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Inspection on 23/01/09 for Spring Lodge Care Home

Also see our care home review for Spring Lodge Care Home for more information

This inspection was carried out on 23rd January 2009.

CSCI found this care home to be providing an Excellent service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

There is a homely atmosphere, and the staff show professional commitment and care for the residents. The home does not use agency staff, as its own staff are prepared to cover any absences. The staff are well trained and their competence is regularly checked by a senior member of staff. Residents and relatives are appreciative of the care and sensitivity of the staff, and of their understanding of the particular needs of people with dementia. The home has prepared a series of informative booklets on many aspects of care and conditions to help residents and relatives. The manager runs the home in an open and approachable style. Staff comments include `the manager has always been supportive and helpful towards me` and `I feel privileged to work with a very efficient manager and team`. The home is caring well for the residents with dementia, through staff training and specific activities. A staff member said `we see the person before the dementia`. A relative reported: `I am impressed by the way in which everybody who cares for my relative is up-to-date on what the situation is - communication and information sharing seems excellent.` The refurbishment of the home has provided residents with a high standard of accommodation and facilities. They enjoy the range of activities available and can choose which ones they take part in.

What has improved since the last inspection?

Every bedroom has been redecorated with new furniture. Communal areas have been upgraded with new chairs, flooring and arrangement of furniture to give a more homely feel. This is especially noticeable in the dining room. The new owners have introduced an annual quality report of the home, which gives residents the opportunity to say what they think, and what changes or new things they would like.

What the care home could do better:

