Inspection on 21/09/06 for Springfield Care Centre

This inspection was carried out on 21st September 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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

Springfield Care Centre 10/02/06

Springfield Care Centre 04/05/05

Springfield Care Centre 02/02/05

Springfield Care Centre 02/06/04

Springfield Care Centre 28/01/04

Similar services:

Ashlong House

Henry Nihill House

Birchwood

The Infirmary

Orchard House Nursing Home

St Josephs Rest Home

Red Court Nursing Home

Spinney (The)

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

CARE HOMES FOR OLDER PEOPLE Springfield Care Centre 20 Springfield Drive Barkingside Ilford Essex IG2 6BN Lead Inspector Ms Gwen Lording Key Unannounced Inspection 21st September 2006 10:30 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 DS0000025962.V312258.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. DS0000025962.V312258.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Care Centre Address 20 Springfield Drive Barkingside Ilford Essex IG2 6BN 0208 518 9270 0208 518 0813 manager.springfield@lifestylecare.co.uk 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) Life Style Care Plc Mrs Mary Edwin Oniah Care Home 80 Category(ies) of Dementia (15), Mental disorder, excluding registration, with number learning disability or dementia (15), Old age, of places not falling within any other category (55), Physical disability (10) DS0000025962.V312258.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 2nd August 2006 Brief Description of the Service: Springfield Care Centre is a purpose built care home registered to provide nursing care. The home can accommodate up to eighty people, in three categories: older physically frail people (55); older people with dementia/ mental disorder (15); and younger people who have physical disabilities (10). The home is operated by Lifestyle Care plc. All residents have single rooms with ensuite facilities. The building is divided into units, where smaller groups of people with similar care needs share communal rooms. The home is situated close to shops and public transport - buses and underground. There is ample parking space within the grounds. On the day of the inspection the range of fees for the home was between £544.00 and £800.00 per week. A copy of the Statement of Purpose and Service User Guide to the home is made available to both the residents and the family. There is a copy of the guide in each bedroom, and copies of both these documents are available at the main reception and on each unit. Copies of the most recent inspection report are available on request. DS0000025962.V312258.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection undertaken by the lead inspector, Gwen Lording. It started at 10.30am and took place over six and a half hours. The registered manager was available throughout the visit to aid the inspection process. This was a key inspection visit in the inspection programme for 2006/2007. Discussion took place with the registered manager, several members of nursing and care staff; the Head Cook; housekeeper and the person in charge of the laundry. Nursing and care staff were asked about the care that residents receive, and were also observed carrying out their duties. The inspector spoke to a number of residents and relatives. Where possible residents were asked to give their views on the service and their experience of living in the home. The inspector contacted some stakeholders by phone including the London Borough of Redbridge Commissioning department and the Primary Care Trust’s (PCT) Care Assessment and Review Team. All spoke positively about the significant improvements in the service delivery and quality of care being provided in the home. A tour of the premises, including the laundry and the kitchen, was undertaken and all rooms were clean and tidy with no offensive odours present throughout. A random sample of residents’ files were case tracked, together with the examination of other staff and home records, including medication administration, staff rotas, training schedules, activity programmes, maintenance records, menus, complaints, fire safety, accident/ incident records and staff recruitment procedures and files. Information was also taken from a pre-inspection questionnaire, which was completed and returned by the manager. At the end of the visit the inspector was able to feedback to the manager and the team leaders. The inspector would like to thank the staff and residents for their input and assistance during the inspection. What the service does well: Those residents who were able to express a view, were very happy with the care they were receiving in the home. Several residents also spoke positively about the nurses and care staff. One relative commented: “ Nothing is too DS0000025962.V312258.R01.S.doc Version 5.2 Page 6 much trouble for the manager or her staff. I know my brother is being well cared for and I am kept informed of any changes”. It was very evident that the home is operated for the benefit of residents, and every effort is made to retain the independence of those people living in the home and for them to continue to exercise choice and control over their lives. Although Springfield is a large care home, there is a relaxed atmosphere on all units and residents appeared unhurried and are given sufficient time and support in their everyday activities. The home has an experienced manager who sets high standards for the home. She works with strong staff teams across the home that are committed to further improve the quality of care for people living in the home. This is reflected in the provision of