Inspection on 03/03/09 for Springfield Lodge Care Home

This is the latest available inspection report for this service, carried out on 3rd March 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Springfield Lodge Care Home 01/02/06

Springfield Lodge Care Home 02/03/05

Springfield Lodge Care Home 13/07/04

Springfield Lodge Care Home 09/03/04

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Springfield Lodge Care Home 45 Watcombe Circus Carrington Nottingham NG5 2DU     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Karmon Hawley     Date: 0 3 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 28 Information about the care home Name of care home: Address: Springfield Lodge Care Home 45 Watcombe Circus Carrington Nottingham NG5 2DU 01159620745 F/P01159620745 yvonnelodge@aol.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mrs Yvonne Angela Harris care home 15 Number of places (if applicable): Under 65 Over 65 0 mental disorder, excluding learning disability or dementia Additional conditions: Date of last inspection Brief description of the care home 15 Springfield Lodge is a converted and extended house, accommodating up to fifteen people with mental health issues. It situated in a residential area and is in keeping with other houses in the neighbourhood. It is close to local amenities and is a short walk from the busy Mansfield Road. There is no through floor lift or stair lift, a number of the bedrooms do not have wash hand basins. The manager said that the current weekly fees are £329.83 - £325; this does not include hairdressing or toiletries. Information of fees are made available upon enquiry. Care Homes for Adults (18-65 years) Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Individual needs and choices Lifestyle Personal and healthcare support peterchart Concerns, complaints and protection Environment Staffing Conduct and management of the home Poor Adequate Good Excellent How we did our inspection: The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for people living at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service delivery that needs further development. A review of all the information we have received about the home was considered in planning this visit and this helped decide what areas we looked at. Prior to the inspection the Annual Quality Assurance Assessment (AQAA) was sent out to Springfield Lodge, which asked questions around the service including staffing levels and number of people using the service. The AQAA, which was returned to the Care Homes for Adults (18-65 years) Page 5 of 28 Commission for Social by the registered manager/provider, was used within this inspection report. One regulatory inspectors conducted the unannounced visit over 1 day. The main method of inspection we use is called case tracking which involves selecting the care plans of three people and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. Case tracking is used to establish if the needs of the people are being appropriately assessed by the home and their needs are being catered for. Five people using the service were spoken to about the service they receive. Four staff files were examined. Two members of staff were spoken with in addition to the manager. We also undertook a tour of the care home, which included looking at the bedrooms of those people who we case tracked and communal areas of the home. What the care home does well: What has improved since the last inspection? What they could do better: Ensure that audits of peoples personal allowances take place at regular intervals to ensure that these are consistently correct and the money of people using the service is protected. Make plans in the near future to redecorate the identified bedrooms to make sure that people live in a well maintained environment. Care Homes for Adults (18-65 years) Page 7 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 28 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured that their needs will be assessed and that staff can meet these before they make a decision to move into the care home. Evidence: The manager visits people who may wish to use the service in the community before admission to carry out an assessment. This is to make sure that staff are able to meet peoples needs before they make a decision to move into the care home. We saw evidence within plans of care to show us that these assessments are taking place and that social worker assessments are obtained so that staff have enough information about people before they move in. So that people can get a feel for what it would be like to live at the care home they may come and visit, spend time there and meet other people who currently live at the care home. Care Homes for Adults (18-65 years) Page 10 of 28 Evidence: Staff spoken with confirmed that they are given an information sheet about people when they move in so that they can support them appropriately. Care Homes for Adults (18-65 years) Page 11 of 28 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are reflected in individual support plans, which are kept under review. They are enabled to make decisions about their lives and assistance is given where needed to manage risks. Evidence: When examining peoples case files we saw that people as able have been involved in planning the care and support that they need. Support plans are in place for peoples identified needs, such as mental health and complex medical needs and these are personalised so that peoples needs are met in their preferred way. Support plans outline what peoples skills are and the areas that they made need support so that independence is enhanced and promoted where able. Care Homes for Adults (18-65 years) Page 12 of 28 Evidence: Appropriate risk assessments and management plans have also been negotiated with people using the service. These are in place for all identified risks such as leaving the building unescorted and behaviour that may be challenging so that risks are managed and reduced and people are protected. The Mental Capacity Act and Best Interests has been fully utilised within all areas that people need support to ensure that their rights and choices are maintained. Support plans and risk assessments are updated on a regular basis to show whether any changes have occurred in peoples condition so that they can be supported appropriately. People using the service told us, the staff are very supportive, and the staff are very nice and they look after me. Staff spoke of making sure that they offer people choices in everything that they do, for instance choosing their own clothes, food and how they spend their time. One person using the service confirmed this, saying, I can spend my time as I