Inspection on 28/07/05 for Spinney (The)

This inspection was carried out on 28th July 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. 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 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

Spinney (The) 15/05/07

Spinney (The) 04/09/06

Spinney (The) 08/03/06

Similar services:

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Queen Elizabeth House

Spring Lane Care Home

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

CARE HOMES FOR OLDER PEOPLE The Spinney 21 Forest View Chingford London E4 7AU Lead Inspector Harun Rashid Announced Inspection 28th July 2005 10:00am 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. The Spinney Version 1.10 Page 3 SERVICE INFORMATION Name of service The Spinney Address 21 Forest View, Chingford, London E4 7AU 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) 020 8542 7200 020 8559 3115 Care Base (Chingford) Ltd Ms Carol Ann Bryan Care Home 46 Category(ies) of Dementia (0), Dementia - over 65 years of age registration, with number (0), Old Age, not falling within any other of places category (0) The Spinney Version 1.10 Page 4 SERVICE INFORMATION Conditions of registration: NONE Date of last inspection 21/9/04 Brief Description of the Service: The Spinney is a purpose built care home on three levels run by Care Base (Chingford) Ltd .The home is stuated in the north Chingford area of the London Borough of Waltham Forest. It overlooks Chingford golf course and is at the edge of Epping Forest, but close to a shopping centre, Chingford British Rail station and various bus routes. The Spinney caters for 46 elderly people of both sexes. 35 Service users’ are accommodated in single rooms have en-suit facilities,1 single room without en-suite facilities and 5 double rooms have ensuites. There are various lounges and dining rooms located throughout the home and there are satellite kitchen facilities on all floors. The grounds of the home are maintained to a high standard and accessible to service users with wheel chairs. Advice is sought from relatives and there are regular service users’ meetings to which relatives are invited. Religious and spiritual needs are met by visits from local clergy to the home or by service users visiting local churches. A range of medical dietary needs can be met. Service users are encouraged to be as independent as is possible within a risk management framework. The Spinney Version 1.10 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The announced inspection took place on a weekday morning of 28th of July 2005. The Inspector was able to interview four members of staff including the registered manager. The regional manager of Care Base Ltd. was present during the inspection. The Inspector spoke to nine service users and received 10 feedback cards from service users’ relatives and from a G.P. They all expressed their satisfaction with the high standards of care provided in the home. The service was awarded a major variation for dementia category for 11 beds on the top floor of the Spinney known as Maple unit. The regional management advised the Inspector that they have reviewed the staffing level of the service, which was confirmed in writing on 5/8/05 by the regional manager of Care Base Ltd. The management informed that they are in the process of increasing by two additional beds and an additional staff room. The Inspector advised that the registered person must apply for a major variation to the CSCI should the home wish to increase bed numbers. What the service does well: What has improved since the last inspection? The management worked hard with staff to meet all previous requirements. Members of staff received training in various areas including NVQ level 2/3 in care. Staff interviewed expressed their satisfaction with the training opportunities provided by the management. Staff attended dementia awareness training as the service now provides dementia care. The Spinney Version 1.10 Page 6 What they could do better: 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. The Spinney Version 1.10 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 The Spinney Version 1.10 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) 1,3,4 and 6 The registered manager ensures that prospective service users’ assessments of needs are carried out prior to the admission. Staff are provided training to meet assessed needs of the service users. However, it is required that the Statement of Purpose and Service Users’ Guide are amended. EVIDENCE: The home has a Statement of Purpose and a Service Users’ Guide. However, as the home was awarded 11 beds for dementia care, it is required that the management must amend their Statement of Purpose and Service Users’ Guide by including information about the dementia category and how those service users needs are to be met. The newly admitted service users are assessed before they are admitted to the home. The registered manager who has several years of experience of carrying out assessment usually carries out pre-admission assessments. The Inspector spoke to nine service users, four members of staff and received 10 feedback cards from service users relatives and health professional. They all expressed their satisfaction with the standard of care provided in the home. The Spinney Version 1.10 Page 9 Daily records and staff interviewed suggested that service users assessed needs are met. Staff are provided training to meet service users needs. Staff seek specialist advice as and when required. Evidence of referral letters were available in the care files. Standard six is not applicable to this service, as this service does not provide intermediate care. The Spinney