Inspection on 14/05/09 for Springfield Nursing & Residential Home

This is the latest available inspection report for this service, carried out on 14th May 2009.

CQC found this care home to be providing an Good 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 Nursing &... 22/10/07

Springfield Nursing &... 10/05/07

Springfield Nursing &... 05/10/06

Springfield Nursing &... 24/04/06

Springfield Nursing &... 29/11/05

Springfield Nursing &... 27/07/05

Springfield Nursing &... 19/09/04

Springfield Nursing &... 21/04/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report CARE HOMES FOR OLDER PEOPLE Springfield Nursing & Residential Home Preston New Road Blackburn Lancashire BB2 6PS Lead Inspector Mr Jeff Pearson Key Unannounced Inspection 14th May 2009 09:30 DS0000022482.V375416.R01.S.do c Version 5.2 Page 1 This report is a review of the quality of outcomes that people experience in this care home. We believe high quality care should: • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care homes for older people 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 2 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Nursing & Residential Home Address Preston New Road Blackburn Lancashire BB2 6PS Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01254 263668 01254 690461 None Four Seasons Healthcare (England) Limited (Wholly owned subsidiary of Four Seasons Health Care Ltd) Manager post vacant Care Home 69 Category(ies) of Dementia (49), Old age, not falling within any registration, with number other category (20) of places Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following categories of service only: Care home with nursing - Code N to service users of the following gender: - Either whose primary care needs on admission to the home are within the following categories:Old age, not falling within any other category - (OP) (maximum number of places: 20) Dementia Code (DE) - (maximum number of places: 49) The maximum number of service users who can be accommodated is: 69 Date of last inspection 29th April 2008 Brief Description of the Service: Springfield Nursing and Residential Home is registered to provide care to a maximum of 69 adults who need help with personal care or who have nursing needs. Springfield is a detached building standing in its own grounds. Accommodation is provided on four floors, referred to as Levels. Each Level is regarded as a separate unit and accommodates a different resident group. Each has its own communal facilities, including lounges, dining areas, kitchens and bathrooms. A total of sixteen bedrooms have en-suite facilities; the remainder have handwash basins installed. There lifts to provide access to all levels. There are various adaptations to assist the residents with self-help and mobility. The garden has seating areas for residents and car parking spaces available to the front of the home. The home is situated in a residential area close to local amenities, on a main road into Blackburn town centre; bus stops are a short distance away. Staff are available to provide assistance with personal care and support 24 hours a day. The home had available a Statement of Purpose and Service User Guide Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 5 providing information about the care and services available. This information should help people make an informed choice about moving into Springfield. At the time of this inspection visit, the range of fees charged were between £344.50 and £621.00 per week, there were additional charges for hairdressing, toiletries and some newspapers. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. A key unannounced inspection, which included a visit to the service, was conducted at Springfield Nursing and Residential Home on the 14th May 2009. The visit took 13 hours and was carried out by one inspector over 2 days. At the time of the visit there were 31 people living at the home. The people living at the home and staff were invited to complete surveys, to tell us what they think about the care and service provided at Springfield, some were received at the Commission. Before the site visit, the acting manager was required to complete and returned to the Commission an Annual Quality Assurance Assessment (AQAA). This was to enable the service to show how they were performing and provided details about arrangements, practices and procedures at the home. The files/records of three people were examined as part of ‘case tracking’, this being a method of focusing upon a representative group of people living in the own home. We spoke with people living at the home; the acting manager and staff. Various documents, including policies, procedures and records were looked at. Most parts of the home and some outside areas were viewed. What the service does well: The home was being run by a team of staff, who were keen to provide a good service for the people using the service, people spoken with said, “Things are fine” - “The manager and staff are very helpful” There were some good ways of finding out about peoples’ individual needs abilities and preferences before they moved into Springfield. This meant the home made sure they could properly care for people before they moved in. People were encouraged to visit so they could get to know the home, current residents and staff, one person said, “I think I have settled in well, I am enjoying my stay” People were getting attention for health care needs and personal privacy needs were being dealt with sensitively and they were being treated with respect and as individuals. “They look after me well” was one comment made. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 7 Most people were happy with the arrangements for activities and daily routines were flexible, choices were being encouraged and monthly outings arranged. The catering arrangements made sure people could choose different meals; individual tastes and diets were being catered for. Mealtimes were flexible to fit in with peoples’ lifestyles and preferences. Any complaints made were being taken seriously and well managed, people spoken with were aware of how to make a complaint and were confident their concerns would dealt with they said, “They always sort things out” and “If I had a complaint, would ask for the manager she is very nice” To help make sure staff provide effective care, good arrangements were in place for ongoing training and development. What has improved since the last inspection? There was a new manager at Springfield, who was keen to put people living at the home at the centre of how the care and support is provided; there had been a number of positive changes at the home. One staff wrote in a survey; “This home has improved a lot” Information about