CARE HOMES FOR OLDER PEOPLE
Springfield 14 Elms Road Bare Morecambe Lancashire LA4 6AP Lead Inspector
Mrs Marie Cordingley Unannounced Inspection 20th January 2006 13:00 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 Springfield DS0000062334.V275515.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. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Springfield Address 14 Elms Road Bare Morecambe Lancashire LA4 6AP 01524 426032 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) michelle.grossetinternet.com Springfield Retirement Home Ltd Mrs Michelle Grosse Care Home 15 Category(ies) of Old age, not falling within any other category registration, with number (15) of places Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. All radiators and pipework within the home must be covered with suitable guards by December 31 2004. A suitably qualified and experienced manager must be employed at all times who is registered with the Commission for Social Care Inspection. The home must not accommodate any more than 15 people in the older person (OP) category at any one time. 27th October 2005 Date of last inspection Brief Description of the Service: Springfield is registered with the Commission for Social Care Inspection to provide care and accommodation for up to 15 older people. The home is situated in the Bare area of Morecambe. It is close to a number of facilities and amenities and the Promenade is within walking distance. Accommodation is provided over two floors and there is a chair lift available for the use of residents. All the accommodation at the home is offered on a single room basis. Two of the fifteen bedrooms have en-suite facilities. Care is provided on a 24 hour basis including waking watch care throughout the night. Some of the carers have National Vocational Qualifications in care at level two or above. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced inspection which meant that the manager, staff and residents did not know it would be taking place until the inspector arrived. As the owner of the home was on a rest day the inspector was assisted by a senior carer. Discussions took place with regard to the running of the home and a number of documents were examined. A tour of the home was undertaken and the inspector consulted several residents and staff members. As part of the inspection, a case tracking exercise was carried out. This involved the inspector closely examining the care of selected residents from the point of their admission to the home. What the service does well:
During this and previous inspections it has been determined that residents at Springfield are looked after well. On the inspector’s arrival residents were relaxing after their lunch and there were several visitors at the home. Residents who were observed appeared content and comfortable and those consulted expressed satisfaction with the standard of care at the home. One resident said ‘’It is home from home here, we have everything we need.’’ Carers were observed throughout the visit going about their roles in a competent and professional manner. Staff consulted clearly enjoyed their work and were happy with the working environment. This fact is also reflected in the very low turnover consistently enjoyed by this home. It was confirmed during this visit that there had been no staff leave since the last inspection. The fact that the turnover of staff is extremely low is of great benefit to the residents. It means that residents have continuity of care and receive support from people they know very well. The owner of Springfield maintains a regular presence in the home working in it on a full time basis. This close contact with staff and residents not only means that she is regularly available to provide advice and guidance but also allows her the opportunity to closely monitor all aspects of the service. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 6 Through discussions with staff and in viewing records, the inspector was able to determine that the owner of Springfield takes a very positive approach to quality assurance. There are a number of processes in place to constantly monitor standards and review the service provided. In addition, residents are regularly given the opportunity to express their views about the running of the home. For example, within the residents’ meetings which are held on regular basis. What has improved since the last inspection? What they could do better:
Currently, approximately one quarter of carers hold National Vocational Qualifications in care at level two or above. The National Minimum Standard is to have 50 of carers qualified and as such, the home is falling slightly short. The manager is continuing to work towards the target. In the meantime it is recognised that in terms of staffing hours, over half of the care hours on the home’s rota are covered by a qualified care staff members (due to the ratios of full and part time staff). Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 7 Records of all staff training were viewed during the visit and were well maintained and in good order. However, the manager may wish to consider reviewing the current format for recording training. A matrix format would be a useful design to consider, as this would enable information in relation to training to be accessed very quickly and efficiently. The inspector viewed records of personal monies held for residents. The records appeared to be in good order and no inaccuracies were noted. However a number of recommendations were made during the inspection as to how to improve procedures to further safeguard residents. It is recommended that when any cash is booked in or out on behalf of a resident, that two staff sign to confirm the amounts and the fact that the transaction has taken place. It is also recommended that any purchase made on behalf of a resident be evidenced with a receipt. Receipts should then be numbered and kept on file so as to create an auditable trail. 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. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 8 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 Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 9 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): None of the above standards were assessed during this inspection. EVIDENCE: Springfield DS0000062334.V275515.R01.S.doc Version 5.1 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 the following standard(s): None of the above standards were assessed during this inspection. EVIDENCE: Springfield DS0000062334.V275515.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 Residents at Springfield are provided with the opportunity to take part in fulfilling activities on a regular basis. EVIDENCE: Discussions held and records examined, confirmed that there are a variety of activities provided to residents at the home on a regular basis. Such activities include various visiting musicians, arts and crafts and a fortnightly keep fit session. In addition, carers advised the inspector that every afternoon an activity would be held such as a word quiz or a game of dominoes. It was also confirmed that residents are supported to enjoy trips out of the home for instance, to local shopping centres or for a pub meal. The inspector was advised that recently, trips out had been limited to a small number of residents at a time as this had seemed to be of more benefit to the majority of residents. Residents’ meetings take place on a regular basis and minutes confirmed that during the meetings, issues such as menus and activities are discussed. It was also noted that residents’ families and friends are routinely invited to the meetings.
Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 12 At the time of the inspection there were several visitors at the home and it was confirmed that there were no undue restrictions in relation to the times or frequencies of visits. It was also confirmed that the home enjoy some good community links. A number of local community groups visit the home such as the local church choir. Communion is held at the home on a fortnightly basis. Springfield DS0000062334.V275515.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): None of the above standards were assessed during this inspection. EVIDENCE: Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 14 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): None of the above standards were assessed during this inspection. EVIDENCE: Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 15 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 & 29. Staffing levels at this home are adequate to meet residents’ needs. Careful measures are taken to ensure that only suitable people are employed at the home, therefore ensuring residents’ safety. EVIDENCE: Staffing levels at the time of the visit and those outlined on rotas, appeared to be adequate for the size of the home and were in line with previous guidance issued by the Department of Health. In discussion, carers felt that staffing levels were appropriate and enabled them to provide a good standard of care. Staff consulted also confirmed that the manager of the home was flexible when drawing up staffing rotas and that these could be altered at any time to meet the needs of residents. Through discussion with staff and in viewing personnel files, it was confirmed that carers at the home benefit from thorough induction and a good standard of training. The senior who was consulted confirmed that a thorough induction took place with every new staff member during which they would be guided through the home’s policies and procedures and areas such as health and safety. In addition, it was confirmed that close shadowing of all new staff took place until their induction period was successfully completed.
Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 16 Carers were enabled to access training in a number of areas pertinent to their roles including adult protection and caring for people with Dementia. Records also confirmed that all carers had been enabled to access the mandatory health and safety training in areas such as moving and handling and infection control and that this training was regularly renewed. As earlier stated 5 out of 16 carers have achieved National Vocational Qualifications in care at level 2 or above. Another two staff members were undertaking the course at the time of the visit. Records of training were found to be well maintained and in good order. However the inspector recommended that the manager consider reviewing the format used for recording training. Consideration should be given to a matrix which provides all the information to hand, in an easily accessible manner. In viewing a selection of staff files, it was evident that all the necessary checks are completed prior to offering a candidate a position within the home. Such checks included a full employment history and investigation into any gaps, a Criminal Records Bureau check and a POVA (Protection of Vulnerable Adults) check. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 17 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): 31,33,35 & 38. Residents and staff at Springfield benefit from a good standard of management. There are measures in place to protect the health and safety of residents, staff and visitors. EVIDENCE: As earlier stated the manager of this home has a very positive approach to quality assurance and there are a number of measures in place to constantly monitor and improve standards. Such measures include the use of an external quality assurance system (ISO) and regular audits of all areas including cleaning, purchasing and care planning. Satisfaction questionnaires are issued to residents and their families on a six monthly basis. In addition, residents are encouraged to express their views on
Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 18 all aspects of the home during daily contact with the manager or within forums such as residents’ meetings. One carer who was consulted during the visit commented that she and her colleagues were always asked for their views about everyday issues such as the development of policies and procedures during staff meetings. Records of residents’ personal monies were well maintained and in good order. However, it was recommended that when dealing with cash, there should be two staff members who should both sign the records. In addition, it was recommended that all purchases made on behalf of residents should be evidenced with a receipt. Springfield has a health and safety policy in place which is supported by a number of separate procedures such as COSHH (control of substances hazardous to health) and moving and handling. Records of staff training confirmed that all the mandatory health and safety training such as infection control and food hygiene is provided and regularly updated. In discussion, it was evident that staff had a good understanding of health and safety procedures and their importance. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 19 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 X X X X X X HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 X X X X X X X X x STAFFING Standard No Score 27 3 28 2 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 20 Are there any outstanding requirements from the last inspection? yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP28 Regulation 18 Requirement 50 of carers must hold National Vocational Qualifications in care at level 2 or above. Timescale for action 31/12/06 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. 3. Refer to Standard OP30 OP35 OP35 Good Practice Recommendations Consideration should be given to implementing a training matrix to hold all the necessary information about staff training. Two carers should witness and sign any cash transactions carried out for residents. All purchases carried out on behalf of residents should be evidenced with a receipt. Springfield DS0000062334.V275515.R01.S.doc Version 5.1 Page 21 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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