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Inspection on 11/08/05 for Springfield Court Nursing Home

Also see our care home review for Springfield Court Nursing Home for more information

This inspection was carried out on 11th August 2005.

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

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

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

What the care home does well

The 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.

What has improved since the last inspection?

Progress has been made in addressing all but one of the few requirements made at the last inspection. The addition of a large summerhouse has provided additional communal space in light, airy surroundings that allows residents to enjoy the well-maintained gardens.

What the care home could do better:

Some improvements to the internal environment are needed so that residents continue to live in an environment that is safe, well maintained and decorated to a satisfactory standard. The recruitment process needs to be improved so that the home is able to show that any staff they employ are suitable to work with vulnerable adults. The home should continue reviewing and developing the service provided to ensure that current good practice is maintained.

CARE HOMES FOR OLDER PEOPLE Springfield Court Nursing Home Springfield Court Springfield Road Aughton, Ormskirk, Lancashire L39 6ST Lead Inspector Anne Taylor Announced 11 August 2005 09:30 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Springfield Court Nursing Home Address Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Springfield Court Springfield Road Aughton Ormskirk Lancashire L39 6ST 01695 424344 Springfield Court Ltd Mrs J Nixon Care Home 52 Category(ies) of Old Age (OP) registration, with number Physical Disability (PD) of places Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: 1.This home is registered for a maximum of 52 service users to include: 2.Up to 50 service users in the category of OP (Old Age, not falling in any other category). 3. Up to 2 service users in the category of PD (Physical Disability). 4. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection 4. 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 regasrding staffing levels in care homes. Date of last inspection 9th December 2004 Brief Description of the Service: Springfield Court is a purpose built fifty-two bedded care home for residents over the age of sixty-five who need personal and nursing care. At the time of inspection fifty-one residents were living at the home. 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 shared rooms are available for any residents that wish to share. Three of these have an en-suite. All the accommodation is at ground floor level and ramps are provided to allow easy acces for wheelchair users and the less mobile. A large conservatory has recently been added that provides additional communal space and also a pleasant sitting area for residents and any visitors. The home is set in its own well maintained gardens with a new summer house for residents to enjoy. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was an announced inspection that took place over one full day in August 2005. 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. Comment cards received from residents, relatives and other health care professionals have also been used in the production of this report. 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. 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 F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 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 F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) EVIDENCE: These standards were not assessed at this inspection. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 & 8 The care planning and risk assessment processes were thorough enough to ensure the needs of residents were properly identified and managed. The provision of basic nursing care and management of health care needs was of a good standard and made sure the health and welfare of clients was put first. EVIDENCE: Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 10 Care records seen showed that each resident had a plan of care that had been agreed with him or her or a relative. This meant that residents or their relatives had some idea of what care they should expect to receive whilst living at the home. It also gave them the opportunity to discuss any concerns and identify any specific needs or preferences. One relative said, “I haven’t seen a care plan but my sister does that”. The registered manager said that each resident had a named nurse that was responsible for keeping the care plan up to date so that other staff could be kept informed of any changes or new treatment. Some minor shortfalls were identified in the care planning process although this had not affected outcomes for residents. The issues were discussed with the manager so that she could make sure the advice given was acted upon. Risk assessments that enabled health care to be provided safely were in place so staff were confident about this part of their job and residents able to feel safe when being assisted with personal care needs or receiving nursing care. Residents were settled, appropriately dressed and well cared for. Records, comment cards and discussion with residents and staff showed that the home had a positive and proactive approach to the management of health care so the outcomes for individuals were good. One relative said, “ the staff bring a doctor if my father is ill, they are quick to respond to any changes”. A doctor that attends residents in Springfield Court commented, “The home has an impressive grip on all aspects of the medical care of patients”. Staff were able to discuss the individual needs of the people they cared for and how they organised their workload to ensure those needs were met. They made reference to way they used the care plans and attended regular handovers when there was a change of shift, so that they were kept informed of any changes to the care residents needed. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 14 & 15 Residents were helped to exercise choice so that they had some control over their lives. The importance of providing a well balanced diet was recognised by the home so that clients were able to eat healthily and given a choice about what they ate. EVIDENCE: During conversations with residents and staff it was evident that residents were able to make choices about the way they lived within the home and in particular within the privacy of their own room. Rooms had been personalised and residents had been encouraged to bring in some of their own belongings so that they could feel more at home. A record of all items brought into the home by residents was kept so that staff knew which items belonged to each resident. Residents not able to exercise full control over their financial affairs were mainly helped by a family member. The manager was able to give examples of when she had arranged for an advocate to act on behalf of a resident without a representative to ensure that any decisions made were in the best interests of that resident. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 12 Records were kept of individual likes and dislikes and staff were aware of residents’ dietary needs and personal preferences, which ensured that those living at the home received a nutritional diet in accordance with their needs. The lunchtime meal was relaxed and unhurried with staff available to assist if needed. Some residents had chosen to eat in the dining room, others in their bedroom. Most of the residents spoken to at lunchtime did not know what they would have to eat. They were not concerned about this and said that if they didn’t like it they could have something else and that they always had a choice at breakfast, tea and supper. Residents spoken to were generally satisfied with the range and quantity of food available to them. When asked one resident said, “I have no complaints about the food. I get a choice, whatever I want really”. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home had a clear complaints procedure that was available to resients and visitors so that they knew how and who to complain to. EVIDENCE: A complaints procedure was in place and residents spoken to know how and who to complain to one resident said, “I’d go to the matron if I had a omplaint, she is very nice and understanding”. The complaints procedure was displayed in the home and a copy included in the service user guide. This meant that the procedure was available to residents and any visitors to the home. The home had received two complaints since the last inspection that had been satisfactorily resolved. One visitor said, “If I mention anything, when I next come it has been done, I am always listened to”. Resident’s spoken to felt that they were encouraged to raise any concerns they might have about the home, that they would be listened to and action would be taken on any issues raised. Staff were able to discuss how they would respond if a resident complained to them and realised how important it was to make sure residents felt able to raise concerns and be sure they were listened to. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19 The home was clean, comfortable and homely, providing an environment that was suitable for it’s stated purpose and safe for the people living there. EVIDENCE: The home was accessible to all residents. Ramps allowed easy access to the outside and all accommodation was at ground floor level. Outside the grounds were tidy and well maintained, providing a pleasant area for residents to enjoy if they wished. The new summerhouse provided additional communal space for residents in light airy surroundings with views of the gardens. Residents spoken to were happy with their private accommodation and most had personalised their rooms so that they felt more at home. One said, “I like my room, it’s lovely and there is enough room for me and my things”. A programme for maintenance and refurbishment was in place so that furnishings, fittings and décor in all parts of the home could be renewed and kept up to date when needed. Some minor decoration work was needed in the Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 15 dining room and not all pipe work in bathrooms had been covered but the manager had included this in the home’s refurbishment programme. The manager should ensure that this work is completed so that residents continue to live in well-maintained and comfortable surroundings. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 The skill mix of and the number of staff on duty was sufficient to ensure the needs of residents were met. The recruitment process was not thorough enough to ensure the continued protection of residents. EVIDENCE: Staff rotas showed the number and skill mix of staff on duty at any time and that enough staff were on duty to ensure the needs of residents could be met. Comment cards completed by relatives also confirmed that there was always sufficient numbers of staff on duty so that residents were looked after and attended to properly. One visitor commented, “My father is treated really well by the staff they are friendly and responsive”. When asked about staff, residents said, “the staff are good, they will always help you” and “I think the staff are marvellous”. Staff spoken to felt that there was enough staff on duty so that they were able to provide a good standard of care to residents. A recruitment checklist was in place and staff files were organised, both of which helped the recruitment process. In order to protect residents all necessary checks including an up to date Criminal Record and POVA check, and two written references must be obtained prior to the start of employment. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 17 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. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 The systems in place for managing health and safety matters were thorough enough to ensure the continued safety and welfare of people living and working at the home. EVIDENCE: Certificates were inspected which confirmed that regular servicing had taken place in relation to systems and equipment used by the home to make sure they were safe to use. Discussion with the manager and staff demonstrated a clear commitment to health and safety issues and a number safe working practices were verified at the time of inspection. Training in relation to health and safety issues had been provided for all staff so that they were able to promote the health, safety and welfare of the people they cared for. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 19 Residents felt safe living at the home one said, “I feel safe and well looked after here”. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x x x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 3 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 2 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x x x x x x x x 3 Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 21 YES Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard 19 Regulation 23(2)(d) 13(4)(a) Timescale for action The registered provider must 31st March ensure that the maintenance and 2006 refurbishment programme is completed and includes replacement of stained corridor carpets, guarding of pipe work in all bathrooms and repair or redecoration of the torn wallpaper in the dining area. A thorough recruitment process 31st must be in place which includes October obtaining a criminal record and 2005 POVA check and two written references prior to the start of employment. (Timescale of 31st March 2005 not met) Requirement 2. 29 19(1) Schedule 2 17(2) Schedule 4 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. 2. Refer to Standard 7 Good Practice Recommendations The registered manager should ensure that all parts of residents care plans are reviewed monthly. Springfield Court Nursing Home F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Levens House Ackhurst Business Park Foxhole Road Chorley, Lancashire 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 F57 F08 Springfield Court S25576 V226523 110805 Stage 4.doc Version 1.30 Page 23 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!