care to residents. Many of the residents have high dependency levels and require a great deal of assistance from both nurses and care staff. The routine of daily living and activities are flexible and varied and suited to the differing needs of the residents, together with their religious, cultural and social preferences. Appropriate signage and décor is in place throughout the home and this makes it easier for those residents living with dementia, to find their way more easily around the home, especially the toilets. The attitude and practice of the service and that of the staff teams promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. During the inspection staff were seen to be providing good personal care and all residents appeared clean and well groomed. What has improved since the last inspection? All the requirements made at the last inspection have been met in full and only one requirement has been made in this report. A major improvement was noted in the development and standard of care plans across all units. Care plans are now very comprehensive and are being used as working tools. There have been great improvements in the service delivery and quality of care in the home, over a period of one year and significantly since the last inspection, across all areas of the service. All staff work as a team and the registered manager Mrs Oniah, and her staff are to be commended for these significant improvements. She is very resident focused and has worked continuously to improve services and provide an increased quality of life for DS0000025962.V312258.R01.S.doc Version 5.2 Page 7 residents with the support of strong staff teams and in partnership with the families of residents and other health professionals. 98 of care staff are qualified to NVQ level 2 or above and this demonstrates a very positive commitment to training from the care staff and the organisation. There is a well developed and comprehensive training programme and the low turnover of staff means that a consistently good service is being delivered to residents. 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. DS0000025962.V312258.R01.S.doc Version 5.2 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 DS0000025962.V312258.R01.S.doc Version 5.2 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): Standards 1, 3, 4 & 5 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to this service. Comprehensive assessments are being undertaken for all residents prior to them moving into the home. Care plans are drawn up from the information in this assessment, ensuring that the needs of the residents are identified, understood and met. The home does not offer intermediate care. EVIDENCE: Individual records are kept for each resident. A total of fifteen files were examined, three on each unit of the home. All records inspected have assessment information recorded and the information had been used to continue assessment following admission to the home and develop written care plans. The records showed that residents, where capable and their relatives/ representatives are involved in the assessment process. Where appropriate, information provided by the placing authority was also on file. DS0000025962.V312258.R01.S.doc Version 5.2 Page 10 Through discussion with the manager it was evident that prospective residents and their relatives are given a copy of the Statement of Purpose, service user guide and other useful information is made available to them. There is always the opportunity to visit the home prior to making any decision to move in. DS0000025962.V312258.R01.S.doc Version 5.2 Page 11 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): Standards 7, 8, 9, 10 & 11 Quality in this outcome area is excellent. This judgement has been made using all available evidence including a visit to this service. Residents’ health, personal and social care needs are set out in individual care plans and provide staff with the information they need to satisfactorily identify and meet residents’ needs. Care plans are being used as working tools and residents benefit from the attention to detail paid by staff at the home in meeting their needs. All residents could be assured that at the time of their death, staff would treat them and their family with care, sensitivity and respect. EVIDENCE: General A major improvement was noted in the standard of care plans across all units. Care plans are very comprehensive and are being used as working tools. They are sufficiently detailed as to be understood by all staff and to others who may not be as familiar with the individual resident. Care plans are detailed to the degree of identifying specific choices around the time a resident wishes to have DS0000025962.V312258.R01.S.doc Version 5.2 Page 12 their night light turned off; low light left on all night, curtains not to be drawn at night. Particularly of note was the detail of care plans relating to residents who have specific religious or cultural needs and for staff to be able to understand and assist with the communication of the individual’s needs. As far as possible, residents are involved in the drawing up of their care plan, and relatives are invited to attend the annual reviews. In addition to the team leader and the individual’s key worker, one of the activity co-ordinators attends the reviews. Management of risk routinely takes into account the needs of a resident, balanced with maintaining their independence and choice. The inspector was able to evidence many positive examples of this during the visit and these will be included in this report. The wishes of individual residents about dying and death are openly and sensitively discussed with both