Inspection on 27/05/05 for Palm Court Nursing Home

This inspection was carried out on 27th May 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Palm Court Nursing Home 01/04/08

Palm Court Nursing Home 05/10/07

Palm Court Nursing Home 01/06/07

Palm Court Nursing Home 24/04/06

Palm Court Nursing Home 03/10/05

Palm Court Nursing Home 26/11/04

Similar services:

Wingham Court

Old Hastings House

The Shelley

Springfield House

Sutton Lodge Nursing Home

St Helier`s Residential Hotel

St Joseph`s

Ridgemount

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Springfield 17-19 Prideaux Road Eastbourne East Sussex BN21 2ND Lead Inspector Debbie Calveley Unannounced 27 May 2005 07:00 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 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 3 SERVICE INFORMATION Name of service Springfield Address 17 - 19 Prideaux Road Eastbourne East Sussex BN21 2ND 01323 722052 01323 722052 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) DFB (Care) Ltd Care home with nursing 30 Category(ies) of Dementia - over 65 years of age (DE(E)) 30 registration, with number of places Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum number of service users to be accommodated at any one time should not exceed thirty (30). 2. Service users to be aged sixty-five (65) years or over on admission. 3. Service users to have a dementia type illness. Date of last inspection 26 November 2004 Brief Description of the Service: Springfield is registered as a care home providing nursing care for thirty service users with dementia and physical disability over the age of 65 years old. The accomodation includes with ten single rooms, four with ensuite facilities and ten double rooms, three with ensuite facilities. However they have changed three of the double rooms to single so the amount of service users taken at any one time is twenty-six. On the day of inspection, twenty-five service users were in residence, with one vacancy. The home comprises of two houses joined by a link way and each has its own staff allocation and service users. The kitchen is centralised and serves both groups and there is a large lounge area for both houses either side of the kitchen. Each house has its own laundry and this prevents any confusion over the clothing. There are adequate bathing facilities for the service users. There is one clinical room and once again this is central to both houses. The home has a passenger lift and stair lift which provides access to all areas of the home. There is a large garden area that is well maintained and consists of mostly lawn and is assessable to wheel chair users. There is no car park but unrestricted parking is allowed in Prideaux Road. There is a bus route nearby and the home is approximately 15 minutes from the town centre. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced inspection took place on the 27 May 2005 from 0700 am until 2pm. Two inspectors inspected the home and conducted informal interviews with five service users, four relatives and four members of day staff and one member of night staff. The inspection process consisted of a tour of the building, inspection of documentation and records and looked at the delivery of care for eight service users. Since the last inspection in November 2004, there have been concerns regarding the standard of care, recruitment process and staffing levels in Springfield and there have been meetings to discuss the concerns with the Registered Providers. Monitoring visits have been undertaken on a regular basis with action plans and correspondence regarding training and staffing received from the Registered Provider on a regular basis. What the service does well: What has improved since the last inspection? What they could do better: Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 6 Care plans, records and risk assessments need to have more detail and outline clear support and risk management guidelines. That they are kept up to date in respect of wound care, nutrition and continence management. The recruitment process needs to be more robust to ensure the suitability of the staff employed. Staff need to attend training in moving and handling, fire safety and infection control to ensure the health, safety and well being of the service users. The medication procedures within the home need to be followed to ensure safety of all service users. Staffing levels need to be assessed against the specific needs of the service users. There needs to be evidence of choice and flexibility to residents lifestyle experienced in the home. Dedicated staff member to organise appropriate activities, and advice sought re stimulation for the withdrawn and frail service users. Staff roles should be clear, with dedicated time for tasks that do not affect the supervision and safety of service users. A number of health and safety matters need to be addressed; including that call bells are accessible in all rooms, that fire doors are not propped open and that all bedrails are safely in place. The maintenance of the building needs to improve. Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 7 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 Standards Statutory Requirements Identified During the Inspection Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 8 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 1, 2 & 3. The homes statement of purpose and service users guide provide service users/representative and prospective service users/representative with details of the services the home provides enabling them to make an informed decision about admission to the home. Service users receive a written contract/statement of terms and conditions on admission to the home confirming the services agreed. EVIDENCE: The service users guide and the statement of purpose were both updated in November 2004. They are written in a user friendly format and are available to all service users, families and to prospective service users and include information about life in the home, accommodation, staff and facilities available at Springfield. All service users receive a comprehensive written contract/statement of terms and conditions on admission to the home. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 9 Two new service users had, had a pre-admission assessment completed before admission, however the document was not fully completed, signed and dated. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 10 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7, 8 & 9. There is no clear or consistent care planning system in place to adequately provide staff with information they need to satisfactorily meet service users needs. It is not possible to evidence that the health needs of service users are met. The home has failed to improve their procedures for the storing, administration and recording of medication thus placing service users at risk and harm. EVIDENCE: The care plans of eight service users were viewed and whilst have improved in the formation, still lack information regarding action the staff need to follow in key areas. e.g nutrition and feeding, wound care, communication and continence. It was not evident from the documentation available whether all the health needs of the service users were being met. Two service users wound care charts were viewed and the information was poor with no clear recording that the wounds were redressed and at what Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 11 stage the wounds were following treatment. This does not enable staff to track the healing process and request specialist input, if and when required. On five care plans there was no plan found as to how staff could communicate with the service user and how to interpret certain behaviour patterns which may indicate pain, enjoyment, sadness or fear. Fluid charts of two heavily dependent service users had not been completed between the hours of 8pm and 7am, and 8pm and 10 am, on 26/05/05 and 27/05/05 respectively. Two relatives said that they had not been consulted or involved in the care plan process. There are no service users in Springfield that self medicate their medication. There are policies and procedures in the home for the receipt, recording, storage, handling administration and disposal of medicines. However poor practice was observed during the inspection concerning the administration of medicine and was considered unsafe practice. A carer was asked to give an unknown tablet to a service user. Records in the medication administration record charts were on several occasions incomplete. There were gaps for when a medication was missing in the blister pack and presumably administered. The midday medication round was completed without the medication administration chart leaving the clinical room. Medication for a service user was still in the fridge nine days following his death, and 3 bottles of eye drops were found without an opening date, one was out of date by one month. The medication box, which is stored in the domestic fridge in the kitchen was found unlocked. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 12 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12, 13, 14 & 15. The arrangements for leisure and social activities inside and outside of Springfield provide limited opportunity for mental or physical stimulation. Service users are not enabled to exercise choice and control over their lives. The meals are good but currently offer limited choice and variety. EVIDENCE: On arrival at 7 am in the lounge area of house 19, there were five service users out of thirteen already up, washed and dressed, of those five one was seen to be fast asleep, one was restricted by a lap tray and was trying to get up. The night staff were seen to be getting other service users up and bringing them to the lounge area for breakfast. On talking to three service users at this time, it was not evident that they had been offered a choice of either getting up or staying in bed. The care plans of these service users did not include any information regarding choice of daily routine. At approximately 720 am, in the lounge area of house 17, eight out of twelve service users were up, washed and dressed. Not all service users were able to converse with the inspector, therefore it was not possible to establish if this was their choice or the routine of the home. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 13 Breakfast was served at 8am, and by this time all but six service users were downstairs in the lounge areas. All but one service user in the lounge areas received porridge with sugar, this could be their choice, but they were not offered the choice of an alternative at serving time, and the records did not indicate their preference. One service user was dressed and then was found in bed asleep at 0930 hrs, staff were not sure why. The morning routine seen at Springfield for those service users in the lounge areas did not offer any choice and little staff supervision or interaction was observed. None of the service users have access to drinks to encourage any independence or choice and receive drinks only at specific times, e.g morning coffee. This was discussed with senior staff at the time. No activities took place during this unannounced inspection. Two service users said that they were bored and were irritated by other service users. Service users in their rooms also had little or no positive stimulation or interaction during the morning. It is difficult to ascertain whether service users are helped to exercise choice and control over their lives. The documentation is insufficient at this time to evidence that service users are consulted about how they spend their time, of what they eat and of when they go to bed and get up. There is little documentation to support that relatives are consulted and this is an area which needs to be addressed. One service user who remains in bed said it is her choice, but feels that sometimes she is forgotten. One service user said she “hated the new carpet as it was too busy and made her feel dizzy”, “and if she had been asked she would have told them”. She also said that they always” sat her in a chair by the door, but she didn’t like that chair because of the constant in and out of people”. It was requested that she moved to a different area where she was more comfortable. There is “open” visiting, and three relatives were seen visiting and were complimentary about the home. One visitor remarked that she felt welcomed in to the home and that staff always asked how she was and were cheerful and caring. Two family members of a resident expressed that they could visit any time and were always welcomed in to the home. Menus were viewed and were seen to offer some choice and variety of wholesome food. The meals observed were breakfast and the midday meal. The breakfast was served at 8am and the porridge in house 17 was only vaguely warm and two service users exclaimed “it’s cold” the porridge was then reheated. Two service users stated “porridge again” it seems to be a routine rather than choice. The service users in house 19 also had mainly porridge. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 14 The midday meal was fish pie or fish and chips and a pureed version of the meal, followed by rhubarb crumble. The choice offered was just fish. The food seen was attractively presented. Due to the high number of service users requiring assistance food was served and then as staff were not ready had to go back to the kitchen to be kept warm. A food diary has been commenced, but does not always reflect individual choices and amounts taken at all times. The kitchen area was clean and functional and the cupboards contained a few tins of beans and spaghetti and bread, the fridge had milk, eggs and yogurts. There was no evidence of snacks or fresh fruit being assessable to the service users so that they can help themselves during the day to promote their independence. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 15 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 & 18. Policies and procedures are in place for dealing with complaints which are assessable to service users and their representatives. Arrangements for protecting service users are not satisfactory at this time, placing them at possible risk or abuse. EVIDENCE: A policy and procedure is in place for dealing with complaints and this is also outlined in the statement of purpose and service users guide. The manager is aware of the timescales set down for dealing with complaints and a complaints register is available. There have been no formal complaints made since the last inspection. The home have shared with the CSCI some positive complimentary letters regarding the home from representatives of service users. There is evidence of training sessions in respect of the prevention of abuse, and this training will be on-going for all staff. Practice seen during the inspection indicated that further training needs to be scheduled to cover certain areas of staff awareness in regard to POVA, use of inappropriate verbal exchange, use of restraint and inappropriate moving and handling techniques. During the inspection an exchange was heard in a toilet between a service user and staff member, which was undignified and non-respectful. A service user suffered a fall at 0715 am and when called staff lifted her under her arms from the floor and then put her in a chair that a staff member said “ that she wouldn’t get out of”. It was requested that she was moved to a more appropriate chair. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 16 Omissions in the recruitment process also indicate that service users are not protected from abuse. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 17 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 23, 24, 25 & 26. The homes environment needs on going maintenance and renewel in order to create a warm, safe and welcoming environment. Service users bedrooms are functional rather than homely. EVIDENCE: The environment of Springfield has undergone some improvement, the lounge areas of both houses have been redecorated and have new carpets and present as clean and welcoming. There are a number of chairs that need to be replaced or repaired as they are damaged and torn. This is an infection control and health and safety matter. There are well-tended garden areas to the rear of the building that are assessable to all the service users. There were a number of maintenance issues that need attention, and mostly concern the communal bathrooms. The ground floor bathroom has a hanging Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 18 shower facility, which contravenes the legionella guidelines, the floor is uneven and could cause a trip or spill and there is evidence of rust and peeling on equipment in the bath. The sliding door of a communal toilet is also poorly hung. An upstairs bathroom has a broken bath panel, which was also damp. The bathroom facilities need attention to ensure safety and adequate infection control prevention. Bedrooms are functional rather than homely though some rooms do have personal items of service users. Again some furniture needs to be repaired or replaced. Not all rooms have the recommended furniture e.g bedside tables with lamps, a table to sit at, and two comfortable chairs and a lockable facility. If theses items are deemed unsuitable or not required it needs to be appropriately documented and included in the written contract of that individual service user. Call bell facilities are in place, though not always assessable to service users, the lounge areas need a facility that the service users can reach. One service user in house 17 lounge said she was uncomfortable and when asked how she asked staff for help, she said she waited until a nurse was nearby then called out. She had no knowledge of the call bell facility. Another service user new to the home joined in this conversation and confirmed that she did not know where the bell was. It is acknowledged that not all service users will be able to use a call bell, so there is an identified need for individual risk assessments concerning call bells. There are hoists and other equipment in the home to cope with the needs of the service users, there are still divan beds in use, and some bedrails were found loose and ill fitting, one in particular was brought to the attention of the senior nurse on duty, as it posed a heath