Version 1.10 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 and 10 The service ensures that service users’ health and personal care needs are met adequately. Staff review care plans on a monthly basis as required by National Minimum Standards (NMS). Staff respect service users privacy and dignity at all times. EVIDENCE: The care plans were generated from comprehensive assessments of care managers/health professionals for service users placed by the health and local authorities. A large numbers of service users at Spinney are self funded and their care plans were developed from comprehensive assessments carried out by the home. Care plans were reviewed on monthly basis as required by the NMS. It was recorded in the care files that staff escorted service users to medical appointments for example G.P, optical and dental. The manager informed that if any service user is not able to attend a medical appointment, the doctor will visit him/her in the home. At the time of the last announced inspection, the Pharmacist Inspector of the Commission carried out an inspection to check the medication administration system and the policy and procedure of the home. The management advised The Spinney Version 1.10 Page 11 that all requirements and recommendations were met. The Inspector was satisfied from examination of medication administration that all medications are provided in blister packs from a local chemist. Staff members follow medication administration procedures of the home. Staff keep records of all medications received, administered and disposed of, to ensure there is no mishandling. Staff interviewed confirmed that they respect service users privacy and dignity at all times. From observation it was evident that the bedroom doors, toilets and bathroom doors were closed during the delivery of personal care. The Spinney Version 1.10 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 and15 Social activities for service users are well arranged. Staff welcome and encourage service users’ friends and families to visit them. Choices of menus are offered and special individual dietary requirements are met. EVIDENCE: The Spinney employs two part-time activity co-ordinators who organise individual and group activities on each of the three floors. The Inspector observed an activity programme which was attended by the service users. Service users spoken to during the Inspection process informed the Inspector that they were enjoying the programme. Service users are encouraged to join Dial-a-Ride. Service users are encouraged to visit local parks, theatre and sea side during the summer. Service users informed that they were able to receive their family members in their bedroom in private. The home encourages family members and friends to visit them. Family members mentioned in feedback cards that staff welcome them into the home. All service users are on the electoral register and some of them voted at the last general election. The Spinney Version 1.10 Page 13 Staff encourage some of the service users to handle their finances by encouraging them to cash their pensions, pay rents and hold personal allowances. They have lockable drawers to keep their personal money in their bedrooms. Service users have access to their personal records. The Inspector was satisfied from discussion with cook, staff and service users and viewing weekly menus that service users receive a varied, appealing, wholesome and nutritious diet, which is suited to individual, assessed and recorded requirements. The weekly menu offers of at least two main meals at each mealtime. The Spinney Version 1.10 Page 14 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 and 18 The complaint policy and procedure of Care Base Ltd. is simple, clear and was made available to all relevant parties. The Adult protection policy and procedure contain sufficient guidance for staff to enable them to protect service users from abuse. EVIDENCE: Care Base Ltd. provides a simple, clear complaint policy and procedure for service users, their family members and for other relevant parties. A record of complaints was kept by writing in a complaint book including details of investigation and action taken by staff. The complaints received were minor in nature and those were investigated and resolved accordingly. Service users’ relatives raised the following concerns by completing inspection feedback cards. One relative was concerned for not knowing about the new ownership and other was concerned about increment of fees. The regional manager and the registered manager informed that the managing director of the company wrote letters to all relatives on 30/9/04 about the change of the management. The management also wrote letters to all relatives about the increment of fees. All members of staff attended adult protection training. The adult protection policy and procedure of Care Base Ltd. contains sufficient guidance for staff to protect service users from abuse. The registered person knows her responsibility to refer staff who harm service users in their care to the POVA list. The Spinney Version 1.10 Page 15 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) 19,20,21,22 and 26 The home is quite suitable for its stated purpose, which is safe and well maintained. There is an attractive courtyard accessible to older people with physical disabilities. EVIDENCE: The home is located in a desirable residential area of north Chingford, which is popular. The home was built to provide services to elderly people with physical disabilities. There are 35 single rooms and five double rooms with en-suite facilities. The grounds are kept clean and tidy and safe. An attractive garden is provided to the rear of