No requirements or recommendations have been made as a result of our visit. The manager described a number of improvements that were being planned, such as improving the decor with pictures in the corridors and in the bathrooms, putting memory boxes in each bedroom, and designing a sensory garden. The owners have planning permission for a new-build dementia unit in the grounds.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Spring Lodge Care Home Main Road Woolverstone Ipswich Suffolk IP9 1AX     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: John Goodship     Date: 2 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 26 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 26 Information about the care home Name of care home: Address: Spring Lodge Care Home Main Road Woolverstone Ipswich Suffolk IP9 1AX 01473780791 F/P01473780791 spring.lodge@kingsleyhealthcare.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Spring Lodge (Care Home) Limited care home 28 Number of places (if applicable): Under 65 Over 65 28 28 dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 0 Spring Lodge is situated in the small village of Woolverstone about five miles from Ipswich. The home is a registered care home for 28 people, registered to admit both older people, and older people with dementia. The accommodation is situated on two floors. The majority of the bedrooms are on the ground floor and provide single accommodation. Each bedroom has a wash hand basin and two rooms (one double and one single) have a WC en-suite. Bathrooms are situated on both floors. Communal areas are all on the ground floor and include a main lounge and three other areas, including a new conservatory. There is also a central dining room. The home is situated within its own grounds with parking for visitors. There is a large, attractive and enclosed garden at the rear of the property, which is well maintained and provides a variety of seating areas for service users. A major refurbishment programme has Care Homes for Older People Page 4 of 26 Brief description of the care home recently been completed. The current fees range from 600 pounds to 620 pounds per week. Care Homes for Older People Page 5 of 26 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We visited the home on a weekday unannounced. We looked at the outcomes for the residents, assessed against the national minimum standards. The manager was present throughout and we were there for six hours. This was a key inspection. The last key inspection was on 24th November 2006. An annual service review had been undertaken in 2007. We toured the home, spoke to three residents in private, two staff in private, and chatted to other residents and staff. We looked at three care plans, staff records, training records and maintenance records. Before the visit, we invited interested parties to complete a questionnaire survey for Care Homes for Older People Page 6 of 26 us. We received thirteen forms back from residents, thirteen from staff, and seven from relatives. The manager had also completed our Annual Quality Assurance Assessment where she described how the home was meeting the standards and maintaining and improving care. Information from these sources has been used to compile this report. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 26 Care Homes for Older People Page 9 of 26 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 26 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents and their relatives have sufficient information to assess how the home can meet their needs. In addition, no one is admitted without an assessment of their care needs to ensure that the home can provide for them. Evidence: The statement of purpose and the service users guide contained all the items of information needed by people considering the home for themselves or their relative. These items covered for example, how the home was staffed and managed, the levels of staff training,the facilities and services, the needs which the home could meet, and how to make a complaint. These documents had been revised in April 2008 to make them more user-friendly. We saw that they were clearly written and laid out. They included details of the fees for residence. Care Homes for Older People Page 11 of 26 Evidence: An assessment form was fully completed when new people moved into the home so that staff knew what their needs were. The form included information from other agencies, the managers own assessment when visiting the person, and details from the person and their relatives. The home had also prepared a number of booklets to help residents and relatives understand aspects of their illness and conditions. One person told us that they had come in for a weeks holiday initially and that gave me all the information I needed. The manager told us in the AQAA that they encouraged people where possible to spend a day in the home before agreeing to live there. Care Homes for Older People Page 12 of 26 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents health and personal needs are assessed, reviewed and monitored and reflected in care plans. Evidence: We looked at three care plans covering a recent admission, a person with behaviour management issues and a person recently returned from hospital. The care plans were user friendly, well presented and held clear relevant information about health, social and personal care needs. Staff told us that these plans were reviewed monthly and these reviews were recorded. One relative said that they had seen their relatives care plan and agreed with it. One care plan had the date of the next review planned by their keyworker and including the persons spouse. Another plan noted that a copy had been given to the named relative. Staff completed a daily record sheet which they signed. These entries provided a clear and full picture of what that resident had done, and was used at staff handovers to ensure staff were up-to-date with any changes to care needs. Staff surveys confirmed Care Homes for Older People Page 13 of 26 Evidence: that the information passed on at handovers was relevant and helpful to them. A relative told us I am impressed by the way in which everybody who cares for my relative is up-to-date on what the situation is - communication and information sharing seems excellent. The home kept records of all visits by health professionals. Residents were weighed monthly and this information, together with their pulse and blood pressure was faxed monthly to the GP practice. Risk assessments were in the care plans and showed that staff were alerted to specific dangers and given instructions on minimising risks, for example of falling. We noted that one resident had acted violently or abusively to members of staff seven times in one month. This was a symptom of their condition, and the GP had been asked to review the medication. He had then referred the person to the hospital consultant for re-assessment. We observed part of the lunchtime medication round in the dining room which showed that residents safety was assured by the correct procedures being followed. The records showed that they were being given the medication prescribed for them. The home had prepared a booklet to help relatives understand what action needed to be taken on the death of their loved one. Each care plan held the wishes of the residents about their end of life arrangements. Staff told us that most of them had attended a palliative care course at a local college which had given them the skills and knowledge to provide appropriate care. They described how this had been given to a recently deceased resident. Care Homes for Older People Page 14 of 26 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The routines of the home are planned around the residents needs and wishes. There is active encouragement to participate in community activities. The home seeks the views of residents. Meals are nutritious and varied. Evidence: Residents told us about the things they enjoyed doing in the home. I like to take part in cake making, drying cutlery, and the church service. Another said I really like the brain games. A relative told us how their family member was encouraged to take part in activities. They have encouraged X to do things like folding napkins which X enjoys doing having been a waitress when they were young. We saw the programme of activities which included different levels of physical and mental stimulation. Some activities were of particular benefit to those with dementia, such as reminiscence sessions with picture games, quizzes and a sensory tray. Other sessions such as hairdressing, manicures, hand massage and foot spas contributed to the well-being of residents. A relative told us that as well as the monthly church service, the staff have very open attitudes to spirituality, race and ethnicity. Care Homes for Older People Page 15 of 26 Evidence: The main dining room had been refurbished with new furniture. The table layout had been improved since our last visit to provide tables of four with