want, there are no restrictions. Staff spoken with are able to discuss the mental health needs and medical needs of people using the service and how they support them in meeting these; I make sure I respect peoples independence and support them as needed, and I am happy and confident in my work, which helps me to support people as needed. Care Homes for Adults (18-65 years) Page 13 of 28 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and enabled to live a full and independent life as able and maintain contacts with people that are important to them. Evidence: So that people are supported in regard to their social life and activities that they may wish to do, support plans outline peoples social skills and areas that they need support in. Some people attend day centres whereas other spend time at home and join in activities that are on offer there. In house activities are offered on a one to one basis if desired and also group activities take place. These include, arts and crafts, games and baking. Care Homes for Adults (18-65 years) Page 14 of 28 Evidence: People using the service offered the following comments; I spend a lot of my time watching TV, I am happy doing that, I really enjoy bingo, monopoly and the game of life, there are activities on offer, I can do what I want but I prefer to stay downstairs and watch the television. Staff spoken with feel that there is sufficient for people to do to occupy their time. They told us, the routine is flexible, they can do what they want, people are always doing activities, they enjoy making posters for each others birthdays, most people get involved but some just like to sit and watch, when the weather is good we take people out that usually dont get the chance to go on their own, and residents help in the kitchen, we help them and give them encouragement in this. There is a mini bus available for service users use, which facilitates trips outside the home. The manager said that there is access to the local churches if required. So that people can maintain contacts with people that are important to them, the support that may need to do this is documented within plans of care. Staff said there are no restrictions on visiting and people may receive visitors in private if they wish and people using the service confirm this. Some people also go out and spend time with their families. We saw people coming and going throughout the visit and one person said that they often go out for a walk around. People using the service assist in drawing up the menus. The food on offer is varied and wholesome. There are choices at each meal and homemade cakes are available. Relatives may also stay for meals on occasion and there are facilities to make drinks if desired in a kitchenette off the quiet room. Meal times are flexible and the main meal is reheated if service users wish to eat at a later time. Following a risk assessment people may spend time helping staff in the kitchen in the preparation of food and making cakes, one person using the service told us, I enjoy the baking sessions. One person using the service told us, we get enough to eat and there is enough choice. Care Homes for Adults (18-65 years) Page 15 of 28 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal support that people receive is based upon their individual needs. Evidence: The manager stated that the staff have a brilliant rapport with the doctor, district nurses and community psychiatric nurses. We saw within peoples case files that they are supported to access specialist services as needed including age appropriate screening. Support plans in place outline the support and assistance people need in regard to personal and health care to make sure that these are met. People using the service told us, the staff are very nice, they look after me as needed, and staff help me with my personal care. Staff spoken with are able to discuss how they ensure that they maintain peoples independence as able and promote their dignity at all times. Care Homes for Adults (18-65 years) Page 16 of 28 Evidence: All staff who administer medication have been trained to do so. Medication records examined show us that people receive their medication as prescribed. People undergo assessments in regard to their capacity to look after their medication so that they receive assistance and support with this if required. We saw that regular audits are taking place and that the medication policy has been updated following an incident in respect of missing medication. One person using the service told us how the staff make sure that they get their painkillers following an operation. Care Homes for Adults (18-65 years) Page 17 of 28 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are assured that their complaints will be listened to and acted upon and that they are protected from abuse. Evidence: The service has a complaints policy that is available in a format that people using the service can understand. The service has not received any complaints since the last inspection. Staff spoken with are able to discuss how they would deal with a complaint should one be received to ensure that this is remedied. People using the service did not express any concerns during our visit and one person told us, I would tell staff if I was unhappy, I am always happy and cheerful. Staff have undertaken training in safeguarding adults and they are able to discuss how they ensure that they keep people safe from abuse. There has been one safeguarding alert since the previous inspection in regard to missing medication. The police were informed of this and they spoke with staff at the care home, they did not take any further action. The manager investigated this incident and updated the medication policy to ensure that an incident of this nature Care Homes for Adults (18-65 years) Page 18 of 28 Evidence: does not reoccur. People using the service may keep their money in the care home safe should they wish. We examined four peoples personal accounts; these show us that whilst receipts are available for all transaction, there are minor discrepancies in three accounts. The manager stated that accounts are normally audited on a regular basis, however the person who does this has been off work sick. She stated that she would check all accounts so that any discrepancies can be rectified. People can access their money at any time and if needed staff will support people when they go to the bank to draw out their money. Support plans are in place in regard to personal allowances and budgeting where required. We saw within one plan of care that a person had negotiated their budgeting arrangements so that their money lasts them throughout the day. Care Homes for Adults (18-65 