Inspection on 24/11/06 for Spring Lodge Care Home

This inspection was carried out on 24th November 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

Spring Lodge Care Home 23/01/09

Spring Lodge Care Home 07/12/05

Spring Lodge Care Home 18/05/05

Spring Lodge Care Home 15/12/04

Spring Lodge Care Home 30/06/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

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

CARE HOMES FOR OLDER PEOPLE Spring Lodge Care Home Main Road Woolverstone Ipswich Suffolk IP9 1AX Lead Inspector John Goodship Key Unannounced Inspection 24th November 2006 9:00 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 DS0000024492.V321883.R01.S.doc Version 5.2 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. DS0000024492.V321883.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Spring Lodge Care Home Address Main Road Woolverstone Ipswich Suffolk IP9 1AX 01473 780791 F/P 01473 780791 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) Spring Lodge (Care Home) Limited Miss Susanna Boar Care Home 28 Category(ies) of Dementia - over 65 years of age (28), Old age, registration, with number not falling within any other category (28) of places DS0000024492.V321883.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 7th December 2005 Brief Description of the Service: 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 is underway. The current fees range from £475.00 to £500.00 per annum. DS0000024492.V321883.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection visit was unannounced and covered the key standards which are listed under each section overleaf. This report includes evidence gathered during the visit together with information already held by the Commission. Two inspectors took part. The inspection took place on a weekday and lasted seven hours. The manager was present throughout, together with staff on the morning shift and, later, those on the late shift. The inspectors toured the home, and spoke to some of the residents, and the staff, both individually and in a group. The inspectors also examined care plans, staff records, maintenance records and training records. Prior to the visit, the commission had issued a Questionnaire Survey to service users and relatives. Twelve responses were received from service users and fourteen from relatives. Their comments and responses have been included in this report, on this page and on relevant Outcome Group pages. What the service does well: What has improved since the last inspection? A new conservatory has been built on at the rear with access to the garden. Several resident’s rooms have been redecorated, and a bathroom has been refitted. There is on-going work, which is scheduled to last until June 2007. Recruitment procedures now follow safe practice in obtaining the proper checks on applicants. DS0000024492.V321883.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. DS0000024492.V321883.R01.S.doc Version 5.2 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 DS0000024492.V321883.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2,3. The home does not offer intermediate care. Standard 6 is therefore not relevant. Quality in this outcome area is good. This judgement has been made using available 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 required by the Regulations. The Statement of Purpose was a large document which included a detailed staff induction programme. The manager said that she was revising this document to make it more userfriendly. DS0000024492.V321883.R01.S.doc Version 5.2 Page 9 Contracts and conditions of residence were seen in the files of all 3 residents tracked. Pre-admission assessments were seen in the care plans for the residents who were case-tracked. The manager also showed the inspector a number of informative booklets which the home had prepared and which were given out to relatives. They included explanations of dementia and Alzheimer’s disease. DS0000024492.V321883.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8,9,10,11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Resident’s health and personal needs are assessed, reviewed and monitored and reflected in care plans. EVIDENCE: Three residents care plans were inspected to case track their care. The care plans were user friendly, well presented and had information relating to health, social and personal care needs. Reviews by the care home staff took place regularly at monthly intervals. However, there was no evidence of family involvement with the reviews. The manager explained that relatives were invited but often chose not to attend. DS0000024492.V321883.R01.S.doc Version 5.2 Page 11 The Medication Administration Record charts (MAR) were checked and all three found to be completed fully. All three records had a photograph of the resident. All three residents had an inventory checklist, which had not been completed. The daily record sheets had day and night entries signed by care staff. For one resident there were two entries that were unsigned in the last month. On discussion with the manager this was identified to be a new member of staff. Records of doctors and district nurse visits were recorded. Residents are weighed and blood pressure recorded monthly and faxed to the GP Surgery. One resident who had been losing weight had been seen by the dietician and their care plan updated accordingly. Activities were recorded at times in the daily record sheets; a more comprehensive log was kept in a separate book, which was kept by the activities co-ordinator. The records showed that two of the residents had participated in activities such as bingo, gardening, watching television, painting and quizzes. One of the resident’s records had minimal entries for activities, but on talking with the resident, it was found that this was their choice as they did not like all the activities that were offered. This resident reported they enjoyed the activities that they wanted to join in with. The third resident had some entries in the daily record sheet where they were described as “agitated” and “unsettled”; however, the record sheet did not state how or if the resident was pacified. The next entry did state the resident was more settled. One of the residents said they had “no complaints”, the staff were “nice and helped him” when he needed help. One said that there was a little noise from the refurbishment, “but not much”. The inspectors arrived at the dining room at 9:45, where the 8:30 medication round was being completed. All but two of the residents had come to the dining room for breakfast, thus helping the process of administration. The drug room was off the dining room. It was observed that the carer made sure that medication was taken before returning to the medicine trolley and