Inspection Reports for
The Wellington at Springfield

Incident reporting: The Residence filed 97 incident reports greater than 24 hours after the occurrence of the incident during the period reviewed (repeat finding).

Quality assurance program: Documentation of Service Plan reviews for 2022 and 2023 lacked specific findings, follow-up actions, responsible staff, and documented outcomes; medication audits were incomplete and some medication cassettes were unlabeled or missing documentation (repeat finding).

Resident screening and assessment · Resident care plans: Multiple resident records were missing nurse assessments, legal representative documentation, timely reassessments, enrichment activities, and supervised cooking capacity documentation (repeat finding).

Emergency call response: In August and November 2023, there were 305 emergency call response times over the ten minutes required by the Residence policy.

Controlled medication handling: Staff were not following the Controlled Substance count audits; some residents were without supply of PRN medication upon observation.

Resident records: Correspondence logs were inconsistently documented and missing information necessary for continuity of care (repeat finding).

Staff training: Records lacked documentation that introductory visits were consistently conducted by a nurse and that a 2022 training needs assessment was completed (repeat finding).

Food and dietary services: Missing dietitian reviews.