years) Page 19 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a comfortable environment, which is clean and satisfactorily maintained. Evidence: There is evidence of ongoing maintenance taking place so that people live in a comfortable environment. Some of the bedrooms on the top floor are now in need of redecoration, however the manager stated that she needs to discuss this with those people who occupy these rooms, so that plans can be made to redecorate with a minimum amount of disruption to them. A new smoking area has been made so that those people who smoke can do so without causing discomfort to others. There are two lounges that people may choose to sit in during the day as well as a small conservatory and the dining room. People spoken with said that they can use whichever area they like and that there are no restrictions applied. All areas of the care home accessed during the brief tour are clean and tidy. Care Homes for Adults (18-65 years) Page 20 of 28 Evidence: One person using the service said, I have a nice bedroom upstairs, I can manage the stairs alright. Care Homes for Adults (18-65 years) Page 21 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported by sufficient numbers of staff that are trained to meet their needs. Evidence: The duty rota demonstrates that there is the manager and two carers on duty throughout the day and one waking and one sleeping carer during the night. In addition to this there are also domestic staff to assist in keeping the care home clean and tidy. Staff spoken with told us, the manager has employed some new staff, there are enough staff now but it will be better when they start so that we can spend more quality time with people and there are enough staff on each shift, although it can be busy at times with people going out and doing activities. People using the service told us that staff are nice to them and always available when they need them. So that staff understand their roles and responsibilities when they first start working at the care home they undertake an induction. Within staff files examined we saw that Care Homes for Adults (18-65 years) Page 22 of 28 Evidence: these are taking place and one member of staff spoken with confirmed that they had undertaken an induction when they first started working at the care home. One member of staff has attained the National Vocational Qualification (a nationally recognised work and theory based qualification designed to enhance skills and knowledge in caring or people) level 3 and three have attained level 2, the rest of the staff are working towards gaining this qualification. Both members of staff spoken with confirm that they have undertaken this training. We examined staff personnel files to make sure that they contained all the documentation such as references and a criminal record bureau check (a police check to see if a person has a police conviction or caution) required by law. All staff files contained the relevant documentation and staff confirm that they had undertaken a criminal record bureau check before they started working at the care home. Staff files examined show us that staff continue to undertake compulsory training in areas such as fire, health and safety, aggression management and the Mental Capacity Act to make sure that they have the necessary knowledge and skills to care for people. Staff spoken with are able to demonstrate a good understanding of peoples needs and they said, we are offered a good standard of training; I am due to go on two courses in April, one on dementia care and the other on equality and diversity. I have done the Mental Capacity Act and challenging behaviour, it is good as I have more understanding of these issues now, and the training is never ending, it is good, I have done my NVQ (National Vocational Qualification), I am happy and confident in my work. One person using the service told us that they felt that staff are well trained to meet their needs. The manager stated that staff undertake supervisions on a three monthly basis but they may have these in between if they want to. One member of staff spoken with confirmed that they undertake regular supervisions and that these are helpful. Care Homes for Adults (18-65 years) Page 23 of 28 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a well run home where they are able to express their opinions and have them listened to and acted upon. Evidence: The manager continues to complete compulsory training and training in regard to management to make sure that she remains up to date with current practices. Staff spoken with said I love working here, there is a good atmosphere, Yvonne is lovely, if ever a problem arises she does her best to sort it out, it is well run and friendly, and Yvonne is very approachable and she is on top of all the training that we need. People using the service told us, Yvonne is nice, she looks after me, and I have been here for 15 years, I like it here, it is alright. People using the service are given an opportunity to have their say in how the care Care Homes for Adults (18-65 years) Page 24 of 28 Evidence: home is run and managed by way of questionnaires. There are no recent questionnaires for us to look at as these are not due to be given out to people until May of this year. So that people are able to express their views and opinions residents meetings are held on a regular basis. The minutes of the last meeting examined show us that issues such as the menu, activities and people taking care of the fixtures and fittings in the care home was discussed. We saw that action points to address any issues and follow up notes as to the outcomes are available. Staff also attend regular meetings so that quality issues can be addressed. We saw that at the last meeting standards of care, confidentiality and activities have been discussed. So that people are protected from fire, staff have undertaken training in fire safety and the testing of fire systems are carried out as required by the fire authority. The annual quality assurance assessment information tells us that routine servicing is taking place as required on all equipment. We examined the gas certificate that confirms this. Care Homes for Adults (18-65 years) Page 25 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 23 Ensure that audits of peoples personal allowances take place at regular intervals to ensure that these are consistently correct. Make plans in the near future to redecorate the identified bedrooms to make sure that people live in a well maintained environment. 2 24 Care Homes for Adults (18-65 years) Page 27 of 28 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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