We saw that appropriate and accurate records were kept for people using the service and the overall effective management of the home.

On the day of this visit we spent most of our time on the dementia unit where we had identified areas for improvement at the last inspection. We found that staffing levels had been increased and leisure activities suitable for people with a dementia were routinely organised.

People who were able to express their views told us that they liked living at Springhill. One person said, “It’s lovely here, I like being looked after. The staff are very good and treat me properly.”

One visitor told us the staff were caring and said, “Nothing is too much trouble.”

Most of the people we asked told us the meals were good. One person said, “The food is very good, I like having all my meals got ready.” However, another person told us they weren’t entirely happy with the food served at tea time because it was always sandwiches.

The manager told us that she had an 'open door' policy so that people using the service and their relatives could discuss the care and facilities provided at the home at anytime when she was on duty.

People who were able to express their views told us that they liked living at the home. One person said, “I’m happy here.” Another person said, “I’ve got used to it and made plenty of friends.”

One visitor explained that staff were nice and attended to their relative when

needed.

People’s comments about the food ranged from ‘alright’ to ‘very good’. One person said, “They come round and ask what you want.”

All the people we asked said they could choose when to get up and go to bed. One person said, “You can please yourself.”

We asked one lady what she did all day and she replied, “They’re busy, we watch television.”

A person who was visiting a lady suffering from dementia told us she had never seen any activities taking place on the dementia unit.

People using the service were unable to tell to us about their experience of living on the dementia unit at the home. However, members of staff told us that activities were not routinely organised for people suffering from dementia.

Staffing arrangements meant that on each floor of the dementia unit during meal breaks there was frequently only one member of staff on duty.