the home had been updated; it was more individual to Springfield so that people should get a better awareness of what it might be like to live there. Peoples’ care plans gave staff detailed instructions, to help them respond to individual needs and help reduce any identified risks. People living at the home, or their families, were being consulted about how they wanted their care to be provided. “Oh yes, I was fully involved”, explained one person. Information about what people liked to do and how they spend their time had been include in care plans, which meant that people were being better supported to live their chosen lifestyle and pursue their personal interests and hobbies. In order to protect people living at the home, staff had been given guidance on what and when to take further action when people have minor unexplained injuries and bruising. The home was undergoing a significant programme of refurbishment; many improvements had been made to the home, in particular Level 3 which had been upgraded to a very good standard. The kitchen had been completely refitted and new equipment provided which had improved the catering arrangements and health and hygiene practices. The large damp area that affected the stairwell and floor leading to Level 1 had been repaired and repainted. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 8 There were sufficient domestic staff to help keep all areas of the home clean and free from odours. More care staff had gained National Vocational Qualifications, to help ensure they have the knowledge and skills to understand and respond to the needs of people living at the home. People living at the home had more opportunities to make their views about the service known and to make suggestions for improvements. What they could do better: 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 on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line – 0870 240 7535. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 9 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 10 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3 and 5 People using the 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 admission process helped ensure peoples’ needs and wishes, were considered and planned for before they moved into the home. EVIDENCE: Information packs about the home, including a brochure and terms and conditions of residence, were available in the entrance hallway. Previous inspection reports were also available and the homes’ statement of purpose was on display. The acting manager explained that the homes guide and statement of purpose had been updated, to provide more current and accurate details, also that information packs were being placed in bedrooms. Most residents completing surveys indicated they had received enough information about the home prior to moving in. It was suggested, the homes guide could Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 11 be further developed with the involvement of residents, to help make it more accessible to people with dementia. The acting manager explained the homes admission process; this involved gathering information from various sources such as Social Services and health professionals, but mainly from the prospective resident and their families. A new way of considering peoples’ needs prior to admission had been introduced, the Care and Health Assessment Profile form was a 48 page document which enabled a very wide-ranging assessment to be carried out of peoples’ individual needs, abilities and preferences. The assessment routinely considered peoples’ capacity and consent issues. The records seen showed initial assessments had been completed. Staff spoken with said they had been involved with the assessing people and that outcomes of assessments were being discussed with them, for example, the catering team were made aware of dietary needs. People were being encouraged to visit the home to see the accommodation available and meet with current residents and staff. The manager said they could stay for a day or half a day depending what was best for them, they may encouraged to join in an activity or stay for a meal. Trial periods were being offered. The home had written guidelines for staff to support the admission process; a checklist was being used for practical matters, such as getting the room ready, checking the bed and welcoming people on their day of arrival. At the time of this inspection Springfield did not provide intermediate care. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 12 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care practices and procedures, were effective in ensuring people’s individual needs are sensitively responded to. EVIDENCE: Residents spoken with were satisfied with care and attention they received at Springfield. This response was also reflected within surveys completed by residents, which indicated they usually or always, get the care and support they need. One comment was, “They look after me well” There had been significant improvements in promoting a person centred approach at the home, this meant peoples’ individual preferences about their care and lifestyle was more central to way support was provided. Staff were being given training in this approach, in particular ensuring it is reflected within individual care plans. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 13 The care plans looked at as part of ‘case tracking’, provided detailed instructions for staff to follow, in response to peoples’ individual needs, wishes The plans were sensitively written and very person centred. They included peoples’ capacity to make their own choices and decisions and efforts had been made to involve the residents and/or their families in putting together their care plans. Two of the people spoken with expressed an awareness of their care plan, one said, “Oh yes, I was fully involved, I have signed in agreement with it” Records showed that peoples care needs and progress were being monitored and evaluated with care plans being updated in response to changes. Staff spoke with said there had been an in improvement in care planning at Springfield. Residents completing surveys indicated they always or usually receive the medical support needed. Health care needs were included with care plans; specific risk assessments had been completed, for example in relation to pressure areas, moving and handling, falls, nutrition, depression and behaviours. Care plans seen, included detailed instructions to minimise the level of identified risk. Records and discussion showed people were getting attention as appropriate, from healthcare professionals such as GPs, District Nurses, Dieticians and Chiropodists. Medication practices had improved, for