Inspection on 01/03/06 for Springfield Court Nursing Home

This inspection was carried out on 1st March 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 there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Springfield Court Nursing Home 26/10/06

Springfield Court Nursing Home 11/08/05

Springfield Court Nursing Home 09/12/04

Springfield Court Nursing Home 12/05/04

Springfield Court Nursing Home 01/03/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Springfield Court Nursing Home Springfield Court Springfield Road Aughton Ormskirk Lancashire L39 6ST Lead Inspector Anne Taylor Unannounced Inspection 09:30 1st March 2006 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 Court Nursing Home DS0000025576.V265187.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 Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Springfield Court Nursing Home Address Springfield Court Springfield Road Aughton Ormskirk Lancashire L39 6ST 01695 424344 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) Springfield Court Limited Mrs Janet S Nixon Care Home 53 Category(ies) of Old age, not falling within any other category registration, with number (51), Physical disability (2) of places Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. This home is registered for a maximum of 53 service users to include: Up to 51 service users in the category of OP (Old Age, not falling in any other category). Up to 2 service users in the category of PD (Physical Disability). The service should employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. Staffing must be provided to meet the dependency needs of the service users at all times and will comply with any guidelines which may be issued through the Commission for Social Care Inspection regarding staffing levels in care homes. 2. 3. Date of last inspection Brief Description of the Service: Springfield Court is a purpose built care home for service users over the age of sixty-five requiring personal and nursing care. The home has fifty- two permanent places and one dedicated respite bed. At the time of inspection there were fifty people living at the home. Forty-eight requiring nursing care and two, needing personal care. The home is privately owned by Springfield Court Limited. The day-to-day management of the home is the responsibility of Mrs Janet Nixon, the registered manager. Most rooms are single with an en-suite facility. Five companion rooms are available for service users who wish to share. Three of these are en-suite. Accommodation is all at ground floor level and ramps are provided to enable access for wheelchair users. There is a large lounge and conservatory, both of which provide a suitable venue for activities. The home is set in it’s own gardens that include a lawn, an enclosed courtyard area with seating and a summerhouse. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an unannounced inspection that started at 9:30am and lasted six hours. The inspection involved discussion with the people who lived and worked at the home and visitors, examination of records, policies and procedures and a tour of the premises. As part of the inspection process the inspector used “case tracking” as a means of assessing some of the National Minimum Standards. This process allows the inspector to focus on a small group of people living at the home. All records relating to these people are inspected along with the rooms they occupy in the home. They are invited to discuss their experience of the home with the inspector, however this is not to the exclusion of other people living at the home. Most of the key standards assessed had been met and for those not fully met only minor shortfalls were identified. What the service does well: The procedures and management processes in place to assess and address health care needs were well developed and individual needs were met in a supportive and caring environment. The staff team worked well together and showed a good understanding of the needs of the people living at the home. The staff team received appropriate training and guidance that provided them with the knowledge and experience needed to care for this client group. People living at the home benefited from the happy relaxed atmosphere and good relationships have been established between residents and staff. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 6 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 Court Nursing Home DS0000025576.V265187.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 Court Nursing Home DS0000025576.V265187.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): 3 The preadmission process was adequate, however the assessment tool used by the home could be improved to make sure that enough detail is provided about the assessed needs of prospective residents. EVIDENCE: Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 9 Care records of the residents chosen for case tracking showed that a detailed assessment of health, personal care and social needs had been carried out by the local council and gave a clear picture of the individual needs of prospective residents. In addition the home carried out a preadmission assessment on any person who was coming to live at the home. Discussion with the manager showed that the manager or other trained nurse, who had experience of the assessment process, usually completed these assessments. Used collectively the two assessments outlined above would give a clear and detailed picture of residents needs. However, the assessment tool used by the home could be extended and developed to improve the amount and detail of any information obtained. Each resident had a plan of care based on the pre admission assessment and information gained on or shortly after admission. This helped the care process and promoted the welfare of residents. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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): 9,10 The arrangements in place for handling medication were generally satisfactory and carried out with minimum risk to residents. Staff were sensitive to the needs of residents and made sure that residents’ rights to privacy and dignity were upheld. EVIDENCE: Polices and procedures describing the handling of medication were available within the home so staff had clear guidance to follow. Registered nurses on duty confirmed that only trained nurses were authorised to administer medication and a sample list of signatures was kept at the front of the medication file so that checks for compliance could be made. Records of drugs administered were generally up to date. However, handwritten medication administration record entries and amendments to the pre-printed dosage instructions were not independently checked and countersigned. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 11 The medication storage was orderly and secure. The refrigerator temperature was checked daily and recorded. New arrangements had been made for the disposal of medicines to reflect recent changes in legislation. A revised procedure was in place and available to staff so that they were all aware of the new procedures. Records showed that induction training included instruction on privacy dignity and respect so that staff had knowledge and understanding of this before they started to give care to residents. Staff spoken to were able to discuss how they put into place the home’s policies and procedures relating to maintaining the privacy and dignity of the people they cared for and how this helped to make sure that residents felt respected. Staff were observed knocking on bedroom doors before entering. They were seen to be providing care in a sensitive and caring manner, which promoted residents’ dignity. People living at the home say staff maintained their dignity and treated them respectfully. One resident said, “they always close the door when they wash me and make sure the door is closed when they take me to the toilet or bath me”. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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 The daily routines were flexible so that residents were able to exercise choice and the range of social activities available met their expectations. The management arrangements in place at the home, underpinned by organisational policies and procedures, supported residents to maintain contact with family and friends. EVIDENCE: Records and discussion with residents showed that appropriate attention was paid to helping them take part in valued and fulfilling activities that were already established or developed in and outside the home so that the lifestyle experienced by residents met their expectations and preferences as much as possible. Residents had a range of needs and ability; some were able to go out independently, whilst others were reliant on support from staff. Residents spoken to were generally satisfied with the activities available. One resident said, “There is an activities lady who sees us and asks if we are OK and if there is anything in particular we want to do, there’s enough going on if you want to do it”. At the time of inspection some residents were taking part in a group activity. Others were doing more solitary things like reading the newspaper, doing a crossword and listening to music. All were enjoying their chosen activity and spoke positively about the way in which activities were organised for them. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 13 The statement of purpose outlined the home’s visiting policy and included a statement about residents being able to exercise choice in relation to visitors. This meant that residents and relatives knew what the home’s approach to visiting was and could comply with any policies operated by the home. Residents spoken to confirmed that they were able to see visitors in their own room or in one of the communal areas of the home so the meetings could be private if they wished. Visitors spoken to at the time of inspection said, “we are made very welcome by staff, we can come anytime, there is open visiting here”. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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): 18 Management processes in relation to abuse were thorough enough to ensure the protection of any vulnerable residents. EVIDENCE: The home had its own adult abuse policy and whistle blowing policy, in addition to a copy of guidance issued by the department of health. Discussion with staff showed that they were aware of the above documentation and were quite clear about what they would do if an allegation or suspicion of abuse came to their attention. The manager was aware of her responsibilities in relation to protecting people living at the home and making sure staff were appropriately trained to recognise and act upon any signs of possible abuse. Induction training records for new staff included a training pack about abuse with a multiple-choice test at the end to assess knowledge and understanding. Staff confirmed that they received regular updates so that they continued to be made aware of the need to protect the people they care for. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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): 19,26 The home was clean, free from offensive odours and well maintained, providing an environment that was comfortable and suitable for it’s stated purpose. EVIDENCE: Standard 19 was not fully assessed at this inspection. Progress in meeting the requirement made at the last inspection was monitored. The dining room had been redecorated and refurbished providing a lighter and brighter communal area for residents. Most of the exposed pipe work in bathrooms and toilets had been covered, however one or two still needed to be covered. The home was clean and free from offensive odours. One resident said, “ My room is always clean and tidy”. One visitor said, “ the rooms are lovely, light and spacious, the home is always clean it never smells, the standard is high like living in a hotel”. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 16 Policies and procedures were in place that identified infection control measures in place at the home. The principles of infection control were taught to staff at induction. And staff were able to discuss infection control procedures and how they implemented them so the risk of cross infection was minimised. The manager had arranged for the facilities and services provided at the home to be assessed as to whether they complied with the Water Regulations 1999. An assessment had been carried out and work recommended completed. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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): 28,29,30 Training was provided for new and existing staff that helped make sure they were competent do their jobs and able to practice safely. The recruitment process was not thorough enough to ensure the continue protection of people living at the home. EVIDENCE: Training records showed that new staff received induction and ongoing training that provided them with the basic skills needed to carry out tasks allocated to them. Staff spoken to said that training opportunities were good and that regular training courses were held for fire safety, moving and handling and other health and safety topics so that they were kept up to date about safe working practices. A training and development programme was not in place although this did not prevent staff from receiving training. A formal training and development programme would help to make sure that training needs identified at appraisal were consistently met and give more structure to the training process. National vocational training (NVQ) was available to care staff and a significant number of care staff had already achieved level two or three so that the home exceeded the fifty per cent needed to meet the national minimum standard. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 18 Discussion with the manager showed that she was aware of her responsibility to appoint suitable staff that would be able to provide good care and the continuing need to protect people living at the home. However, the files of two new members of staff examined showed that some of the documentation relating to “fitness”, in particular a criminal record check and checks against the protection of vulnerable adults register had been obtained after the start of employment so the home could not be assured of their suitability to work with vulnerable adults. Staff talked about how they had been recruited and confirmed that they had received a statement of terms and conditions of employment and a job description so that they knew what their responsibilities were and what was expected of them. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 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, 33, 35 Residents lived in a well run home, managed by a responsible person who was able to make sure the home met its stated purpose, aims and objectives. The home was managed and organised in a way that helped make sure the service was run in the best interests of residents. The arrangements for handling money on behalf of residents were thorough enough to ensure their financial interests were safeguarded. EVIDENCE: Records showed that the registered manager is a first level registered nurse who has completed a relevant management course and kept up to date with clinical areas of practice so that she can meet the professional registration requirements of the Nursing and Midwifery Council. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 20 Discussion with staff showed that the manager provided leadership and direction so that every one knew what their role was and what was expected of them. Residents and visitors said that they saw the manager regularly and could tell her if they had any problems. One Visitor said, “ the manager is very approachable and keen to help we have good relationships with her and the rest of the staff”. The home was able to meet its stated purpose as demonstrated by comments from residents and visitors. Residents’ comments included, “there are no complaints we are looked after very well here”. Visitors spoken to were positive about the care their relatives received one said, “my mother’s needs are met and we are told about any changes and consulted about her care, nearly every time we come”. A system was in place to monitor the quality of service delivered so that the home could be made aware of its strengths, weaknesses and whether residents were satisfied with the service they received or not. This was achieved by sending out satisfaction questionnaires each year. The feedback obtained was collated and a summary made available to so that residents could be reassured that their views were acknowledged and contributed to the running of the home. Discussion with the manager showed that feedback from the survey was used as a means of improving and developing the service. An annual development plan was not available so the inspector was not able to confirm that feedback from residents had been included in it. There was no evidence to show that monthly, unannounced visits to the home by the registered provider were being carried out. And a report of the findings from such visits produced. The visits provide an overview of the management of the home and show that residents have an opportunity to comment on the running of the home on a regular basis. Residents and staff spoken said that they were consulted about the day to day running of the home as much as they could be so that they felt involved. One resident said, “We are asked about things and get the chance to say if we are not happy about anything”. The home handled few personal allowances for residents. Any personal allowances and money brought in by relatives for residents was stored in a safe that only two members of staff had access to. This meant that residents’ money was appropriately safe guarded. Records were kept of any money handed in for safekeeping and receipts kept for any purchases made on behalf of residents so a clear audit trail of income and expenditure was available if needed. When asked about access to their money residents said, “my daughter does everything and brings me money if I need it”. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 21 Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 22 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 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 X 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 X 17 X 18 3 3 X X X X X 2 3 STAFFING Standard No Score 27 X 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 2 X 3 X X X Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 23 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 OP29 Regulation 17(2) Schedule4 Requirement Timescale for action 30/04/06 2. OP33 26 All checks relating to the fitness of prospective employees, including criminal record bureau checks and checks against the protection of vulnerable adults register must be obtained prior to the start of employment. (Timescale of 31st October 205 not met) A consistent system for making 30/04/06 sure monthly unannounced visits to the home, by the registered provider, needs to be established and maintained. Reports of the visits must be made available to the registered manager and the CSCI. 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 OP3 Good Practice Recommendations The preadmission assessment tool used by the home DS0000025576.V265187.R01.S.doc Version 5.0 Page 24 Springfield Court Nursing Home 2. 3. OP9 OP26 should be developed further to allow more detailed information to be obtained. The person carrying out the assessment should sign the document. Handwritten additions or alterations to the MAR should be signed, independently checked and countersigned. The home should ensure that they have written confirmation that the facilities and services provided comply with the Water Supply (Water Fittings) Regulations 1999. Springfield Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Chorley Local Office Levens House Ackhurst Business Park Foxhole Road Chorley PR7 1NW 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 Court Nursing Home DS0000025576.V265187.R01.S.doc Version 5.0 Page 26 - 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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