the building with access to wheelchair users. Lighting in communal areas are domestic in character, sufficiently bright and positioned to facilitate reading and other activities. Furnishings of communal rooms are domestic in character and of good quality, and suitable for the range of interests and activities preferred by service users. The Spinney Version 1.10 Page 16 Bedrooms have en-suite toilets and washing facilities. There are additional toilets and bathing facilities also available on each floor, which meet mobility standards. Toilets and bathrooms are clearly marked and are close to the lounge and dining areas. An occupational therapist assessment was carried out early this year. The management advised the Inspector that all recommendations made by the OT were met accordingly. All service users with wheelchairs have access to the premises including outdoor gardens. The home also provides grab rails and other aids in corridors, bathrooms, toilets and communal areas. At the time of the inspection the premises were kept clean, hygienic and free from offensive odour throughout. Hand wash facilities are prominently sited in areas where infected material is handled. The home employs laundry persons. The Spinney Version 1.10 Page 17 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) 27,28,29 and 30 The management has reviewed the staffing level of the Spinney. The service provides training for its staff development. There is a shortfall in NVQ level 2 qualifications in care and this is being addressed by the management. EVIDENCE: The registered manager and the regional manager informed that the home currently employs 36 full and part-time care staff and ancillary staff e.g. cooks, domestic workers, laundry persons and a handyman. The home also employ two activity co-ordinators. The regional manager advised that previously care staff were involved in cooking and serving breakfast and tea. Now they split the kitchen assistant’s hours, re-arrange the duties of the kitchen and care staff. Care staff no longer cook and serve breakfast and tea. They also re-arranged laundry and domestic hours, so laundry and domestic duties are carried out by the laundry and domestic staff only. At the time of the inspection 7 members of staff had completed their NVQ level 2 qualifications in care and 9 members of staff anticipated to complete their NVQ level 2 training in care by September 2005. The management is confident that more than 50 of their care staff will complete their NVQ 2/3 qualifications in care by 2005. Care Base Ltd. operates a thorough recruitment procedure based on equal opportunities. The management receive two references for each member of staff prior to their appointments. The management ensure that all staff have a The Spinney Version 1.10 Page 18 current CRB disclosure. The copies of references and CRB checks were available in staff files for inspection. It was evident from examination of staff files that the management have completed ‘the Spinney residential home foundation work book’ for newly appointed members of staff. The induction programmes were completed within six weeks of staff being appointed. The Spinney Version 1.10 Page 19 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) 31,33,35,36 and 38 There is effective leadership; guidance and direction to staff to ensure service users assessed needs are met. The home ensures that service users health, safety and welfare is maintained at all times. EVIDENCE: The registered manager is qualified and has completed her NVQ level 4 in care and Registered Managers’ Award. She is experienced in running the home for several years. She is intending to start her Diploma in ‘Dementia Care Matters’ in October this year. The service obtains service users and relatives’ satisfaction survey questionnaires on a periodic basis. These were found to be satisfactory and made available for all relevant parties. The Inspector received 10 feedback The Spinney Version 1.10 Page 20 cards from service users relatives and they were satisfied with the standards of care provided in the home. Staff interviewed confirmed that regular supervision takes place as required by the NMS. Staff also confirmed that they have opportunities to discus issues they wanted to discuss with their supervisors. Supervision notes were available in staff files. A fire risk assessment of the premises was carried out. The home ensures that regular fire equipment; gas and electric appliances are checked by the professionals involved. Copies of certificates were available during the inspection. The home has a valid insurance against loss or damage to the property. The Spinney Version 1.10 Page 21 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 2 x 3 3 x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 3 3 3 x x x 3 STAFFING Standard No Score 27 3 28 2 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x 3 3 x 3 The Spinney Version 1.10 Page 22 NO 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 OP 1 Regulation 4 and 5 Requirement The management must amend the Statement of Purpose and Service User Guide by including information about the dementia category and how service users needs to be met. The management must ensure that 50 of their care staff complete NVQ level 2 qualifications in care by 2005. Timescale for action 31/10/05 2. OP 28 18 31/12/05 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 The Spinney Version 1.10 Page 23 Commission for Social Care Inspection Gredley House 1-11 Broadway London E15 4BQ 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 The Spinney Version 1.10 Page 24 - 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. 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