CARE HOMES FOR OLDER PEOPLE
Southfield House Woolram Wygate Spalding Lincolnshire PE11 1PB Lead Inspector
Julie Western Unannounced Inspection 5th January 2006 09:30 X10015.doc Version 1.40 Page 1 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 Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 2 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. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Southfield House Address Woolram Wygate Spalding Lincolnshire PE11 1PB 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) 01775 724612 The Orders Of St John Care Trust Mrs Dawn Louth Care Home 32 Category(ies) of Dementia (2), Old age, not falling within any registration, with number other category (30) of places Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 20th September 2005 Brief Description of the Service: Southfield House is a purpose built care home, formerly owned by the local Authority and now owned by the Orders of St. John Care Trust, who manage a group of 16 homes across the county. The home provides care and accommodation for up to 32 people over 65 years, including two service users with a dementia, for personal care only. Accommodation is situated on the ground floor except for one room on the first floor. There are four lounges and a spacious dining room, with a separate room designated for smoking. The home is situated in a quiet residential area a mile from the centre of Spalding, which has a good range of shops and facilities. It is situated in its own grounds and includes a large garden laid to lawn and flower-beds, with seating and a patio area for residents to sit out in good weather. There is parking to the front and the side of the Home. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 3 hours. A partial tour of the building took place and care records were inspected. The main method of inspection used was called ‘case-tracking’; this involved selecting three residents and tracking the care they received through the checking of their records, discussions with residents and care staff and observation of practices. Some policies and procedures were examined and records concerning the safety of the home were also seen. Three of the 29 current residents, four staff and two visitors were spoken with. The Manager was not present for the inspection, which was conducted with the assistance of the Care Leader on duty. What the service does well: What has improved since the last inspection?
Recent improvements to the home have included the complete refurbishment of one bedroom and the creation of an extra patio area by removing a fishpond and gravelling the area. The home now has an activities co-ordinator for 10 hours weekly and the activities programme has benefited from this. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 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 Outcomes Statutory Requirements Identified During the Inspection Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 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 the following standard(s): 1-5 The home clearly sets out what it intends to do for its residents and this information is freely available to residents. Prospective residents are encouraged to take time before making the decision to move into the home on a permanent basis. EVIDENCE: The statement of purpose was very comprehensive; it took the form of a folder with inserts. The Manager said a copy was given to all residents on admission, together with a copy of the service user guide, which was called the Residents’ Handbook and a copy of the latest Orders of St. John Care Trust quarterly magazine. Assessments were made by the Manager or a Care Leader, using two dependency tools and the Standex cards. The home has a respite care bed and prospective residents are given an opportunity where possible, to experience life in a residential care home before making a final choice; a resident described how he had spent a day and had lunch at the home before admission.
Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 9 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 the following standard(s): 7-10 The home’s records give a clear indication of the needs of residents and enable staff to meet their needs with sensitivity and regard for their privacy and dignity. EVIDENCE: The three care plans looked at in depth contained clear and comprehensive assessments, were reviewed regularly and were signed where possible by the service user or relatives/advocates. The home uses a Standex system for the main care plan, which has been adapted to contain only the most important information, additional information being kept in folders. There was a clear medication policy and the most recent visit from the pharmacist was 28/12/05, from which there were no requirements. Residents said they felt safe and well looked after; one resident said ‘it’s almost as good as being at home’. A visiting District Nurse, who had been visiting the home for over two years, said that the standard of care was very good and the home compared extremely well with other homes in the area; staff members were knowledgeable and communication was exceptionally good. The staff team were observed carrying out their duties with kindness and sensitivity towards the residents, especially when attending to their personal needs. The nursing team was planning a training package for staff to include issues such as continence.
Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 10 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 the following standard(s): 12-15 A variety of activities is available and residents are usually informed about the programme of events. The residents exercise choice about which activities, if any, they wish to participate in and what meals they want to eat. EVIDENCE: An activities co-ordinator has been appointed for 10 hours weekly; staff member spoken with said that this was not enough time, but it was hoped to extend the hours to 20. Residents spoken with said that there was a number of activities at the home, including bingo, puzzles, keep fit and dominoes. Events over the Christmas period had included several entertainers including two visiting pantomimes; these were advertised in the ‘Southfield House Newsletter’. Two residents spoken with mentioned going on day trips and holidays but said they preferred not to take part in activities, although they were very happy to watch or to stay at home. The midday meal was balanced, nutritious and easy for older people to eat; one resident said ‘It’s pretty good, better than hotel quality’. There was a menu board displaying the day’s meals including the alternative choice and the cook said she visited each resident for their choice of meal for the following day. Two pureed meals and five diabetic meals are catered for. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 11 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 the following standard(s): 17,18 The home’s complaints procedure is clear and gives residents and their relatives the confidence that comments and concerns will be listened to; there is a robust adult protection procedure. EVIDENCE: Residents and visitors to the home all said they did not wish to complain but knew how to make a complaint. There was a clear adult protection procedure, which was linked to the Local Authority procedures. Staff members spoken with had received training on adult protection issues. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 12 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 the following standard(s): 19-21,23-26 The residents live in a very comfortable and pleasant environment with both private and communal space, which is generally suitable for their needs, but which needs some updating. EVIDENCE: The home has a rolling maintenance programme and recent improvements to the home have included the complete refurbishment of one bedroom and the creation of an extra patio area by removing a fishpond and gravelling the area. The ground floor bathroom was still in need of renovation; this is outstanding from the previous report and the Care Leader said that there were plans to carry this work out shortly. Risk assessments are carried out on the premises to ensure that residents are safe from any potential hazards. One resident said ‘This room suits me well; it’s very comfortable’. Some of the fittings, namely wash-hand basins in some bedrooms now need replacing. A ground floor toilet has a sliding door opening directly opposite and loss of privacy and dignity can occur, especially with residents using frames and wheelchairs; a door should be fitted with a closure device to prevent this.
Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 13 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected EVIDENCE: Although these standards were not fully inspected, the staff rota showed that there were enough staff numbers according to the staffing matrix and shifts were staggered to accommodate the needs of residents; residents and staff thought there were enough staff members on duty to complete their tasks. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 14 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33, 35, 36, 38 The home is managed competently and the staff are supported and supervised in carrying out their respective roles. The views of residents are listened to and they are involved in decisions affecting them. EVIDENCE: The quality assurance manual demonstrated a positive approach to seeking the views of residents; residents’ meetings were regularly held and residents spoken with said they were constantly asked for their views on matters concerning the running of the home. The Manager said that quality surveys went out with invoices each month, for relatives/advocates to complete. There was a monthly record of meals with satisfaction, complaints and concerns logged and forwarded to headquarters. The home has the ‘International Standards Organisation 9000’ award and the ‘Investors in People’ award. In addition, the home is regularly audited from headquarters. The administrator holds the credit cards from the Post Office for five residents; she collects the personal allowances after banking the accommodation fees. Two monies held
Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 15 on behalf of residents balanced and clear accounts were retained, including receipts. Staff members described how they had regular supervision sessions with the Manager. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 16 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 4 3 3 3 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 3 18 3 2 3 2 X 3 3 3 3 STAFFING Standard No Score 27 X 28 X 29 X 30 X MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X 4 X 3 3 X 3 Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 17 Are there any outstanding requirements from the last inspection? yes 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 OP21 Regulation 23[2](n) Requirement The registered person must fit the ground floor toilet with the sliding door opening directly opposite, with a closure device, to prevent loss of privacy and dignity, especially with residents using frames and wheelchairs. The registered person must forward plans for renovating and updating the ground floor bathroom containing the footbath and the bathroom containing a corner bath. This matter is still outstanding, but the handyman and other staff members confirmed that work should commence shortly. The registered person must forward plans for replacing or those wash-hand basins needing attention in several bedrooms The registered person must repair or replace the worn armchair in Room 5 Timescale for action 02/03/06 2. OP21 2323[2] (j) 02/03/06 3. OP21 23[2](n) 02/03/06 4. OP24 16[2][c] 02/03/06 Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 18 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 It is a recommendation that the front of the home is made more attractive in winter months by the use of planted tubs or climbing plants on the walls. Southfield House DS0000002419.V276095.R01.S.doc Version 5.1 Page 19 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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