residents and their family members and end of life issues detailed on care plans. The necessary religious rights are recorded in care plans and observed where appropriate. There are arrangements in place, to enable family and friends to stay with a resident and to assist with their care if the residents wishes. Staff in the home routinely support relatives following the death of a resident through sympathy cards, floral tributes and support for staff to attend funerals. From discussions with staff and from viewing letters received from relatives it was evident that staff dealt with a person’s dying and death in a sensitive and understanding manner, both for the individual and their relatives. One relative commented: “The management, nursing staff and the carers were all most kind and treated her with the utmost respect until she passed away” another said, “My Granddad could be difficult but he was treated with patience, respect, care and affection”. The manager of this home is currently involved in a project to develop End of Life care in line with the most recent Department of Health (DOH) initiative. This project is being developed in conjunction with two inspectors from the Commission, a manager of another Life Style plc care home, the Redbridge Primary Care Trust, Macmillan nurses, clinical specialists and other interested agencies. As a result of this initiative areas of development have been identified and will include care planning, staff training, information for service users and their relatives/ friends, review of current policies, and links to other health and community resources. The principles of respect, dignity and privacy were evidenced throughout the inspection. Residents are treated with respect and the arrangements for their personal care ensure that their right to privacy is upheld. Staff were seen to be DS0000025962.V312258.R01.S.doc Version 5.2 Page 13 very gentle when undertaking moving and handling tasks and offered explanation and reassurance throughout the activity. There is an ongoing project with the Primary Care Trust (PCT) in supporting the home to reduce the number of residents being admitted to hospital. The home has regular and valued input from a psycho-geriatrician and any resident can be referred to her for assessment. They now find that fewer residents are needing to be admitted to hospital. Residents were asked about the care they receive in the home. Comments included: “Staff couldn’t be kinder. They do everything with such good grace and care”. Another said, “Nothing is too much trouble for staff. I know I can be difficult at times – but they understand”. There are clear medication policies and procedures for staff to follow. Discussions with staff and the review of medication records show that staff are following the policies and procedures, so as to ensure that residents are safeguarded with regard to medication. Sparrow Unit Individual care plans are available for each resident and the files of three residents were case tracked. It was evident from these files that there have been significant improvements in the development of care plans. All care plans were found to be detailed and comprehensive. There was evidence that care plans were being reviewed at least monthly and updated to reflect changing needs and current objectives for health and personal care. Care plans contained specific information with regard to the individual’s cultural; social care needs and leisure activities. Files indicated evidence of health care professionals involvement including, optician, chiropodist, dentist and tissue viability nurse specialist. Nutritional screening was being undertaken on admission and a record was being maintained on nutrition, including weight loss or gain with appropriate action being taken when necessary. Food intake charts are maintained where necessary however, staff must record the amount of food intake as well as the type of food. For example, on one chart staff entries included “porridge, soup, sandwich”. The amount of food taken by the resident must be clearly recorded for example, two tablespoons; large bowl; size and number of sandwiches. This detail of recording will ensure that an accurate record is being maintained of nutrition. This is slightly disappointing as all other monitoring charts throughout the home were being maintained to a very good standard. DS0000025962.V312258.R01.S.doc Version 5.2 Page 14 All staff had undertaken training in the care of people living with dementia and the benefits of this were evident in the interaction observed between staff and residents, and in the way that residents were treated with respect at all times. The training has also improved the understanding of residents’ behaviour, which has enabled improved care provision. Nightingale Units 1 & 2 The files of four residents were case tracked and discussions held with the team leader, care staff and several residents. All residents had comprehensive and detailed care plans, which were being reviewed at least monthly and more frequently if necessary. It was evident, that where possible, residents were involved in the development of their care plans, and where this was not possible relatives were involved. Risk assessments are routinely undertaken on admission around nutrition, manual handling, continence, risk of falls and pressure sore prevention; and reviewed on a regular basis. The documentation/ health records relating to wound management; the management of a resident with insulin dependant diabetes; the management of a resident with a non isolated infection and the most recently admitted resident, were found to be detailed and adequately maintained. Fluid intake/ output charts and turning regimes, were up to date and being adequately maintained. Files examined indicated the involvement of health care professionals including speech and language therapist, physiotherapist; and optical, dental and chiropody services. Kingfisher Unit Individual care plans are available for all residents and the files of three residents were case tracked. All the care plans examined were found to be detailed and comprehensive, with evidence of regular reviews and the updating of care plans to reflect changing needs. The documentation/ health records relating to wound management and the management of a recently admitted resident, were being adequately maintained. The care plan examined of a resident with an isolated infection was shown to be very detailed and included reference to universal precautions for the control of infection and eradication protocols. Records indicated that residents are seen by health professionals such as tissue viability nurse specialist; dietician; and care from community health services and hospitals. Nutritional screening is routinely undertaken and records are maintained of nutrition including weight loss or gain with appropriate action being taken where necessary. Fluid monitoring, turning regimes and blood sugar monitoring records were up to date and being adequately maintained. DS0000025962.V312258.R01.S.doc Version 5.2 Page 15 Robin Unit The files of three residents were case tracked and all were found to be detailed and comprehensive. It was evident that, where possible, residents were involved in the development of their care plans, and where this was not possible relatives were involved. Care plans were being reviewed at least monthly and updated to reflect changing needs. The documentation/ health records relating to wound management and the management of insulin dependant diabetics, were detailed and being adequately maintained. The care plan of a resident with an infection, included reference to the use of universal precautions in the effective control of infection. Records indicated that residents are seen by other health care professionals such as dermatologists; tissue viability nurse and care from community health services. Risk assessments are routinely undertaken on admission around nutrition, manual handling, continence, risk of falls and pressure sore prevention; and reviewed on a regular basis. Starling Unit Individual care plans were available for each resident and the files of three residents were case tracked. All residents had comprehensive care plans, which promoted the values of choice and independence by considering all aspects of a person’s life. Care plans were reviewed at least monthly and more frequently if necessary and updated accordingly. Nutritional screening is being routinely undertaken and a record maintained on nutrition, including weight gain or loss, with appropriate action being taken to address nutritional issues when necessary. Files indicated evidence of health professionals involvement such as physiotherapist; and care from community health services. It was evident that, where possible, residents were involved in the development of their care plans, and where this was not possible relatives were involved. Where necessary risk assessments were in place, and the management of risk takes into account the needs of residents with regard to independence and choice. DS0000025962.V312258.R01.S.doc Version 5.2 Page 16 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): Standards 12, 13, 14 & 15 Quality in this outcome area is excellent. This judgement has been made using all available evidence including a visit to the service. The lifestyle within the home matches the expectations and preferences of residents with regard to social, cultural, religious and recreational interests and needs. The attitude and practice of the service and that of staff teams and individuals working in the home, promote opportunities for residents to remain independent, exercise choice and express their wishes and needs. The nutritional needs of residents are well considered so that food and mealtimes are seen as being important for all residents. EVIDENCE: There is a general programme of activities available for residents on all units of the home. Activities have greatly improved and are now more individually planned. All residents have had an activity assessment completed and this provides guidance on the appropriate level of activity for each individual. In addition a “One to One” weekly activity record has been introduced and each resident has an individual copy on file, which records the activity and level of participation. DS0000025962.V312258.R01.S.doc Version 5.2 Page 17 The home employs two full time activity co-ordinators and they are viewed as valued members of the staff teams. From observation during the visit, discussions with residents and staff, and information on individual activity records, it was evident that a great deal of consideration and time is given to planning and undertaking activities. This included: “ watching Asian video’s; listening to religious song; enjoys watching the Punjabi TV channel; likes to walk around the garden – smelling, touching and talking about plant/ flowers; just sat, chatted and looked at old photographs; goes to the local supermarket once a week with the activity co-ordinator to do her personal shopping”. During the inspection, one of the activity co-ordinators was encouraging residents to participate in small group and individual activities, with a great deal of success. As well as undertaking activities the co-ordinators arrange activities for care staff to undertake with individuals and