and safety risk for the service user. Random water temperatures were tested and were found to be between 40°C and 47°C, the temperatures need to be tested and adjusted accordingly. The temperature of the home was suitable for the time of year and was comfortable. The home was adequately clean in the communal areas of the home, there was a malodorous smell in three of the bedrooms which was reported to the senior nurse. The sluice area on floor one, in house 19 is still being used as a storage area for hairdressing equipment, hoovers and other miscellaneous items, which is a fire and infection hazard. The sluice area on the ground floor in house 17, has a broken sliding door, which needs to be repaired. The laundry area in house 17 was found to be below the expected level of cleanliness and was also found with fire doors tied and wedged open. It was left as an Immediate Requirement that the directives from the fire service are followed concerning the use of wedges and ties. The laundry in house 19 was clean and organised but the laundry bin lids were broken and dirty. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 19 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27, 29 & 30. The staffing levels are insufficient to meet the complex needs of the service users. EVIDENCE: There were three members of night staff on duty, one trained nurse and two carers. One carer said she had washed dressed and then taken to the lounge eight service users by 730 am. She said that when she needed help she asked the other carer. The service users all need a high level of input from staff due to their physical and mental needs. This also meant that service users already in the lounges are unsupervised and as observed on the morning of the inspection, service users are at risk from falls. There was also a concern that the staff are inappropriately moving and handling service users by themselves when transferring service users to chairs and wheelchairs, due to insufficient staff. Another concern was that insufficient time was being given to personal care. Three service users were being treated for eye infections and crusting was still around their eyes, some were dressed in torn clothing, which was noticed by a day carer who changed the items. Some were without stockings or shoes and two had their leg dressings hanging off. One was dressed in soiled clothes, again noted by a day member of staff later on in the day. One member of night staff said “it was very busy and they tried very hard to get the work done”. Consequently there were found to be insufficient staff on duty during the night shift. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 20 The day staff comprises of one trained nurse and four carers and a fifth carer has been employed to assist across both houses. From observation of practice during the inspection this is still insufficient staff to ensure that service users are adequately supervised and stimulated. The meal times are a struggle as so many of the twenty-five service users need assistance. A staff member said “staff too busy in the mornings, they rush, not sure why certain tasks have to be done by a certain time” feels that “service users are rushed with their food, possibly do not always have time to give all the food they should”. The midday meal when served did go back to the kitchen a couple of times as staff were not ready to continue with feeding other service users. This is a time of day that would benefit from additional staffing. The recruitment process generated real concerns about how the home ensured that service users were only supported by staff who had been appropriately vetted. The recruitment files of four new staff members were viewed and significant gaps in documentation were found throughout. Of particular concern was the lack of current mandatory checks from the Criminal Records Bureau. In addition these files did not contain two written references and photographs and an issue with suitable work permits was also identified. it was requested that these staff do not work unsupervised until all the necessary checks are done. A training programme for staff has been commenced and there was evidence of training in dementia, which 13 staff members attended, tissue viability and food and hygiene. The records for moving and handling and fire safety need to be updated as most of the staff listed have left. The manager/provider is proactive with ensuring that all staff receive the opportunity for training pertinent to their jobs, however all staff including the night staff need to also attend. One member of night staff said that she had not received training in moving and handling, fire safety or infection control. Staff need to be appropriately trained to competently perform their job. There is now a more stable work force. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 21 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The health, safety, and welfare of service users at the present time are not adequately promoted and protected. EVIDENCE: The accident book was viewed and was correctly completed. Throughout the inspection, a number of issues regarding health and safety and fire safety were identified and need addressing. • • • • • • Fire doors propped or tied open. Wheelchairs being used without the appropriate foot rests. Gaps between the bedrails and bed head. Inaccessible call bells. Poor practice observed of lifting service user off the floor following a fall. Hanging showerheads in relation to a risk of legionella. H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 22 Springfield • • • • • • • Health and safety poster in the laundry area incorrect in regards to staff named as representative. Variable water temperatures found in bedrooms, between 40°c-47°c Lack of qualified first aiders in the home and first aid boxes. No water in room 7 house 17. Back doors found open and entry to maintenance room unsecure. A fire extinguishers found in service users’ room was free standing. Wheelchairs were being used without footrests. Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 23 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. Where there is no score against a standard it has not been looked at during this inspection. 