more room between them, particularly for those in wheelchairs. Two people who needed support with eating had their meals in the ante room off the main dining room. There was also a table for four in the conservatory. We spoke to one person who told us what a nice place the conservatory was to have their meals. A tea station had been provided in the dining room so that residents and visitors could make their own beverages at any time. On the day of our visit, the main dish was fish and chips followed by semolina and jam. Some residents had booked for fried eggs, or an omelette or a salad. All the comments from the residents we spoke to and who returned a survey form said that they enjoyed the meals.They always provide what I ask for. The environmental health officer had inspected the kitchen in 2008 and had made some recommendations regarding the completion of records and the calibration of probes. These had been actioned. Care Homes for Older People Page 16 of 26 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home investigates and acts upon any concerns and complaints of residents and relatives. Residents are protected from abuse by the homes training and supervision policies Evidence: Residents and relatives told us that the manager was always ready to listen to concerns. One person said they responded with discretion to some concerns I had about a family visitor. Staff told us that they knew how to help someone who came to them with a concern or complaint. There were no records of any complaints being received. A suggestions box was on the wall in the entrance lobby, along with the complaints policy, and the address of the Commission. In addition we saw a booklet which the home gave to residents and relatives on admission describing the complaints policy and procedure. Staff told us that they understood the homes policy on the protection of vulnerable adults, and had received training in this. A booklet on this topic had been prepared by the home for staff, and it was also given to relatives. Care Homes for Older People Page 17 of 26 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents enjoy a safe and comfortable environment, suited to their needs, and wellmaintained. They are protected from cross-infection by the homes cleaning and hygiene procedures. Evidence: A major refurbishment and upgrading project had been completed in the last year. Every residents room had been redecorated and refurnished. Some rooms had been changed round to provide more space.The furniture had been made specially for the home and was substantial and clearly not flat pack. Every room had a new profiling bed for the comfort of residents and the safety of staff. There were new curtains and new hand wash basins. In addition, communal rooms and bathrooms/shower rooms had been refurbished. All bathrooms, and the kitchen, had been fully tiled for easier cleaning and better hygiene. All rooms had large coloured numbers on their doors, with an engraved nameplate. Residents told us that they were very pleased with their rooms which were kept clean and tidy. We noted that the television sets in the rooms had been taken down from wall brackets and placed on the furniture. The manager explained that residents had Care Homes for Older People Page 18 of 26 Evidence: said they were too high up for them. The early part of the project had provided a large conservatory leading to the secure garden, and a new laundry.The manager showed us that the home used its own ironon labels for residents clothes to reduce the incidence of lost items. We noted that there were glove dispensers around the home for staff, and hand sanitisers to enhance residents protection from cross infection. Care Homes for Older People Page 19 of 26 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that there are sufficient numbers of trained and supervised staff, recruited in a safe way, to meet their needs. Evidence: Residents told us that staff were always available when they needed them, and always listened to what they said. A relative told us that staff handle situations with thought and sensitivity. One resident wondered if new staff could be asked to introduce themselves when they came into the room, as they did not wear name badges. We spoke to the manager about this, who said she would emphasise how staff should act towards residents. We observed staff talking and supporting residents in the lounge, and in the dining room. Staff told us that they believed the staff levels on each shift allowed them to spend some time with residents. One said that there is always adequate staff on duty at all times. We spoke to some staff in detail about their work. They were able to describe their particular responsibilities, for example as a keyworker, and give an in-depth account of the health and personal needs of residents. One person described how they had been guided to deal with a resident who had violent outbursts. They felt confident in dealing with them. This person said that they were able to speak to the manager at any time if they had concerns. One of the catering staff had been on the course on dementia care Care Homes for Older People Page 20 of 26 Evidence: awareness. They said that they had been able to understand how the residents looked at their world. They described some of the things they were hoping to introduce to build on this knowledge,such bas picture based menus for residents to use. The recruitment procedures of the home protected residents from harm, and staff records were in order and complete. The deputy manager had the responsibility for planning and implementing the annual training plan. All staff who replied to our survey said that training opportunities were good, which kept them up-to-date and ensured good practice in caring for residents. The majority of staff hold an NVQ at Level 2 or above. Staff listed the courses they had recently undertaken. Their certificates were in the training file. A carer told us that this service practices person centred care. We see the person before the dementia. A relative told us that the home cares for the residents as individuals, responding to their idiosyncracies and all done in a caring way. My relatives state of mind has improved noticeably in the home. Care Homes for Older People Page 21 of 26 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents can be assured that the home is run effectively and in their best interests. Evidence: The home was sold to new owners last year. This was registered by the Commission in April 2008. The manager remained in post and now reported to a senior manager in the organisation. The other management arrangements in the home continued with the deputy manager leading on training and staff supervision. Staff said that they received positive support from the manager, and that she ensured that the home ran smoothly. Comments in the surveys included I feel privileged to work with a very efficient manager and team and the manager has always been supportive and helpful towards me and other members of staff. The home used a number of ways to ensure that it was run in the best interests of the residents. The new owners instigated an Annual Quality Report which was shown to us. Care Homes for Older People Page 22 of 26 Evidence: It included the results of a residents and relatives survey. Overall both groups were very satisfied with the care. A few suggestions were made for improvements, both to individuals care and to the general running of the home. One suggestion from residents was for the introduction of pets into the home. The Pat A Dog service already visited. There were now rabbits in a hutch, canaries and dogs living in the home. We saw photos of residents handling some of the animals. A senior manager visited the home once a month to talk to residents and staff about the care and to pick up any concerns that cannot be addressed by the manager. They happened to be present when we visited, completing their most recent report. No issues of concern had been raised. The home also held the Investors in People Award which listed the key strengths of the home as staff training, the positive feedback from residents and relatives, and the fact that staff felt valued and were recognised for their contribution to the quality of care. Residents health and safety was protected by the homes procedures, including the fire risk assessment which was reviewed in April 2008, by the fortnightly water temperature checks, and by the regular maintenance of equipment. The home did not hold any monies for residents. The home paid for all expenses such as hairdressing, and toiletries, and then invoiced the person responsible for such payments. This system was explained in the service user guide. Care Homes for Older People Page 23 of 26 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 26 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations Care Homes for Older People Page 25 of 26 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 26 of 26 - 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!