small groups. Several residents became restless and staff were on hand to take them for a walk or found time to sit and talk to residents on a small group or individual basis. Other residents were seen to be pursuing their own interests such as reading, listening to music or watching television their own rooms. Several residents attend activities at specialist day service in the community e.g. Link Place. One resident who had enjoyed riding motorcycles in his younger days had been taken to a local venue where a motorcycle club meets. With the support of the activity co-ordinator he had been able to meet with other enthusiasts and discuss a shared passion. He was most proud of a photograph that the staff had taken of him to remember the day. One resident was celebrating her birthday and the kitchen had provided a cake. A number of residents and staff were able to join her and share a ‘birthday tea’. A birthday card had been signed by staff and residents. From discussion with staff and residents it was evident that this is arranged for all residents wishing to celebrate their birthday. There are regular visits by local clergy and if any resident wishes to attend a religious service outside the home then this would be arranged. The staff of a recently admitted resident of the Muslim faith are making contact on his behalf with a local mosque. His care plan includes information for when he needs support to pray privately, several times a day. All staff were aware of this and the manner of support required. The inspector was able to observe that the routines of daily living and activities were flexible and varied and suited to the differing needs of residents across all units of the home. The inspector observed members of staff allowing time for residents to express their wishes and supporting individuals to make choices in their daily lives, for example choosing a drink, newspaper, type of music to listen to or where they wished to take their meal. All staff including administrative and ancillary staff are very aware that Springfield is the home of the residents and try to make this as pleasant as is possible. DS0000025962.V312258.R01.S.doc Version 5.2 Page 18 Many of the residents have high dependency levels and require a great deal of assistance from both nurses and care staff. At all times it was observed that residents were treated with respect and dignity. Appropriate signage and décor is in place to aid the orientation of residents living with dementia. Visiting times are flexible and relatives/ friends are encouraged to visit whenever possible and such visitors are involved in the lives of the residents. Relatives/ residents meetings are held every three months and they are very well attended and supported. Menus are varied and food served was observed to be appealing, wholesome and nutritious. Food was presented and served in ways that were suited to the individual needs of residents, for example smaller portions, nutritious snacks and finger foods. Pictorial menus have now been developed and residents are also encouraged to make a choice at meal time through the use of small plated portions of the meals being made available, so that they can see and smell the food and thereby make a more informed choice. Staff are on hand to assist individuals with eating when necessary and residents were not rushed. Religious or cultural dietary needs are catered for and this is recorded in care plans. Meals are served in the dining rooms or residents may choose to eat in their rooms. In all units dining tables were laid with cloths, napkins, condiments, cutlery and glasses and the settings were very congenial. The manager has recently introduced an internal catering survey for residents and / or their relatives to complete with the aim of improving menus and the overall dining experience. A visit was made to the main kitchen and the inspector discussed the storage and preparation of food and menus with the head cook. She demonstrated a good knowledge and understanding of the importance of well balanced and well presented meals. It was also evident that religious, cultural and specialist dietary needs are being catered for. Following a requirement at the last inspection separate storage has been provided for kosher and halal foods. Each day the kitchen prepares nutritional “smoothies” for those residents whose diet requires supplementing due to reduced food intake/ diminished appetite. DS0000025962.V312258.R01.S.doc Version 5.2 Page 19 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): Standards 16 & 18 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The manager and staff make every effort to sort out any problems or concerns and makes sure that residents and their relatives feel confident that their complaints and concerns are listened to and will be acted upon. Staff working in the home have received training in adult protection/ abuse awareness to ensure that there is a proper response to any suspicion or allegation of abuse. EVIDENCE: The home has a written complaints policy and procedure and the complaints log inspected indicated the number of complaints received and included details of investigation, action taken to resolve them and the outcome for the complainant. The manager also maintains a register of issues and concerns, which enables her to address any expressions of concern or dissatisfaction with any element of the service without delay. Complaints and concerns made to the manager are always taken seriously and she actively addresses all concerns and aims to resolve to the satisfaction of the complainant. No complaints have been received by the Commission since the last inspection. There is