example, temporary arrangements had been to ensure medication is stored at an appropriate temperature until the matter was fully resolved. Medication storage seen was mostly safe and secure, however, it was recommended further safeguards be introduced for items to be destroyed, we have since received confirmation this matter has been addressed. Medication policies and procedures were available. People managing their own medication had been assessed for competence and safety. Self administration was discussed with the acting manger and it was suggested, further attention could be given to considering each persons ability and involvement with this aspect of their care and support. The medication records looked at appeared clear and accurate, however, when care staff applied topical creams, they were not always signing in confirmation of this, with the Nurse on duty completing records on their behalf. This meant it was not a credible record; the acting manager agreed to address this matter. Records showed medication and practices were being checked weekly, also, that medication management training was ongoing. The acting manager had received training in measuring and improving peoples’ individual well being (Dementia Care Mapping), this had helped make sure people were valued and respected. The residents spoken with did not express any concerns about how they were treated. Residents indicated in surveys, that staff always listen to them and act upon what they say. Observations of care practices during the inspection showed peoples’ privacy needs were being respected; staff spoke with residents in a courteous manner. People were being supported to maintain their appearance, a hairdresser made regular Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 14 visits to the home. One person spoken with considered they were “Very well respected” at the home and said, “The principles of care are here”. The AQAA (Annual Quality Assurance Assessment) completed by the acting manager, showed plans for improvement as – continued progress in promoting person centred care, medication reviews and support groups with residents and relatives. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 15 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14 and 15 People using the 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 living at Springfield Care Home, had opportunities to make choices and had lifestyles that generally matched their expectations. EVIDENCE: The residents spoken with indicated they were generally happy living at the home, comments made were, “I think I have settled in well, I am enjoying my stay” and “Things are fine at the moment, really good”. Residents completing surveys indicated there were usually or sometimes activities they could join in with, however, the AQAA (Annual Quality Assurance Assessment) showed the activities programme was to be further developed in response to peoples’ choices and preferences. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 16 People’s individual social needs, interests and hobbies were being more effectively included in the care planning process; this meant progress had been made in engaging people in meaningful activities and promoting independence and choices. A full time activities coordinator was employed at the home; however, the acting manager explained that all staff, including night staff, were being encouraged to arrange planned and unplanned activities. The notice board in entrance hallway showed forthcoming activities, including themed events, film nights and quizzes; monthly trips to Blackpool were being arranged. Some people played dominoes during the inspection visit; others were pursuing their own interests such as reading, gardening or listening to music. One staff member said, “We have enough staff now to do activities”. The rear enclosed garden was being used as an extension to the ground floor accommodation; pet rabbits and other activities were due to be introduced. Plans were also being made to further develop the grounds for better access. Some lounges had ‘rummage boxes’ containing various items, including magazines, knitting, hand bags, reading books, colouring books to encourage discussion and unplanned activities. Routines seemed flexible, it was apparent people could spend time in their rooms whenever they wished and could make use of other areas of the home. The acting manager and staff, explained how work routines, such as assisting people to get up the mornings had been changed to respond to individual needs and choices. People had been enabled to personalise their bedrooms with their own belongs, including furniture, which had helped create a sense of home and ownership. Regular residents meetings were being held, which enabled people to be involved in group decisions and making suggestions. The visiting arrangements were included in the homes’ guide; the residents spoken with mentioned the contact they were having with families and friends. Spiritual and cultural needs and preferences were included in care plans, arrangements were being made for religious observance. People spoken with were generally satisfied with the food provided the home, this response was also reflected in surveys. A more flexible approach had been introduced to meals and mealtimes, “We fit into their routines” explained the acting manager, meals could be served in peoples rooms and at different times. Choices were offered at each meal and alternatives were routinely available, arrangements were also in place to cater for any last minute changes. The Chef said he was made aware of peoples’ specific likes and dislikes and any dietary and cultural needs, also that people would be asked about favourite meals which if possible, would be included in menu planning. Since the last inspection visit, the kitchen had been refitted and new equipment obtained. Meal time practices were observed, tables were attractively set, staff were sensitive when serving meals, choices were offered and satisfaction sought about the meals genuine manner. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Policies, procedures and practices supported the complaints process and provided safeguards for people living at Springfield. EVIDENCE: All the residents completing surveys indicated they were aware of how to make a complaint, none of those spoken with expressed any concerns about the care and practices at the home. “They always sort things out”, was one comment made. The complaints procedure included suitable information; it was displayed in the home and included in the homes guide, it stated, “No matter how small a complaint we need to be aware of it”. The procedure was available in different languages and an audio version had been produced. It was suggested, consideration could be given to producing a procedure which may be more accessible to people with dementia. All staff completing surveys indicated they were aware of how to respond to concerns made by residents and others. Several staff had received customer care training, the AQAA (Annual Quality Assurance Assessment) showed this was to be provided for all staff. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 18 There had been three complaints since the last inspection either to the Commission or directly to the home. Records showed the concerns raised had been investigated, with any necessary action taken to resolve the complaints. The management of complaints was discussed with the acting manager who explained; the aim was to resolve issues “as quickly as possible”. Advice was offered in relation to devising investigation strategies to promote an objective and considered approach; the acting manager took action to respond to this suggestion during the inspection. New staff received safeguarding training during their initial induction. The Annual Quality Assurance Assessment (AQAA) showed that staff had received refresher training and that this was to be ongoing. The acting manager and staff spoken with expressed a good understanding of the action to be taken to protect people at the home. They were also aware of the whistle blowing policy and how to report bad practice to other agencies, if necessary. Protection of vulnerable adults polices and procedures were available, they included relevant information and guidance, for example, definitions, indicators and detection of abuse. The local authorities safeguarding information file was seen to be available, this contained localised reporting procedures and forms for making alerts. In order to fully safeguard people using the service, policies and procedure had been introduced, providing guidance on how and when to take further action with regard to unexplained injuries and bruising, also, peoples’ individual capacity to make decisions and give consent, was being more appropriately addressed within their care plans. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 19 and 26 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Springfield Care Home provided people with a comfortable and clean place to live; improvements to the home were ongoing and needed to continue for the benefit and well being of the residents. EVIDENCE: Since the last inspection, significant improvements had been made to some accommodation and facilities at the home. The whole building was currently being refurbished. So far, the kitchen had been completely refurbished and new equipment provided. The large area on the ceiling of the stairwell between Levels 1 and 2 had been repaired and repainted. Level 3, which was previously not in use, had been completely upgraded to a very high standard, there were Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 20 new furnishings, carpets, furniture and a new call system had been fitted. Residents spoken with explained that they had been able to choose their new bedrooms and were looking forward to moving up to this part of the home. It was noted bedroom doors were yet to be fitted with suitable locks, the acting manager said this matter was in hand. Progress was also being made in other parts of the home, for example, some areas on levels 1 and 2 were being decorated, new wash basins had been provided in some bedrooms, a ‘nurses station’ had been removed to make an additional sitting area for people living at the home. One dining room had been redecorated and new dining furniture ordered, improvements had also been made to the kitchenette facilities, new fridges were being obtained. Previous inspections have shown that progress in improving the home has been slow, and there was still a lot of work to be done to ensure all of the accommodation is of a good standard. However, records were available to show plans and timescales for the programme of refurbishment, which appeared to be on schedule and indicated completion by the end of the year. Garden areas were also to be developed and improved, to enable better access for the residents. The residents spoken with were satisfied with the accommodation, they had been enabled to personalise their bedrooms with their own belongings, which helped create a sense of home and ownership. The acting manager expressed a sensitive approach to providing a pleasant and interesting environment for people living at the home; she explained that careful consideration was being given to suitability of colour schemes and providing décor which reflected the individual personalities, interests and backgrounds of the people accommodated. The laundry facilities were not seen during this inspection visit, however, previous inspections have shown satisfactory equipment and facilities are provided. The home employs three people specifically to manage the laundry; some steps had been taken to improve the process. The home was found to be clean and mostly free from offensive odours. The residents completing surveys indicated the home was always fresh and clean, one person wrote, “My room is cleaned every day, and I am quite satisfied with the cleanliness of my en-suite room”. Staff had access to infection control procedures and protective clothing. There were two full time domestic staff and a relief cleaner; the acting manager said additional staff were to be recruited when the other areas of the home were re-opened. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 People using the 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 staffing arrangements aimed to provide people using the service with effective and consistent support. EVIDENCE: The residents spoken with made very positive comments about the staff at Springfield, they said, “The staff are very helpful,” - “The staff are alright” – “The staff are quite nice, but always busy”. Most residents completing surveys considered there were usually enough staff available. Staff completing surveys and those spoken with indicated there were enough staff on duty to meet peoples’ individual needs; one comment made was; “Now we have enough staff to meet the needs of service users” another staff member spoken with said, “Staffing levels have much improved”. Staff rotas indicated satisfactory staffing levels were in place, the acting manager said, staff had been advised to let management know if staffing levels need increasing to meet the residents’ needs. There sufficient ancillary and administrative staff and arrangements were being made to recruit a deputy manager. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 22 According to information contained in the AQAA (Annual Quality Assurance Assessment) and discussion with the acting manger, improvements had been made to reduce the usage of agency staff and this was to continue. The acting manager said it was part of interview process to ensure applicants’ had the necessary skills and attitude to work with people with dementia, as well as a passion for providing good quality care. The staff recruitment records seen showed most checks had been appropriately carried out for the protection of people living at the home. However, the application form only requested a ten year employment history therefore; peoples’ full work backgrounds had not always been considered and any gaps explored. Details had not been requested about applicants’ general education, which implied this had not been fully considered either. It was also suggested the application form include some guidance on suitable referees. The acting manager took appropriate action to address these matters during the inspection. Records and discussion showed new staff were being given initial induction training, which included an introduction to the organisation, orientation of the building, emergency procedures and company policies. Staff without qualifications in care then completed a detailed induction training programme, which involved being mentored by senior or more experience staff. Staff training and development was being given priority at Springfield, records and discussion showed, there was a rolling programme of ongoing training and updates on courses such as first aid, health and safety, moving and handling infection control, person centred care and fire safety had been completed and arranged. Staff completing surveys and those spoken with during the inspection visit confirmed appropriate training was being provided. Progress had been made in ensuring more care staff had NVQ (National Vocational Qualifications) in care, more than half the cares had attained NVQ level 2 and four staff had commenced this training. The AQAA showed that staff recruitment and retention, training and development were matters for ongoing improvement at the home. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Effective leadership and good management practices need to continue, for the benefit and well being of the people living at Springfield Nursing and Residential Home. EVIDENCE: Previous inspections have shown; there has been inconsistent performance at Springfield Nursing and Residential Home, which resulted in lack of sustained good practice. This inspection showed much progress in the general management of the home for the direct benefit of people using the service, including developing a more person centred approach to care and support and Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 24 addressing the previously made requirements and recommendations. AQAA (Annual Quality Assurance Assessment) showed the home was aiming to continue building a strong management team and become a centre of excellence for dementia care. The acting manager had many years experience of working with older people and several relevant qualifications. This inspection visit showed she was enthusiastic, proactive and competent within her role. People using the service and staff made positive comments about the conduct and ability of the manager. One resident described her as “Very helpful”, a staff member said, “I would recommend her to anyone”. Another commented in a survey, the new manager is working hard to improve our home, she is there for us, she is the best one. At the time of the inspection visit; the acting manager had not applied for registration with the Care Quality Commission, but had commenced this process. Discussion took place with the acting manager, about ensuring suitable management and leadership arrangements are in place when she is absent from the home. Various systems had been introduced to monitor practices and plan for improvements, for example various audits were being carried out and action taken in response to findings. Quality assurance meetings were being held with representatives of the various staff groups, for example, carers and catering, one resident explained how they were due to attend the next meeting. Consultation surveys had been given to residents in October 2008, the results had been collated, and an action plan had been produced this was discussed with the staff team. A suggestion box had been provided to enable people to make comments about the service. Discussion took place with the acting manager on effectively using the AQAA for the quality assurance system; in particular, including as evidence, the results of consultation surveys. Accountable systems were in place for the safe keeping of residents’ monies. The acting explained there were some limitations to accessing money to promote good security; it was therefore advised this stipulation be included in the service user guide. As indicated previously, arrangements were in place to for staff to receive training in safe working practices, various health and safety policies and information was available for staff reference. The AQAA showed the ongoing servicing and checking of equipment and installations. Fire safety risk assessments were said to have been completed and the maintenance person was checking electrical appliances when people moved into the home. Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 25 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 4 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 4 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 4 3 X 3 X X 3 Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 26 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP19 Good Practice Recommendations To ensure people living in the home have a comfortable and pleasant environment, the programme of refurbishment and redecoration must continue throughout the building. To assist with recruitment practices for the protection of the residents, the application form should request full employment histories, education histories (including dates) and information about referees. So there is someone to take legal responsibility for the day to day running of the home, the acting manager should submit an application for registration to the Commission as soon as practicable. 2. OP29 3. OP31 Springfield Nursing & Residential Home DS0000022482.V375416.R01.S.doc Version 5.2 Page 27 Care Quality Commission North West Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 616161 Email: enquiries.northwest@cqc.org.uk Web: www.cqc.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. Copyright © (2009) Care Quality Commission (CQC). 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. 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