Inspection on 28/02/06 for Springfield Care Home

This inspection was carried out on 28th February 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 found no outstanding requirements from the previous inspection report, but made 7 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Springfield Care Home 18/12/08

Springfield Care Home 05/07/06

Springfield Care Home 28/07/05

Springfield Care Home 07/03/05

Springfield Care Home 11/11/04

Springfield Care Home 04/03/04

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Ashlong House

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Edenvale

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Chatsworth Care - Dawson House

Cowden Road, 52 - 54

Chatsworth Care - Tudor Lodge

Foxley Lane (121a)

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

CARE HOME ADULTS 18-65 Springfield Care Home 45 Grove Road Walthamstow London E17 9BL Lead Inspector Rob Cole Unannounced Inspection 28th February 2006 10:00 Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 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 DS0000007315.V285423.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 Adults 18-65. 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 DS0000007315.V285423.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address 45 Grove Road Walthamstow London E17 9BL 020 8520 7429 020 8520 9131 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) Mr Mahendra Pratap Rambojun *** Post Vacant *** Care Home 3 Category(ies) of Learning disability (3) registration, with number of places Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 28th July 2005 Brief Description of the Service: Springfield Care Home is a residential home providing care and support to three adults with learning disabilities. The home is situated in a residential area of Walthamstow in the London Borough of Waltham Forest, and is close to shops, transport networks and other local amenities. The home is in keeping with other homes in the area. The home is privately run. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 28/2/06 and was unannounced. The inspector had the opportunity of speaking with service users, staff and the homes acting manager was present throughout the inspection. Overall the inspector was satisfied that this is a generally well run care home, although there are a number of issues that must be addressed, as highlighted within the report. What the service does well: What has improved since the last inspection? 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 DS0000007315.V285423.R01.S.doc Version 5.1 Page 6 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 7 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 8 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,9 and 10 It is the view of the inspector that service users have a large measure of control over their daily lives. Care plans are of a good standard, and geared towards meeting service users individual needs. However, the home must ensure that any limitations on choice are recorded, including the reasons why. EVIDENCE: All service users have care plans in place. There was evidence that plans are regularly reviewed and that they are clear and comprehensive. Plans cover personal care, health, medication and social and leisure needs, and there are programmes in place for developing service users independence. Service users are involved in drawing up their care plans. Daily logs are also maintained. All service users have risk assessments in place. These are clear, and since the last inspection now appear to be comprehensive. Plans include risks associated with holidays, activities and accessing the community. Assessments identify what the risks are, and set out strategies to minimise and reduce these risks. Guidelines are also in place on managing any challenging behaviours that service users may exhibit. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 9 From observation and discussions with service users there was evidence that they are supported to have as much control and choice over their daily lives as possible. Service users were able to get up as and when they chose, and are able to choose what they wear. However, limitations on choice have not been recorded. When the inspector arrived at the home they found that the kitchen was kept locked. Staff informed the inspector that two of the three service users had access to the key, but that the third service user was only supposed to access the kitchen with staff support. The acting manager informed the inspector that this was because the service user would be at risk from been alone in the kitchen, particularly with regard to boiling water in the kettle. Yet this was not recorded. It is required that any limitations on choice are recorded, along with the reasons why, and that these limitations are subject to regular review. The acting manager informed the inspector that service users are regularly consulted over the running of the home on an ad hoc basis, for example over meals and activities, and this was observed to be the case on the day of inspection. More formal arrangements are in place to involve service users in the running of the home, such as regular service user meetings. These are minuted, and evidenced discussions on holidays and the homes décor. Service users are involved in the recruitment of staff to the home. The home has a policy in place on confidentiality, which makes clear that on occasions a confidence may have to be broken in the health, safety and welfare interests of service users and others. The home also has a policy on Data Protection. Staff spoken to by the inspector demonstrated a good understanding of issues around confidentiality. Confidential records are stored securely, and staff and service users have access to them as appropriate. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 10 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): None The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. EVIDENCE: The standards in this section were not tested on this occasion, but will be tested as part of the next inspection. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 11 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19,20 ad 21 The inspector was satisfied that the home is able to meet the personal and health care needs of service users. Medications are stored securely, and service users have access to health professionals as appropriate. EVIDENCE: Staff informed the inspector that service users are encouraged to manage their own personal care as much as possible, and this was in line with their care plans. Service users were able to choose what they wore, and were appropriately dressed on the day of inspection. All service users have a designated keyworker. All service users are registered with a GP, and the home has drawn up detailed individual health action plans for service users, setting out how the home can meet their health needs. Records are maintained of medical appointments, including details of any follow up action required. Records indicated that service users have access to health professionals as appropriate, including psychiatrists, dentists and opticians. The home has a comprehensive medication policy in place, and staff receive training from the supplying pharmacist before they are able to administer mediations. No service users currently self medicate or are on any controlled drugs. Since the last inspection all medications are now stored securely, Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 12 including those that are kept in the fridge. Guidelines are in place for medications prescribed on a PRN basis. Mediation Administration Record (MAR) charts are maintained, those checked by the inspector appeared to be accurate and up to date. However, it is required that hand written entries on MAR charts are signed for. The home has a policy in place on death and dying, and the acting manager informed the inspector that service users would be able to stay in the home with a terminal illness, as long as the home cold meet their medical needs. The home has sought and recorded the wishes of service users on arrangements to be made in the event of their death. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 13 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 The inspector was satisfied that the home has taken reasonable steps to ensue that service users are safeguarded from the risk of abuse, and appropriate systems are in place for making complaints. EVIDENCE: The home has a complaints log, although the acting manager informed the inspector that no complaints have been received in the past year. There is also a complaints procedure, which included timescales for responding to complaints, and contact details of the CSCI. Service users spoken to demonstrated a good understanding of whom they could complain to if they so wished. The home has a copy of the Local Authorities adult protection procedures, and also its own policy on adult protection. This appeared to be in line with current legislation. Since the last inspection all staff have now undertaken training in adult protection, and staff spoken to demonstrated a good understanding of the issues involved. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 14 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,26,27,28,29 and 30 It is the view of the inspector that the home is generally suitable to meet its stated purpose with regard to the physical environment. All service users have their own bedrooms, and there was adequate communal space. However, more attention needs to be paid to routine maintenance. EVIDENCE: The home is situated in a residential area of Walthamstow, in the London Borough of Waltham Forest, and is indistinguishable from other homes in the vicinity. The home is close to shops, transport networks, and other local amenities. The home has recently been extended, and now has a new kitchen, toilet/shower room and laundry room, and the dining room is now just a dining room, where as it had previously doubled up as the kitchen. The homes communal areas consist of a lounge, dinning room, kitchen and garden. Service users were observed to move freely around communal areas as they wished. The garden had appropriate garden furniture. The home has one shower room and toilet, and one bathroom and toilet. Bathing and toilet facilities are adequate to meet service users needs. On the day of inspection bathrooms were clean, tidy and free from offensive odours. All bathrooms are fitted with locks with emergency override devices. However, there were several minor maintenance issues around the home that must be addressed. For example, the carpet was stained in several places, there were several Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 15 instances of scuffed paintwork, there were holes in one of the bedroom walls and tiles were broken and potentially dangerous on the front step leading into the home. It is a requirement that the home is well maintained and kept in a good state of repair, both internally and externally. All service users have their own bedrooms. On the day of inspection bedrooms were clean and tidy, and service users informed the inspector that they are responsible for keeping their rooms tidy. Rooms were personalised to service users individual tastes. Bedrooms had appropriate natural light and ventilation. Carpets, bedding and curtains were well maintained and domestic in character. Bedrooms had wardrobes, tables and chest of draws. Bedrooms meet National Minimum Standards on size requirements. The home has a small laundry room, which includes washing and drying facilities, and is separate from the kitchen. Hand washing facilities were situated throughout the home. Protective clothing is available to staff such as latex gloves. COSHH products were stored appropriately on the day of inspection, and the home has a policy on infection control. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 16 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,33,34,35 and 36 It is the inspectors judgement that the home is staffed in sufficient numbers to meet service users needs. Staff demonstrated a good understanding of their roles and responsibilities. EVIDENCE: The home provides 24-hour support, including a waking night staff and emergency on-call procedure. There was a staffing rota on display within the home, this accurately reflected that actual staffing situation on the day of inspection. Since the previous inspection the staffing rota now clearly identifies who is in charge of the home at any given time. All staff are over 21 years of age. All staff are given a copy of their job description, and staff questioned demonstrated a good understanding of their roles and responsibilities. From observation there was evidence that staff have developed good working relationships with service users, and were seen to interact with them in a friendly and professional manner. The home has a grievance procedure, and all staff have been given a copy of the General Social Care Council codes of conduct. The home as a policy in place on equal opportunities, but not one on recruitment and selection, and this must be addressed. The inspector checked several staff files at random. These contained evidence of references and proof Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 17 of ID, and since the last inspection now also contain a full written record of employment history, and evidence of CRB checks. The home provides a structured induction programme for staff, this includes service user issues and the environment. Records are kept of staff training, and these indicated that staff have recently had training in medication and food hygiene, and since the last inspection staff have now undertaken training in fire safety and challenging behaviour. The acting manager informed the inspector that of the nine care staff currently employed at the home four have achieved a relevant care qualification, and it is required that at least 50 of care staff have a relevant care qualification. There was evidence that staff receive regular formal supervision. Records are kept of supervision, and staff have access to these records. Supervision covers performance, training and service user issues. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 18 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42 and 43 It is the view of the inspector that appropriate arrangements have been put in place in the absence of a registered manager, but that the home will need to appoint a permanent manager and register them with the CSCI in the near future. EVIDENCE: Since the previous inspection the registered manager has terminated their employment at the home. The deputy manager is currently working as the acting manager. Service users spoken to informed the inspector that they found the acting manager to be approachable and accessible, and staff were observed to interact with the manager in a relaxed manner. Service user meetings, care plan reviews and staff supervisions all contribute to the quality assurance within the home. Copies of previous inspection reports were available to view, and there was evidence of monthly Regulation 26 visits having taken place. The acting manager informed the inspector that they are currently in the process of introducing questionnaires for service users and Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 19 their relatives to help gain their feedback on the home. However, the home has not always notified the CSCI of significant events, for example, as stated the registered manager has left the home, but the CSCI was not informed of this. The home has various health and safety policies in place, such as on COSHH and fire safety, and staff have received appropriate heath and safety training including on food hygiene and first aid. The home has only one fire extinguisher; this is a water extinguisher, last serviced in December 2005. It is required that the home also has a CO2 fire extinguisher for oil and electrical fires. The home holds regular fire drills. There was evidence of in date PAT, gas and electrical installation safety testing. Fridge/freezer and hot water temperatures are regularly tested and recorded. The home has in date employer’s liability insurance cover. Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 X 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 2 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 2 33 3 34 2 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 2 3 3 3 LIFESTYLES Standard No Score 11 X 12 X 13 X 14 X 15 X 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 2 X X 2 3 Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 21 No 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 YA7 Regulation 12 Requirement The registered person must ensure that any restrictions on choice imposed upon service users are clearly recorded, along with the reasons why, and that the decision is subject to regular review. The registered person must ensure that all hand written entries on MAR charts are signed for. The registered person must ensure that the home’s physical environment is well maintained, both internally and externally. The registered person must ensure that at last 50 of the care staff employed at the home have a relevant care qualification. The registered person must ensure that the home has a comprehensive policy in place on staff recruitment and selection. The registered person must ensure that the CSCI is notified of any significant changes to the home, as detailed in the Care Home Regulations 2001. Timescale for action 30/06/06 2 YA20 20 30/06/06 3 YA24 23 30/06/06 4 YA32 18 30/06/06 5 YA34 18 30/06/06 6 YA39 39 30/06/06 Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 22 7 YA42 13 and 23 The registered person must ensure that the home has at least one CO2 fire extinguisher. 30/06/06 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 Springfield Care Home DS0000007315.V285423.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection East London Area Office Gredley House 1-11 Broadway Stratford London E15 4BQ 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 DS0000007315.V285423.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. 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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