an in house training programme for all staff in adult protection and recognising and reporting adult abuse. This has been extended to include all administrative/ ancillary staff and for all new staff during their induction. Those DS0000025962.V312258.R01.S.doc Version 5.2 Page 20 staff spoken to during the inspection were aware of the action to be taken if they had concerns about the safety and welfare of residents and were also vigilant to the potential abuse between resident and resident(s). The outcome for any adult protection referral is managed well and the registered manager works co-operatively with the Commission, local adult protection and other agencies to address all matters. DS0000025962.V312258.R01.S.doc Version 5.2 Page 21 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): Standards19, 20, 22, 24 & 26 Quality in this outcome area is good. This judgement has been made using all available evidence including a visit to the service. The environment on all units of the home is of a good standard and provides residents with a clean, safe and comfortable place in which to live. EVIDENCE: A tour of the premises was undertaken and all areas of the home were found to be well lit, clean, pleasant and hygienic with no offensive odours anywhere in the home. Specialist equipment such as hoists and handrails were evident, and any other equipment required would be provided to enable a resident to maintain independence. All bedrooms are very personalised and those rooms visited indicated and were representative of the occupant’s cultural, religious or personal interests. Residents are encouraged to bring in some of their own furniture. There is a call alarm system fitted to each bedroom, which is located within easy reach of each resident’s bed. DS0000025962.V312258.R01.S.doc Version 5.2 Page 22 The standard of décor, furnishings and fittings are being maintained to a good standard. The external grounds are being well maintained. Toilet door frames have been painted in a different colour with appropriate signage to aid orientation for people living with dementia. More appropriate pictures and photographs have been put up in the corridors and communal areas to provide points of interest for residents. Individual bedrooms also have signage, which is familiar to the occupant. Following a recommendation made at the last inspection the use of the communal areas on Sparrow unit has been reviewed. At the time of this visit work was in progress to change one of the lounges into a dining room/ quiet room. When completed this will provide residents with a choice of place to sit quietly, and meet with visitors. Hand washing facilities are prominently sited and staff were observed to be practising an adequate standard of hand hygiene. The laundry area was visited and this was clean, with soiled articles, clothing and infected linen being appropriately stored, pending washing. Laundry staff were aware of health and safety regulations with regard to handling and storage of chemicals. Personal Protective Equipment (PPE) such as clothing, gloves, masks and goggles were available and in use. DS0000025962.V312258.R01.S.doc Version 5.2 Page 23 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): Standards 27, 28, 29 & 30 Quality in this outcome area is excellent. This judgement has been made using all available evidence including a visit to the service. Staffing levels are satisfactory and residents benefit from a committed staff team who have the skills, training and competence to meet the individual assessed needs of residents. The procedures for the recruitment of staff are robust and provide safeguards for the protection of residents. EVIDENCE: Staff rotas were inspected and the staffing levels and skill mix of qualified nurses and care staff, on all units of the home, was sufficient to meet the assessed nursing and personal care needs of residents. Care workers were being effectively deployed to ensure that residents choosing, or needing to remain in their bedrooms were being cared for appropriately. Springfield has a relatively stable workforce and effective team working was observed and evidenced throughout the inspection. Staff interacted well, both with each other and the residents. There is no use of agency staff and any gaps in the rota are covered by permanent bank staff. This is clearly to the benefit of residents since it provides consistency of care, which is extremely important to all residents, important for those people living with dementia. DS0000025962.V312258.R01.S.doc Version 5.2 Page 24 A random sample of staff personnel files were inspected and these were found to be in good order with necessary references, criminal records bureau disclosures, and application forms duly completed. It was evident that the recruitment procedures are robust and in accordance with the Care Homes Regulations. All staff are given a copy of the General Social Care Council’s code of conduct and standards and are employed in accordance with this. From talking to staff, inspecting training records and observation, it was apparent that staff have the opportunities to undertake various training courses, and that such training is then put into practice within the home to the benefit of residents. The majority of staff have undertaken intensive training in caring for people with dementia and this was evident in the attitude and practices of staff when interacting and caring for residents. A record is maintained of staff training and records showed that staff have undertaken training in essential areas such as fire safety, moving and handling, health and safety, adult protection, infection control and food hygiene. Other staff