signing the Medication Administration Record (MAR). The temperature of the drug room was below 25°C, which is the safe limit for most medication. The temperature of the drugs fridge was within safe limits, and the daily record of temperatures was examined showing safe temperatures were maintained. A list of residents who had authorised either personally or through their relatives that they did not wish to be resuscitated was placed on the drugs fridge. The home took monthly blood pressure and weight readings for all residents with the agreement of the local surgery. A special weighing chair was used. All results were faxed to the surgery. As a result, one resident was under surveillance by the dietician. This was recorded in the care plan. DS0000024492.V321883.R01.S.doc Version 5.2 Page 12 The home had prepared some informative booklets to help relatives to understand what action needed to be taken on the death of their loved one. Each resident’s file contained a Terminal Arrangements form, which gives information on the wishes of the resident, both regarding funeral arrangements and whether they wish to be resuscitated after a cardiac or respiratory arrest. DS0000024492.V321883.R01.S.doc Version 5.2 Page 13 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,14,15. Quality in this outcome area is good. This judgement has been made using available 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: There were 24 residents having breakfast in the dining room on the morning of the inspection. This appeared to be unhurried. Residents were at various stages in their breakfast, with cereals, eggs and bacon, and toast available. The floor covering had recently been renewed, and there were some new chairs. However the manager was sending the latter back as they were of poor quality and not fit for purpose. DS0000024492.V321883.R01.S.doc Version 5.2 Page 14 The residents who spoke to the inspectors all said that the meals were good. Comments from the pre-inspection questionnaire also said that the meals were very good. One person thought that the puddings were rather monotonous. The manager thought this might have been the case while the kitchen was being upgraded and the menu was restricted. The dining room was only just large enough for 27 residents if they all came in for a meal, with little room between the tables. It was noted that those seated next to the wall had to wait until the people beside them were finished before they could leave the table. The home had rotating menus which were changed four times a year. The home had recently asked all residents what they would like to see on the coming year’s menus. The results were being collated. The survey from April 2006 was shown to the inspector. There were few comments. One did raise an issue about cold plates. The action taken to remedy this matter was recorded, and there was on the file a copy of the letter sent to the person concerned explaining what was being done. There were cuttings from the local evening paper on the notice board showing examples of some of the activities that the residents took part in. They had knitted for Kosovo, played water games in the hot weather, and the resident who played the melodeon was featured. This person was going out on the day of inspection to play at a function. The home was part of the pat dogs scheme. One of the residents with dementia although mobile on the day of inspection had had a fall recently. They were able to describe the circumstances, and tell the inspector about some of the activities they did or used to do. The manager said that friends took this person out to local meetings of a women’s group, and to services at the nearby church. DS0000024492.V321883.R01.S.doc Version 5.2 Page 15 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18. Quality in this outcome area is good. This judgement has been made using available 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 home’s training and supervision policies. EVIDENCE: A visitor had recently expressed their concern to the Commission about the health and safety of residents during the inspection. The home had responded with a full explanation of the safeguards in place and this had been sent to the person concerned. During this inspection, the opportunity was taken to check that all reasonable precautions were being taken. No matters of concern were noted except that the floor upstairs had exposed floorboards, which were somewhat uneven while rewiring was undertaken. The manager said that all affected residents had been warned about them when moving about during the day, and they were offered staff support to access their rooms safely if they needed this. One resident confirmed that they were aware of the hazard. A booklet describing the home’s complaints policy and procedure was given to residents or relatives on admission. DS0000024492.V321883.R01.S.doc Version 5.2 Page 16 Staff were trained in the recognition and prevention of abuse on vulnerable people. Their training records evidenced this. A booklet on this topic had been prepared by the home for staff, and it was also given to relatives. DS0000024492.V321883.R01.S.doc Version 5.2 Page 17 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19,21,22,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is managing the upgrading of the home to make the least disruption to residents. The results so far provide residents with a more comfortable and well-maintained environment. Specialist equipment was provided, and hygienic practices protected residents from cross-infection. EVIDENCE: A major refurbishment and upgrading project had been underway for a year and was scheduled to finish in June 2007. It included the building of a new conservatory, now completed, an enlarged laundry, the change of a small lounge into a single bedroom, and the refurbishment and decoration of each room. The results of the rooms completed so far showed that the environment had been improved by the re-alignment of rooms, improved bathroom and shower facilities, and a refurbished dining room and adjacent sitting room. DS0000024492.V321883.R01.S.doc Version 5.2 Page 18 A shower room on the ground floor was nearly ready for use. It had been supplied with a special chair, which could lower the occupant as far as the prone position for showering. The room was also supplied with a special hairdressing basin, whose height could be adjusted. A sample of hot water temperatures showed that they were all at 43°C or close to it. The manager said that the Environmental Health Officer had inspected the temporary kitchen during refurbishment, but had not wished to visit the new one. The kitchen store had also been enlarged with racking. It contained a good supply of fresh vegetables and fruit. The manager stated