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Inspection on 26/04/06 for Springfield Care Home

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

This inspection was carried out on 26th April 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

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

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 manager and staff are very committed to providing good standards of care for the residents. Residents and relatives stated they feel that the staff are sensitive to their needs and choices. The food is well thought of and residents feel respected and enabled to socialise in a manner that is comfortable for them. Evidence from relatives indicated that the staff team have provided excellent care and support for their parents and were particularly complimentary over the general approach provided by the staff team. They also felt that this was consistent throughout the home.

What has improved since the last inspection?

A number of requirements that were set at the previous inspection, have been addressed by the manager and proprietor. The manager has developed new polices and guidance to reduce the incidence of falls in the home and the homes response to such incidences.

What the care home could do better:

There are insufficient personnel records maintained at the home. Some staff records examined did not evidence sufficient pre-employment checks are conducted, prior to commencing work. There was no evidence of any recruitment process being employed. This was also identified at the previous inspection. There is no evidence to suggest that staff are regularly trained in any of the mandatory Health and Safety subjects, or in Adult Protection Issues after they commence work. Staff have not received updates in practical training in safe moving and handling techniques.

CARE HOMES FOR OLDER PEOPLE Springfield Care Home Lawton Drive Bulwell Nottingham NG6 8BL Lead Inspector Andrew Sales Unannounced Inspection 25th April 2006 10:00 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 Care Home DS0000002305.V290428.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 Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address Lawton Drive Bulwell Nottingham NG6 8BL 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) 0115 927 9111 0115 979 4759 Annesley (Oldercare) Limited Mrs Eileen Hester Care Home 40 Category(ies) of Dementia - over 65 years of age (7), Old age, registration, with number not falling within any other category (40) of places Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. To accommodate one named out of category service user for respite care To include up to 7 elderly service users with Dementia. The registration reverts to 40 places for Older People when the placement of the one named individual ceases. 27th February 2006 Date of last inspection 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 homes 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 DS0000002305.V290428.R01.S.doc Version 5.1 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 26 April 2006. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for Relatives 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 residents and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. A number of other residents also spoke with the inspector. The residents and relatives 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. What the service does well: What has improved since the last inspection? A number of requirements that were set at the previous inspection, have been addressed by the manager and proprietor. The manager has developed new polices and guidance to reduce the incidence of falls in the home and the homes response to such incidences. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 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 the following standard(s): 3,4,6. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Resident’s receive an assessment prior to admission. Assessment plans are well documented. Residents and relatives feel that the home will meet their needs. The staff team are familiar with the individual needs of the resident’s. Intermediate Care is not provided at the home. EVIDENCE: The records of three resident’s files were checked as part of this inspection. All of these contained an extended social work assessment, which had been obtained prior to their admission. All files contained assessments conducted by the manager, or deputy manager. All of the assessments were comprehensive and contained sufficient information to enable staff to ensure that they could Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 9 meet the residents assessed needs. There were detailed action plans for care workers. Three residents explained to the inspector how they were supported at the home and felt standards were good in terms of personal care, food and social stimulation. They said they liked the homely environment and services available. Two relatives also spoke with the inspector and they felt the home was right for their mother and father. All residents spoken with felt that the staff were competent and professional. Springfield Care Home DS0000002305.V290428.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): 7,8,9,10. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents receive a comprehensive assessment. Assessments are updated following a review. The home is able to meet the healthcare needs of it’s residents. Medication issues appropriately. EVIDENCE: Three care plans observed, were well set out and detail each area of need and an action plan is drawn up to meet this need. Risk assessments were well documented in each of the resident’s plans that were inspected. Particular attention is placed in the need to prevent pressure sores, falls and safe working practices. Daily records are well maintained by care staff and professional input from district nurses and GP’s is well documented. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 11 are managed appropriately. Residents are treated Evidence gained from speaking to residents and staff suggested the care planning process was accurate and outcomes satisfactory. Resident’s plans contain details of each individual’s health care needs, including tissue viability and continence risk assessments. There is evidence that people have been appropriately referred to health care professionals. Care plans viewed contained records of visits by district nurses, General Practitioners and other professionals. Healthcare professionals were observed visiting on the day. The inspector discussed issues relating to the management of falls, which were raised at the previous inspection. The manager showed the inspector new guidelines for staff, that have been introduced to reduce the incidence of falls and to deal with falls more effectively. The manager also stated that she is on the waiting list for the ‘Falls prevention team’ to visit the home. Staff training records evidenced that medication training was provided for staff responsible for the administration of medication. The homes medication administration systems have been well maintained. There is a policy and procedures for receiving, recording, storing, handling, administering and disposing of medicines. The home is registered with the local pharmacist and support and advice obtained as and when needed. The pharmacist visits twice a year and conducts and audit of the homes medicines. The deputy manager showed the inspector the storage and records for medicines, which is a well managed process. Staff were observed during the visit interacting positively with individuals. All residents spoken with, reported staff provide a good standard of care and areas of concern would be discussed with the registered manager. All residents who spoke with the Inspector commented very positively on the conduct and attitude of the staff. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 12 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): 12,13,14,15. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” Residents feel comfortable with the routines and their ability to exercise choice within the home. Family members are actively involved with the home. Meals are well organised and enjoyed by the residents. EVIDENCE: Residents spoken with, said they were happy with the level of activities within the home and outside. Resident’s commented that the philosophy of the home and the attitude of the staff enabled them to make choices and felt they were generally well respected. They also felt that members of staff were often willing to sit and talk with residents when they had time away from essential duties. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 13 Residents and relatives spoken with, commented that were made welcome at any time when visiting the home. The relatives spoken with confirmed that they have visitors at any time. The accommodation allows for relatives to visit in private rooms where required or there is a quiet lounge if desired. The home arranges for local entertainers to visit and some residents spoken with confirmed that they looked forward to such events. Staff members were observed during the visit interacting positively with individuals. Three residents spoken with, reported that staff provide a good standard of care and areas of concern would be discussed with the registered manager. All residents who spoke with the Inspector commented very positively on the conduct and attitude of the staff. Two relatives were pleased to discuss the care their mother and father have received since moving to the home. Residents and relatives spoken with, commented positively on the standards and quality of food. Staff spoken with, were well aware of individual preferences. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 14 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): 16,18. “Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” The home operates suitable complaints and adult protection procedures. There was no evidence provided to ensure residents safety is promoted through staff training in Adult Protection. EVIDENCE: The inspector observed the homes complaints procedure, that meets the NMS, which is appropriately displayed, throughout the home. The inspector observed an appropriate Whistle Blowing Policy and a policy detailing Adult Protection Procedures. The homes policies and procedures for responding to suspicion or evidence of abuse, or neglect, are all satisfactory. The home has comprehensive policies regarding resident’s money and financial affairs. After discussions with the manager and staff it was evident that a majority of staff require training in Adult Protection, to ensure the safeguarding of residents. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 15 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): 19,25,26. “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The home has been maintained to a satisfactory standard. Residents feel the home provides a safe and comfortable environment. Systems are in place for the control of infection. EVIDENCE: Residents indicated that they felt the accommodation was functional but homely in most parts. The accommodation appears 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. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 16 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. Satisfactory maintenance records were observed for water systems, lighting, electrical and gas central heating. Records were observed for the testing of water temperatures at outlets throughout the home. Should levels exceed the 43c, a risk assessment is required to be conducted for residents in the home, prior to consultation with the local Environmental Health Authority. A team of domestic staff maintain the home to a good standard. Residents feel the home is generally clean and hygienic. The home has polices and systems in place for the control of infection. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 17 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): 27,28,29,30. “Quality in this outcome area is poor. This judgement has been made using available evidence including a visit to this service.” Sufficient numbers of staff are now employed over the 24 hour period. There are insufficient personnel records maintained at the home. Staff do not receive sufficient training, and require updates in health and safety subjects and subjects specific to the care of older people. Resident’s health and welfare is not being safeguarded due to the lack of staff training. EVIDENCE: The inspector observed four staff files and talked to the manager and staff about training and recruitment. There are insufficient personnel records maintained at the home. Some staff records examined did not evidence sufficient pre-employment checks are conducted, prior to commencing work. There was no evidence of any recruitment process being employed. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 18 There is no evidence to suggest that staff are regularly trained in any of the mandatory Health and Safety subjects, or in Adult Protection Issues after they commence work. There was no evidence to show that staff have received updates in practical training in safe moving and handling techniques. However some staff said they received an induction and some training. Some staff have achieved the National Vocational Qualification level 2. All the residents and relatives who spoke with the inspector felt that the staff were competent and professional. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 19 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): 31,32,35,36,38 “Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service.” The home is generally well managed with residents interests put first. Health and safety management is well documented. Staff are well supported but formal supervision is not recorded appropriately. EVIDENCE: Residents and relatives said they felt the home was well run and the management team were always on hand for support and advise. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 20 They also said they were consulted over issues in the home. The manager showed the inspector consultation surveys, that are conducted with stakeholders. Staff spoken with confirmed that they felt supported by the managers and that they are approachable to discuss any issues. They confirmed that there is an open management approach and a positive culture within the home. The staff stated that they had not received monthly supervision but did attend regular meetings and had frequent discussion with management. Resident’s finances are managed separately. Records of these were inspected on this occasion and found to be maintained appropriately. It was observed that equipment is serviced and maintained on an annual basis by agreed contracts. There is a written health and safety policy to guide staff. The inspector was told the manager is responsible for the risk assessment of activities of residents. In addition to individual risk assessments for residents, there are risk assessments relating to environmental areas of the home. Records of fire system tests, water temperatures and other health and safety records were observed and were found to be carried out at the required intervals. Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 21 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 3 3 X X HEALTH AND PERSONAL CARE Standard No Score 7 3 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 Standard No Score 16 3 17 X 18 2 3 X X X X X 3 3 STAFFING Standard No Score 27 3 28 2 29 2 30 1 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 3 X 2 Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 22 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 2 3 4 Standard OP18 OP28 OP29 OP30 Regulation 18.1.c.i 18. Sch 2. 19.1.a.b Sch 2. 18.1.c.i Requirement Timescale for action receive 30/08/06 in adult Ensure all staff appropriate training protection issues Ensure all staff are working 30/08/06 towards NVQ level 2 Ensure appropriate recruitment 30/08/06 records are obtained and maintained at the home. Ensure staff receive regular 30/08/06 training updates in all Health and safety subjects. 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 Springfield Care Home DS0000002305.V290428.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Nottingham Area Office 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 DS0000002305.V290428.R01.S.doc Version 5.1 Page 24 - 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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