Inspection on 08/03/06 for Spinney (The)

This inspection was carried out on 8th March 2006.

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) 28/07/05

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 Spinney (The) 21 Forest View Chingford London E4 7AU Lead Inspector Harun Rashid Unannounced Inspection 8th March 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 Spinney (The) DS0000061978.V285639.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. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Spinney (The) Address 21 Forest View Chingford London E4 7AU 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) 020 8542 7200 020 8559 3115 Care Base (Chingford) Ltd Ms Carol Anne 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) Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. Total number of beds 46 to be used flexibly between the following categories: DE 55 both genders DE(E) both genders OP (not falling within any other category) both genders 28th July 2005 Date of last inspection 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 situated in the north Chingford area of the London Borough of Waltham Forest. The home has access to all community amenities including Chingford rail and bus stations. At present it caters for 46 elderly peoples of both sexes. 35 service users are accommodated in single bedrooms with en-suites, one single room without ensuite facility and five double rooms have en-suites. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The unannounced inspection was conducted on a weekday morning on 8/3/06. The Inspector interviewed four members of staff including the newly appointed manager and a senior carer. The Inspector also spoke to twelve service users and five service users’ relatives. They all expressed their satisfaction with the 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. At present the Maple unit is accommodating seven service users. Following receipt of a complaint the inspector spoke to four service users and interviewed two members of staff including the senior carer of the Maple unit. The inspector also examined care files and other documentation. The management informed that they are in the process of increasing by two additional beds. 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? What they could do better: The registered person must review current staffing level in accordance with service users assessed needs. The newly appointed manager must apply for her registration to the CSCI. The manager to complete her Registered Manager’s Award. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 6 The management must ensure that all staff receive dementia care training in order to meet service users assessed needs adequately. The management should support staff with report writing. This to be addressed in individual supervision sessions and arrange report writing course for those who would benefit from this. 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. Spinney (The) DS0000061978.V285639.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 Spinney (The) DS0000061978.V285639.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, 3 and 6 The management developed the Statement of Purpose further. The manager ensures that prospective service users’ assessments of needs are carried out prior to the admission. EVIDENCE: The home has developed the Statement of Purpose following the recommendation of the previous inspection report. This has included the aims, objectives of the home and information about the dementia category. The newly admitted service users are assessed before they are admitted to the home. The manager who has several years of experience of carrying out assessment usually carries out pre-admission assessments. The newly developed assessment tool called ‘Dependency Level Assessment’ was seen which covers all areas of needs of a service user. The home does not provide intermediate care. Therefore, this standard is not applicable. Spinney (The) DS0000061978.V285639.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): 7,8,9 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 number of service users at the 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 National Minimum Standards. 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 would visit him/her in the home. All medications are provided in blister packs from a local chemist. Staff members follow medication administration procedures of the home. Staff keep Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 10 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. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 11 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): 12,13,14 and 15 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. EVIDENCE: The Spinney employs one full time activity co-ordinator who organises individual and group activities on each of the three floors. The Inspector observed an activity programme (keep fit) 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 the 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. 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. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 12 The Inspector was satisfied from discussion with the 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. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 13 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): 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 in a complaint book including details of investigation and action taken by staff. Following receipt of a complaint the inspector investigated this as follows: The complainant alleged that the home is not able to meet a service user’s needs and informed the CSCI that the home made a referral to social services to accommodate this service user to an another suitable home where this service user’s needs would be adequately met. The inspector spoke to the service user, members of staff and examined the care file which stated that the home is undertaking a dependency level matrix for this service user. As a result this service user had been referred to medical professional and social worker. An allocated social worker has visited the home twice and she is in the process of completing the assessment of needs, which will determine the level of care this service user will require. In the mean time the home will ensure that this service user’s movements are monitored to reduce falls. The manager and staff informed that if the home admits more service users in the Maple unit the staffing levels would be reviewed in accordance with the Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 14 service users assessed needs. The manager stated that the home only accommodate service users with low to medium dependency levels in the Maple unit. With regard to staff training for dementia care it was evident that a newly appointed member of staff has not received dementia awareness training yet. The manager who has ‘Diploma in Dementia Care Matters’ will provide dementia training to this member of staff in this month (March). In addition to this all staff working in the home will be provided a refresher training on dementia care by a trainer recommended by the Alzheimer Society. The inspector spoke to a member of staff who informed the inspector that she is determined to improve her writing skills and will put forward her name for NVQ level 2 training in care. The inspector advised the management that they should address this issue during supervision sessions and provide report writing training. 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 manager knows her responsibility to refer staff who harms service users in their care to the POVA list. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 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 the following standard(s): 19 and 26 The home is suitable for its stated purpose, which is safe and well maintained. There is an attractive courtyard accessible to older people with physical disabilities. The home is free from offensive odour. 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. 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 kitchen was clean and tidy. Cooks keep the record of temperature of the fridge and freezers in the kitchen. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 16 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): 27,28 and 30 The home provides staff training including NVQ training in care. However, the registered provider to review staffing level and provide dementia training to all staff. EVIDENCE: The registered manager informed that the home currently employs 29 full and part-time care staff and 16 ancillary staff e.g. cooks, domestic workers, laundry persons and a handyman. The home also employs one full time activity co-ordinator. At the time of the last inspection the management 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 rearranged laundry and domestic hours, so laundry and domestic duties are carried out by the laundry and domestic staff only. However, it is required that the registered provider must review their staffing levels in accordance with service users assessed needs. The manager advised that 15 members of staff had completed their NVQ level 2 qualifications in care and 20 members of staff anticipated to commence their NVQ level 2 training in care this year (2006). This standard will be assessed at the next inspection. It was evident from examination of staff files that the management have completed ‘the Spinney residential home foundation work book’ for newly Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 17 appointed members of staff. The induction programmes were completed within six weeks of staff being appointed. However, the registered provider must ensure that all staff are provided with dementia training in order to meet service users assessed needs. It is recommended that the management should provide report writing course for staff who would be benefited form this. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 18 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): 31,36 and 38 The newly appointed manager is experienced to run the home, however, she is required to apply for her registration to the CSCI. Staff receive regular supervision and the management ensures service users and staff’s health and safety at all times. EVIDENCE: The newly appointed manager has completed her NVQ level 4 in care and commencing Registered Managers’ Award (RMA) training. She is experienced in running a care home for over eight years. Previously she managed two other care homes in the Waltham Forest area. She has completed a diploma in ‘Dementia Care Matters’. The manager is required to apply for her registration to the CSCI and carry out CRB check through the Commission. She informed that she is aware of the process and will do so without delay. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 19 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 for inspection. 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. Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 20 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 3 X 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 Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 3 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X X X X 3 X 3 Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 21 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. 1 2 3 Standard OP31 OP30 OP27 Regulation 9 18 18 Requirement Timescale for action 31/03/06 The newly appointed manager must apply for her registration to the CSCI. The registered provider must 30/04/06 provide dementia training to all staff. The registered provider must 30/04/06 review staffing level in accordance with service users assessed needs. 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 2 Refer to Standard OP30 OP31 Good Practice Recommendations The registered provider to provide report writing training for staff who would benefit from it. The newly appointed manager to complete her Registered Manager’s Award (RMA). Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 22 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford 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 Spinney (The) DS0000061978.V285639.R01.S.doc Version 5.1 Page 23 - 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. 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