that a new air conditioning unit was to be installed. Rooms that were visited were clean and tidy. Cleaning cupboards and the sluice room were locked. The manager intended to install alcohol gel dispensers for staff hygiene. It was pointed out to the manager during a tour of the building that the masking tape on the threshold of the dining room needed renewing as it presented a risk of residents catching their feet. The manager arranged for it to be replaced during the visit. DS0000024492.V321883.R01.S.doc Version 5.2 Page 19 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29,30. Quality in this outcome area is good. This judgement has been made using available 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: A relative had commented in the pre-inspection questionnaire that one of the home’s key points was the home’s record for retaining staff. “This gives the residents the confidence they need, knowing the staff and the staff knowing them.” The manager confirmed that the home did not use agency staff and they had no vacancies. Only one person had been appointed since the last inspection in December 2005. This person’s file was examined. It contained the application form, two references, a photograph and ID documents. The POVA list return had been received before the start date, with the full CRB certificate following later. Induction and training information was also in the file. Training records for all staff were kept in a separate file, with certificates and assessments. There was a comprehensive programme for all staff, informed from the monthly supervision sessions, and planned by the deputy manager. DS0000024492.V321883.R01.S.doc Version 5.2 Page 20 Seven staff had NVQ Level 3 and eight had Level 2. The home had recently received the “Investors in People” Award. This recognised, in the words of the assessor’s report, the work which the home and its “professional extended management team” and staff had undertaken to demonstrate that the home’s policies and practices in developing all its human resources benefited the quality of the service provided to its residents. The home had completed the work on this award in the very short time of six months. This was possible because of their existing management and organisational practices. A full day training session was taking place on the day of inspection on counselling skills. It was held in the new conservatory, which meant that residents were unable to use it for that period. Two staff who were interviewed confirmed that the training opportunities were very good. Staffing levels were sufficient, particularly now that a fourth carer was rostered from 06:45 to 09:00. Both were happy to be working at the home. One of the inspectors observed two carers hoisting a resident from their wheelchair to an armchair. They fully explained what they were going to do, with good social interaction, and the safe use of the hoist. DS0000024492.V321883.R01.S.doc Version 5.2 Page 21 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,35,36,37,38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents can be assured that the home is run effectively and in their best interests. Staff training and supervision are excellent aspects of the management’s commitment to meeting needs and ensuring safe practice. EVIDENCE: The home had clear management arrangements, between the owner and the senior management posts. Responsibilities were clearly defined, with one person leading on training and supervision, and another project managing the refurbishment programme. The owner received weekly management reports from the managers, and also visited the home each week. DS0000024492.V321883.R01.S.doc Version 5.2 Page 22 The home had a system of monthly supervision, which covered all areas of practice and training needs. The deputy manager who was responsible for this system rostered herself on the shift of each person, including night staff, to ensure that practice was seen in context. The system covered practice audits and training needs analysis with regular reviews of competence. The supervision record for one person was seen in the file. The home had a number of ways to ensure the home was run in the best interests of residents. Mention has already been made in this report of the catering survey, and to the regular visits by the owner. A relative had commented on one survey that the plates for hot food were cold. The file recorded the action that had been taken to improve temperatures, together with a letter to the relative advising them of this. The Investors in People process added another string to the quality assurance bow, confirming the quality of personnel and management practices. Specific mention was made in the assessor’s report that the key strengths of the home were: staff training, the commitment by the proprietor to staff development, 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. Water temperature logs were completed monthly. All temperatures were at or below 43°C. The fire log book contained information on drills, alarm tests, and equipment maintenance. The home had a fire risk assessment which had been commended by the fire prevention officer. The home did not keep any monies for residents. Some kept their own in their rooms in lockable drawers. For the rest the home paid for all incidental expenses and invoiced the payees monthly by agreement. The accident book showed that there had been nine falls, or “found on floor”, occurrences in September and nine in October. All concerned different residents and did not result in serious injury. However the record of the accidents was still in the book. It should have been taken out and placed in each resident’s file, both for data protection, and for assistance to care reviews. DS0000024492.V321883.R01.S.doc Version 5.2 Page 23 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. 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 3 3 X X N/A 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 3 17 X 18 3 3 X 3 3 X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 4 3 3 DS0000024492.V321883.R01.S.doc Version 5.2 Page 24 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. Standard Regulation Requirement Timescale for action 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 OP37 Good Practice Recommendations The details of each accident should be taken out of the accident book and placed in the resident or staff file. DS0000024492.V321883.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ National Enquiry Line: 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 © 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 DS0000024492.V321883.R01.S.doc Version 5.2 Page 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. 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