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Inspection on 24/05/05 for Springfield Care Home

Also see our care home review for Springfield Care Home for more information

This inspection was carried out on 24th May 2005.

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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

The service users residing at Springfield that spoke with the inspector, reported that they are happy with the service provided. They commented that the staff and the manager were respectful, approachable and the home was a pleasant place to live.

What has improved since the last inspection?

A number of the requirements set at the previous inspection have been addressed by the proprietor and the manager. Plans are in place to develop care planning and improve the review process of service users care. Work has been carried out on the garden, improving access for service users .

What the care home could do better:

The process of evaluation and review of development plans and risk assessments is improving but more time needs to be allocated to the development of systems and planning the review process. The planning and promotion of healthcare needs to be documented in finer detail to include the input of healthcare professionals and to enable all staff to follow. Outstanding improvements to the general condition of furniture, bathrooms and radiator guards remain. Some service users and relatives said that they were concerned over service users users clothes being lost, service users wearing other people`s clothes and support not being provided at the time required by care needs of the service users. Whilst the manager resolves such issues, the problems re-emerge on a frequent basis.

CARE HOMES FOR OLDER PEOPLE Springfield Care Home Lawton Drive Bulwell Nottingham NG6 8BL Lead Inspector Andrew Sales Unannounced 24 May 2005 10:00 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 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 Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address Lawton Drive Bulwell Nottingham NG6 8BL 0115 927 9111 0115 979 4759 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Annesley (Oldercare) Limited, 21 Arlington, Woodside Park, London N12 7JR Mrs Eileen Hester Care Home (CRH) 40 Category(ies) of Old age, not falling within any other category registration, with number (OP) 40 of places Dementia - over 65 years of age (DE(E)) 7 Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1. To accommodate one named out of category service user for respite care 2. To include up to 7 elderly service users with Dementia 3. The registration reverts to 40 places for Older People when the placement of the one named individual ceases. Date of last inspection 11/03/05 Brief Description of the Service: Springfield is a care home providing personal care and accommodation for 40 older people. The home has seven registered places for people with a diagnosis of dementia.The home is owned by Annesley (Oldercare) Limited.The home is located on the outskirts of Bulwell town centre which is approximately 7 miles to the north of Nottingham city centre.The home was purpose built and was opened in November 1989. It consists of a three-storey building with the lower ground floor being used to accommodate the dining room and conservatory, kitchen and laundry.All but four of the home’s bedrooms are single. All bedrooms have en-suite facilities that consist of a toilet and wash hand basin. There is a passenger lift. The gardens are mainly laid to one side and the rear. They are easily accessible from the conservatory and consist of lawned areas. There is a car park to the front of the building. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was an unannounced visit conducted by Andrew Sales, Regulation inspector on Tuesday 24 May 2005. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Service Users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The service users spoken with, made positive comments about the services provided. They felt comfortable in the home, were pleased with attitude and skills of the staff and were happy with their private accommodation and with the food provided. A number of requirements were made as a result of the previous inspection. A number of these have been addressed, a proportion of these are in the process of being addressed. Although improvements have been made to the maintenance of the accommodation there is further work still to do. What the service does well: What has improved since the last inspection? Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 6 A number of the requirements set at the previous inspection have been addressed by the proprietor and the manager. Plans are in place to develop care planning and improve the review process of service users care. Work has been carried out on the garden, improving access for service users . 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. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 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 Standards Statutory Requirements Identified During the Inspection Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3 and 4 The home demonstrates clearly that it is able to meet the needs of the service users it admits. Care planning is improving but requires more dedicated management time to complete. EVIDENCE: Needs assessments were in place in four of the personal files examined and development plans had been devised from the individual assessed needs. All areas of needs assessment required in standard 3 were present, but details in two of the files was inadequate. The manager showed the inspector plans in place to address this. Evidence of local authority assessments were present, along with input of other healthcare professionals, i.e. GP visits. Some plans evidence family involvement, in particular with service users with Dementia. A dementia link plan developed by the Alzheimer’s society is completed by family members. This focuses on the preferences and abilities of individuals and contributes well to the care planning process. A district nurse spoke with the inspector and commented positively on the interaction and skills of the staff and training sessions made available to the staff team. Evidence of appropriate staff training was found on staff files, and through discussion with staff and the manager. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7,8,9,10 Care planning covers all areas of assessed need but requires more detail in actions required by staff and desired outcomes for service users. The home promotes service users health and personal care needs and interacts well with other healthcare professionals. The home manages medication in accordance with regulations and actively promotes the rights of the individual. EVIDENCE: The care plan files are very well maintained and information is easily accessible. They are divided into sections including an assessment of the individual’s needs, a description of how the assessed needs are to be met and a review section. Two of the four files seen, contained good examples of care planning. The other two were not fully completed however and none of the care plans seen had been reviewed. As the process to address these outstanding requirements is in place, an extension to this requirement deadline has therefore been set. The care records contain evidence that service users health needs are promoted through assessments that have led to the involvement of GP; District Nurses; Chiropodists; Dentists and Dieticians. Equipment for the promotion of tissue viability is evident throughout the home but its prescribed use is not Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 10 recorded in the care plans. A district nurse spoke with the inspector and confirmed that none of the service users required treatment for pressure sores at present, but minor treatment was being provided for other conditions. The district nurse confirmed systems in the home worked well for the identification, communication and treatment of pressure sores. The records and storage of medication was observed. No issues were raised in respect of the management of medication. The service users and a relative told the inspector that they felt the staff were very helpful and respectful towards service users. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 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 standard(s) 12,13,14,15 Service users feel comfortable with the routines and their ability to exercise choice within the home. Family members are actively involved with the home. Meals and snacks are well organised enjoyed by the service users. EVIDENCE: The service users spoken with confirmed that they have visitors at any time. Eight visitors visited the home during the inspection. The accommodation allows for meetings to take place in private if necessary. The home arranges for local entertainers to visit the home and all service users spoken with confirmed that they looked forward to such events. All service users spoken with have brought their own furniture to the home. A record of the service users belongings was seen. Service users have access to their personal records. The service users spoken with confirmed that they enjoy the majority of the meals provided. The staff were observed taking lunch orders from each service user. Some people choose not to eat in the dining room but take their meals in the lounge or in their own rooms. Three full meals are provided and people can chose a cooked breakfast or tea also if they wish. Hot and cold drinks and snacks are offered at regular intervals during the day. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 12 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 standard(s) 16 and 18 The home has a complaints policy and provision for recording complaints. The home complies with adult protection procedures. EVIDENCE: Staff cover adult protection and whistle-blowing policies and procedures during induction and sign to acknowledge this, this was evidenced on staff files. Staff spoken with demonstrated an understanding of adult protection issues. Complaints procedures were observed, but records were not available for inspection. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 13 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 standard(s) 19,20,21,25 The accommodation is suitable, clean and hygienic. Improvements have been made to the garden. Improvements to the furniture, bathrooms and some health and safety requirements remain outstanding. EVIDENCE: The accommodation is flexible enough to provide for a range of different needs. There is a conservatory that is the homes designated smoking area. There is a smoke free sitting room. Some of the lounge and bedroom chairs require replacing. This is outstanding from the previous inspection. There are accessible toilet facilities close to the lounge and dining room. In addition all rooms have en-suite facilities that include a toilet and wash hand basin. Bathrooms are in need of renovation. This is outstanding from the previous inspection. Some radiators still require guards or measures put in place for the protection of service users in particular those with dementia. This is outstanding from the last inspection. Maintenance records were observed for water systems and gas central heating. Staff record testing of water temperatures at outlets. These were observed to Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 14 be at 21C degrees. The inspector recorded two different outlets, one was 35c degrees and one at 46C degrees. The latter exceeds the recommended safe temperature and needs to be rectified. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27,28,29,30 Satisfactory numbers of staff were on duty on the day of the inspection. Suitable recruitment methods and training plans are in place at the home. The home is progressing the NVQ training program for staff. EVIDENCE: There were appropriate staff numbers on duty at the time of the inspection. The staff rota was observed and found to be consistent in staffing numbers. Criminal records Bureau (CRB) enhanced disclosures and POVA first checks, along with other pre-employment checks are being sought prior to a person commencing employment. This was evidenced form three staff files. One staff member discussed her induction and training at the home. This met with the requirements and was confirmed by records seen. Training records and plans were observed. The manager is a qualified NVQ assessor for level 2 and 3. Four care staff currently have the level 2 certificate and 3 are studying. Distance learning is provided by the Peoples college. All new staff attend the T.O.P.P.S induction to social care at the Peoples college. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,32,34,35,36,37,38. The home strives to ensure the service users interests and safety are a priority. EVIDENCE: The registered manager has undertaken training aimed at developing the staff team. The staff and service users and a relative stated that the manager is approachable and encourages good practice amongst the staff team. One staff member stated that the team work well together and are supportive to one another. The staff were observed approaching the office for advice and to handover information to the manager. The inspector observed appropriate recruitment procedures on staff files. The records maintained are well organised and kept in an office that is lockable. Service users can access their records and one person informed the inspector that they had been involved in the formulation of their care plan. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 17 Service users finances are managed separately. Records of two these were inspected and found to be correct. Although environmental improvements remain outstanding, health and safety issues are well managed and promoted by the manager. Training in moving and handling is provided by Beeston Care. Evidence of contract servicing was observed for the following: • Nurse call system. 29.03.05 • Lift.27.04.05 • Hoists.9.05.05 • Fire officer.13.05.05 The manager stated that electrical and gas servicing is conducted at required intervals, but records were not present. Fire drills and alarm tests are delegated to the team leader and records were evidenced. Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 18 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 2 3 x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION 3 2 2 x x x 2 x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 x 3 3 3 3 3 Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 19 yes Are there any outstanding requirements from the last inspection? 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 7 Regulation 15 Requirement The registered manager must ensure that the care plans describe the assessed needs of each service user and outline the action to be taken to meet the identified needs. Each care plan must be reviewed on at least a monthly basis. Provide a maintenance plan to the commission to include an audit of the chairs in the home to clean or replace those, which are soiled or badly worn. All bathrooms must be upgraded where necessary to make them fit for their purpose. The locks must be useable to ensure privacy. (This requirement remains unmet from the previous inspection) Environmental risk assessments must be regularly reviewed and considered according to the needs of people with Dementia. This includes the need to cover exposed heaters whilst leaving temperature controls accessible. (This requirement remains unmet from the last inspection) Ensure water temperatures are recorded accurately and Timescale for action 30 August 2005 2. 3. 7 20 14(2) 23 August 30 2005. August 30 2005. 4. 21 23 (2)(i) August 30 2005. 5. 25 13(4) Immediate 6. 25 13 (4) (a,b,c) immediate Page 20 Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 measures are put in place to regulate temperatures appropriately. 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 Good Practice Recommendations Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 21 Commission for Social Care Inspection Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT 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 Springfield Care Home C53 C03 S2305 Springfield V225966 240505 Stage 4.doc Version 1.30 Page 22 - 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. 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