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 3 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 1 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 1 13 3 14 2 15 2 COMPLAINTS AND PROTECTION 2 2 2 x 2 2 2 2 STAFFING Standard No Score 27 1 28 x 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 1 x x x x x x x 2 Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 24 yes Are there any outstanding requirements from the last inspection? 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. 1. Standard 7 Regulation 15 (1) (2) 12 (1) (a) (b) Requirement That the care plans accurately reflect the needs of the service users and are updated on a regular basis. That service users and/or their representatives are consulted regarding the formation of the care plans.(Previous timescale of 26/11/04 not met.) That records pertaining to nutrition, wound care, continence and communication are developed and accurately reflect the service users needs.(Previous timescale of 26/11/04 That an activity programme be developed and that facilities are provided for recreation and fitness.(Previous timescale of 31/01/05 not met.) Medicines to be disposed off when expired ensuring appropriate records are kept. Medication administration record charts must reflect current medication profile and must be a true and accurate record. That policies and procedures are followed in the administration of medication as set by the Timescale for action 31 July 2005 2. 8 14 (1) (a) 2 (a) (b) 13 (1) (b) 12 (1) 16 ((1) (2) 16 (1) (2) (n) 31 July 2005 3. 8 & 12 31 July 2005 4. 5. 9 9 13 (2) 13 (2) 27 May 2005 27 May 2005 27 May 2005 Page 25 6. 9 13 (2) Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 7. 8. 9 9 9. 14 10. 15 11. 18 12. 18 13. 20 14. 15. 22 24 NMC.(Previous timescale of 26/11/04 not met) 13 (2) That all medicines kept in a domestic fridge are stored in a locked box. 13 (2) That medicines belonging to a service user who has died are removed from use and appropriately stored for seven days and then disposed of. 12 (2) (3) That all service users are enabled to make choices and exercise their personal autonomy within a structured risk assessment framework. ( Previous timescale of 26/11/04 not met.) 16 (2) That there is sufficient staff to (i)12 (1) assist the service users in eating (2) (3) their meal.(Previous timescale of 26/11/04 not met) 12 (1) (a) If a method of restraint is used(5) (a) 13 it is a requirement; (7) (8) That it is to be discussed in full with families, the G.P, and with the placement authority and recorded. That it is appropriately risk assessed and only used to ensure the safety and welfare of the service user and not for the convenience of staff.( Previous timescale of 26/11/04 not met.) 13 (6) That all staff receive training in the prevention of abuse, and are aware of the multi-discilpinary guidelines and the different categories of abuse. 16 (1) (2) That furnishnings are of a good ( c) quality and repair and suitable for the needs of the service users. 13 (4) ( c) That call bells are assessible in 23 (2) (n) all areas. 23 (2) (e) That furnishnings provided in bedrooms are as per standard 24.2, unless otherwise agreed. H59-H10 S59836 Springfield V217881 270505 Stage 4.doc 27 May 2005 27/ May 2005 31 July 2005 27 May 2005 27 may 2005 31 July 2005 31 July 2005 27 may 2005 31 July 2005 Springfield Version 1.20 Page 26 16. 24 16 ( c) 17. 18. 25 25 23 (2) (p) That appropriate height adjustable beds are provided for those receiving nursing care.( Previous timescale of 31/03/05 not met) That bedside lighting is provided. 30 September 2005 31 July 2005 27 may 2005 27 may 2005 27 May 2005 19. 20. 26 27 21. 29 22. 23. 30 38 24. 38 25. 26. 27. 38 38 38 13 (30 (4) That hot water is delivered close (a) (c) to 43 ° c, and that the guidelines are followed for the prevention of legionella. 16 (1) (2) That the is clean, hygenic and (j) (k) free from offensive odours. 18 (1) (a) That staffing levels are appropriate to the assessed needs of the service users, the size, layout, and purpose of the home at all times. Schedule That two written references are 2. received before commencement Regulation of employment. That gaps in 7,9,19 (1) the employment history are (a) (b) (c) explored and work permits are in place. That a criminal record check and POVA check is applied for and received before confirmation of post.(Previous timescale of 26/11/04 not met) 18 (1) (2) That all staff receive appropriate (a) (c) (i) supervision and training and there are clear records kept 13 (2) That the mandatory training (3)16 (2) records of all staff now employed (j) in the home are available for inspection and up to date. 23 (4) That the practice of propping open doors ceases in line with the latest guidence from the fire service. 23 (2) (4) That footrests are in place on wheelchairs when in use to prevent injury to service users. 12 (1) (a) That all bedrails in use are appropriately fixed to prevent injury. 13 (5) That a suitable arrangements are in place to provide a safe system H59-H10 S59836 Springfield V217881 270505 Stage 4.doc 27 may 2005 31 July 2005 31 July 2005 27 May 2005 27 May 2005 27 May 2005 27 May 2005 Page 27 Springfield Version 1.20 28. 29. 30. 38 38 38 31. 38 for moving and handling service users. 23(4) (1v) That all fire extinguishers are appropriately stored. 13 (4) (a) That the security of the home is (b) (c) reviewed to ensure the safety of the service users. 13 (4) That there are trained first aiders in the home and an adequate number of first aid boxes assessible. 13 (4) That health and Safety posters are correctly completed. 27 May 2005 27 May 2005 31 July 2005 27 may 2005 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 Good Practice Recommendations Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 28 Commission for Social Care Inspection Ivy House, 3 Ivy Terrace Eastbourne East Sussex BN21 4QT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Springfield H59-H10 S59836 Springfield V217881 270505 Stage 4.doc Version 1.20 Page 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!