have undertaken training in continence management, wound care, effective communication, care planning and challenging behaviour. Three members of the nursing team have obtained an English National Board (ENB) qualification “Teaching and Assessing in Clinical Practice”; and there is a member of nursing staff on each unit who has undertaken, and been assessed as competent to undertake intravenous cannulation and phlebotomy. This means that where appropriate, residents can have blood samples taken by nurses qualified to do so, and avoid unnecessary trips to hospital. The two activity co-ordinators have also completed a training course run by the National Association for Provider of Activities for Older People, and the effectiveness and implementation of this training is clearly evident in the development and improvements to the range of activities available in the home. Approximately 98 of care staff have been trained to NVQ level 2, and some to NVQ level 3. This demonstrates a very positive commitment to training both from care staff and the registered providers. DS0000025962.V312258.R01.S.doc Version 5.2 Page 25 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): Standards 31, 32, 33, 35, 36, 37 & 38 Quality in this area outcome is excellent. This judgement has been made using all available evidence including a visit to the service. The manager of the home is a well qualified and experienced person and residents benefit as the home is run in their best interests. Monitoring visits are undertaken regularly by the responsible individual to monitor and report on the quality of the service being provided in the home. Staff are appropriately supervised and the health, safety and welfare of service users and staff are promoted and protected. DS0000025962.V312258.R01.S.doc Version 5.2 Page 26 EVIDENCE: It was evident during the inspection that the home is being very well managed and the manager is keen to work in collaboration with external agencies and the Commission. Through staff training, supervision and good management, staff are ensuring that residents receive a high standard of care and that the home is run in their best interests. All staff spoken to throughout the visit, both care and departmental staff, spoke very positively about how well supported they felt by the manager. Staff receive regular 1:1 supervision, direct observation of care practices, annual appraisals and staff group meetings. Mrs Oniah has an open and inclusive style of management and staff feel valued. She is very resident focused and works continuously to improve services and provide an increased quality of life for residents with the support strong staff teams and in partnership with the families of residents and professionals. Under her leadership there have been great improvements in the service delivery and quality of care in the home, across all areas of the service, over a period of one year and significantly since the last inspection in February this year. All staff work as a team and in a home of this size the manager and her staff are to be commended for this. The manager ensures that policies and procedures are reviewed on a regular basis and that she keeps up to date with new and changing legislation. Audits, spot checks and quality monitoring systems provide evidence that practice reflects the homes policies and procedures. The responsible individual undertakes Regulation 26 monthly monitoring visits and a copy of the report is sent to the Commission. Information gained from relatives/ residents meetings; complaints, concerns and compliments; and quality assurance questionnaires are all used to make improvements and influence service delivery. Currently the manager does not act as an appointed agent for any resident. Residents’ financial affairs are managed by their relatives/ representatives. The home has responsibility for the personal allowance of several residents. There is a computerised financial system in place, which is managed by the home’s administrator. Through discussion with the administrator and records inspected, there was evidence to show that residents’ financial interests are safeguarded. Secure facilities are provided for the safekeeping of money and valuables held on behalf of residents. A wide range of records were looked at including, fire safety, emergency lighting, water temperature checks, health and safety audits and portable DS0000025962.V312258.R01.S.doc Version 5.2 Page 27 appliance testing. These records were found to be detailed, up to date and accurate. DS0000025962.V312258.R01.S.doc Version 5.2 Page 28 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 4 11 4 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 4 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X 3 X 3 X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 4 X 3 3 3 3 DS0000025962.V312258.R01.S.doc Version 5.2 Page 29 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 Standard OP8 Regulation 12 Requirement Where food intake charts are being maintained, staff must record the amount as well as the type of food. For example, two tablespoons, large bowl; size and number of sandwiches. This detail of recording will ensure that an accurate record is being maintained of nutrition. Timescale for action 21/09/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations DS0000025962.V312258.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Ilford Area Office Ferguson House 113 Cranbrook Road Ilford IG1 4PU 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 DS0000025962.V312258.R01.S.doc Version 5.2 Page 31 - 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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