CARE HOMES FOR OLDER PEOPLE
Springfield Cottage Preston New Road Blackburn Lancs BB2 6PS Lead Inspector
Mrs Jennifer M Turner Unannounced Inspection 16th November 2005 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 Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Springfield Cottage Address Preston New Road Blackburn Lancs BB2 6PS 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) 01254 264704 01254 264704 Mr David Martin Ms Cheryl Weall Care Home 26 Category(ies) of Old age, not falling within any other category registration, with number (26) of places Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 19th May 2005 Brief Description of the Service: Springfield Cottage is a detached property, set in its own well-maintained grounds, within a residential area. It offers 24 single bedrooms, 10 of which provide en-suite facilities and 1 double bedroom, which has its own en-suite. There are 2 lounge areas, both having views over the front garden, and a separate dining room. Various activities are available to residents, both within and outside of the home. Residents may access the garden area at the front, which has a paved patio area. Seating is provided on the patio and at the entrance to the home. To the front and side of the building is a car parking area. Springfield Cottage is approximately one mile from the centre of Blackburn, where most services and facilities are available. Regular bus services pass the home, with routes to both Blackburn and Preston. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This unannounced inspection took place on 16th November 2005 between 10.30am and 2.45pm. Information was obtained by talking with the registered provider, registered manager, five staff members, eight residents, by examining a variety of records and walking around the home. Views were obtained from residents and staff on a variety of topics and information was also obtained by case tracking. Views have been recorded collectively where the answers obtained were similar. Any specific or differing comments have been recorded in the main body of the report. Two comment cards were received from relatives. The inspector’s notes have been retained as evidence of the inspection. At the time of the inspection 24 beds were occupied. What the service does well:
Prior to admission, prospective residents or their relatives are invited to visit the home. This gives them an idea of what the home is like prior to admission. Monthly reviews were carried out on residents care plans. These were supplemented by 6 monthly reviews. Some residents could “remember being included in their review”. A wide variety of social activities took place both inside and outside of the home. Residents spoke about forthcoming Christmas activities and commented “there was plenty going on” and that they felt there were “more than enough” activities provided. Residents are encouraged to manage their own finances if they wish therefore promoting independence. The menu offered a balanced and nutritional diet. Residents said they “could have an alternative meal if they didn’t like what was offered”. Portions were plentiful and one resident said he could “have seconds, or thirds if I wish”. Residents indicated that they were pleased with both the communal and personal space available to them. All bedrooms showed some level of
Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 6 personalisation and provided residents with “homely surroundings”. The written agreement between the Proprietors and the resident states that “The resident may bring small items of furniture which will help them settle in”. The home has a group of staff that has worked at the home for a long time. They are enthusiastic about training and some are committed to progressing beyond N.V.Q. level 2 in care. The staff-training programme was included in the Training and Development Plan. Staff spoken with said they “felt competent” to carry out their work. Staff training is ongoing with outside agencies offering a variety of packages. Continuous training provides staff with the knowledge to care for residents competently. The registered manager was suitably qualified ensuring that there was strong leadership within the staff team. Information received from one relative via a comment card indicated “my mother has only been in a short time and I am very impressed by the care of staff and the standard of the home”. Another relative via a comment card indicated “this is a very well run home providing an excellent standard of care to the residents”. 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 Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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): 2;5 Prospective residents and/or their relatives are invited to the home prior to admission. This ensures that prospective residents can decide if they like their new surroundings prior to admission. Each resident receives a “Residency Agreement”. EVIDENCE: Files of the two most recently admitted residents were examined. Each resident was provided with a “Residency Agreement”. Copies of these were held on resident’s files and showed that they had been signed by the resident or their relative and a representative of Springfield Cottage. They were reviewed annually when fees increased. A pre-admission visit to the home was usually offered to prospective residents who were to be admitted from their own home. However, one resident had been admitted from hospital and the relatives had visited Springfield Cottage. There had been an emergency admission and the appropriate documentation had been completed within the required time. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 the following standard(s): 7 Resident’s healthcare needs were identified and met. EVIDENCE: Individual care plans identified the full range of resident’s care needs. Various risk assessments were seen on residents’ case files. There was evidence that these were reviewed monthly by a Senior Carer and every 6 months by either the manager or deputy manager. Care plans showed that resident’s signed their care reviews if they were able, or if they were not able a reference was made to this. Relatives were able to sign the plan if they had been present. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 10 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;14;15 The dietary, social, cultural and religious needs of residents were met. Social contacts were maintained. Meals offered at the home were good and ensured that the individual dietary needs of the residents were met. EVIDENCE: The notice boards in the main lounge and in the hallway displayed a variety of information in relation to activities and events taking place both inside and outside of the home. The minutes of the six monthly residents meetings showed that a wide variety of topics were discussed including activities and social events. The deputy manager was authorised as the appointee for one service user and draws the pension for another. The inspector examined records of financial transactions. Some residents managed their own financial affairs whilst some had their affairs handled by solicitors. Information relating to the Advocacy Service was available. A tour of the home showed that some residents had brought their own personal items with them The daily menu displayed in the dining room, showed that a balanced diet was offered. The inspector observed that the residents were encouraged to be independent when eating and that staff were available to offer any assistance needed in a calm and unhurried manner. Residents said that they enjoyed the
Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 11 food and were satisfied with the quality of the food served. After lunch, a member of staff was seen to ask the residents individually what they wished for their tea from a pre prepared menu. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 the following standard(s): 18 Staff had received training in respect of the Protection of Vulnerable Adults ensuring that residents live in a safe environment. EVIDENCE: Various policies and procedures were available for staff to follow in respect of abuse issues. Copies of the Whistle blowing procedure, the policy relating to gifts and information relating to the Protection of Vulnerable Adults were retained in the staff handbook. Staff spoken with were aware of their content. There was also a copy of the Blackburn with Darwen adult abuse procedure. Records showed that the manager and staff had completed appropriate training, organised by the Local Authority, relating to the protection of vulnerable adults. Although the registered person did not make arrangements to administer residents’ finances, monies for two residents were retained in the home. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 the following standard(s): 20;25 The home was warm, clean and comfortable. Furnishings and equipment met the resident’s needs. EVIDENCE: Prior to admission prospective residents are made aware that there is a “No Smoking” policy. Anyone who does smoke is made aware that they can do so under the covered porch at the front entrance. The “quiet” lounge is used for activities and in the larger lounge seating is arranged in small groups. There is a separate dining room. There is “flat access” at the front door enabling residents using wheelchairs to use the garden facilities at the front of the home independently. Some refurbishment had taken place. Guards continued to be fitted onto radiators. Examination of risk assessments showed that all the radiators assessed as being “high risk” had received a guard. Random water outlets were tested by the inspector and were within
Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 14 the recommended temperature range. The manager was to check with the plumber whether water was stored at the correct temperature to prevent the risk of legionella. A requirement was made for the fitting of radiator guards to continue with a revised timescale being set. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29;30 Staff were recruited using current guidelines and received training suitable to the residents residing at the home. EVIDENCE: Three staff files were examined and all contained the appropriate information. An umbrella organisation was used to obtain CRB and POVA checks. Staff indicated that they had received their own copy of the General Social Care Council Code of Conduct, a job description and Terms and Conditions of Employment (Contract). Appropriate induction training was ongoing. New staff were referred for National Vocational Qualification training as soon as possible following their appointment. Training was evidenced in the training and financial plan. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 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 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;35 The welfare of residents was sufficiently protected. The home was run in an open and transparent way with a good staff and management team. EVIDENCE: The registered manager had obtained the NVQ level 4 and the Registered Managers Award. Lines of Organisational responsibility appeared in the Statement of Purpose. The deputy manager kept the money of two service users securely. The inspector checked that staff administered the records and the money correctly. The manager said “relatives tended to oversee finances”. Although receipts were given to relatives when they collected resident’s monies it was recommended that two signatures were obtained for financial transactions. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 17 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 3 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 X 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 X 3 X X X X 2 X STAFFING Standard No Score 27 X 28 X 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X X X 2 X X X Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP25 Regulation 13 (4)(c) Timescale for action The registered person must 31/12/05 make appropriate arrangements to ensure that stored water is free from the risk of legionella. Although risk assessments are in 31/03/06 place, the registered person must continue to ensure that appropriate action is taken to provide radiators that are guarded or are of the low surface temperature type. Timescale of 31.05.05 not met. Requirement 2 OP25 13 (4) (ac) 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 OP35 Good Practice Recommendations Two signatures should be obtained for all financial transactions. Springfield Cottage DS0000005835.V255834.R01.S.doc Version 5.0 Page 19 Commission for Social Care Inspection East Lancashire Area Office 1st Floor, Unit 4 Petre Road Clayton Business Park Accrington BB5 5JB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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