CARE HOMES FOR OLDER PEOPLE
Springfield Garth - North Yorkshire County Council Springfield Garth York Road Boroughbridge York North Yorkshire YO51 9EW Lead Inspector
Pauline O`Rourke Unannounced Inspection 10:05 5 October 2005
th 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 Garth - North Yorkshire County Council DS0000034398.V253829.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 Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Springfield Garth - North Yorkshire County Council Springfield Garth York Road Boroughbridge York North Yorkshire YO51 9EW 01423 322189 01423 323309 Address 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) North Yorkshire County Council Mrs Yvonne Elizabeth Cook Care Home 30 Category(ies) of Old age, not falling within any other category registration, with number (30) of places Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 4th November 2004 Brief Description of the Service: Springfield Garth is a care home owned and operated by North Yorkshire County Council. It is registered to provide a service for 30 older people of either gender aged over 65 years who do not have any specialist requirements. Up to 6 day-care places are available. The home was purpose-built approximately 35 years ago. It is located about on the outskirts of Boroughbridge where there is a good range of facilities. Harrogate, York and Knaresborough are less than an hour away. The home is a two storey building with bedrooms located on both floors. All bedrooms bar one are intended for single occupancy. There is a passenger lift. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection including preparation time took place over 8 hours. A tour of the building was conducted. A number of the service users records, staff records and records about the management of the home were inspected. 10 service users, and 4 staff on duty were spoken with. What the service does well: What has improved since the last inspection?
Since the last inspection the manager has updated the records kept on and for service users. This means that they all have a signed copy of the ‘Terms and Agreement’ in their file. The staff files also contained the proper information in relation to their employment. Staff have also received training in Adult Abuse Awareness and when spoken to during the inspection were clear about their responsibilities in this matter. The manager reviews the available staffing levels along with the level of help and support required by the service users. This means that she sometimes has to stop admissions or to move people to a more appropriate care setting so that the staff can continue to meet the needs of the service users who currently live in the home. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.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 Garth - North Yorkshire County Council DS0000034398.V253829.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, Standard 6 does not apply. The service users can be assured that their care needs will be met EVIDENCE: The service user files seen contained copies of an assessment by a care manager. The manager confirmed that they do try to visit all prospective service uses before their admission, if they are unable to visit someone then they are invited to the home for a day where an assessment can be carried out. Service users spoken with confirmed that someone had either been from the home or they had visited the home prior to their admission. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.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, 8, 9, and 10. The health, social care and personal needs of the service users are met. EVIDENCE: The service user files seen contained a Promotion of Independence Plan. This document was pertinent to the individual concerned and those service users spoken with were aware of their plans. They have a key worker who reviews the plans at monthly intervals with them. The service users files contained information about their health needs and details of GP visits and district nurses are recorded. The local GP visits the home for a weekly surgery and service users can book to see them at this time. The service users spoken with also said that they could see their GP on request. All visits made either to the home or the surgery were in private. Staff were observed treating the service users with respect at all times. The service users said that staff always treat them with respect and try to preserve their dignity at all times. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 10 There is a medication policy in place and all staff who administer the medication have received appropriate training. The storage, dispensing and documentation of the medication were in line with the policy and procedure of the home. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 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 the following standard(s): 12, 13, 14 and 15. The service users are able to keep their own routine within the home and join in with social activities. The service users have a varied and balanced diet. EVIDENCE: The service users spoken with said that they could follow their own routine within the home. Choosing their own rising and retiring times and where they take their meals. There are regular activities in place and service users said that they enjoyed them. A minister from one of the local churches visits monthly for a communion service. Visitors spoken with said that they are always made welcome and there are no restrictions as to when they visit. The service users confirmed this was the case. A visitors’ policy is in place and all visitors sign a visitor’s book on entering the home. The service users spoken with expressed satisfaction at the quality and quantity of the food provided. They confirmed that choices are available at each meal. The meal observed was relaxed and the staff assisted service users appropriately where necessary. The menu was examined and appeared to provide a balanced and nutritious diet. The cook explained that local fresh produce is used and they are able to vary the menu to include seasonal foods.
Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 12 Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 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 the following standard(s): 16 and 18. Service users were confident that any complaints or concerns they had could be raised and acted upon. Service uses are protected from possible abuse through staff training and a rigorous employment procedure. EVIDENCE: North Yorkshire Social Services has a detailed complaints policy. This policy is provided to all the residents and is displayed around the home. There have been no complaints made to the CSCI or the home in the last 12 months. Service users spoken with all said that if they had any problems there was someone within the home they would go to. There is an Adult Protection Policy in place. Staff spoken with had received training in Adult Protection issues and they had a good understanding of their responsibilities if they believed any inappropriate behaviour was taking place. Policies are also in place regarding the management of service users money. Staff are also subject to a criminal records bureau disclosure and a protection of vulnerable adults check to ensure that they are suitable to work in a care setting. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 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 the following standard(s): 19 and 26. The service users live in a clean and reasonably well-maintained home. EVIDENCE: The home was built for purpose approximately 35 years ago. The location of the home is suitable for its purpose. There is level access into the home. There is a passenger lift. The grounds are well maintained and there is a patio area to the rear of the building. It is well maintained internally, however the exterior of the building is looking tatty and requires updating. All areas of the home seen were clean and free from odour. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.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): 27, 28, 29, and 30 The service users needs are met by staff who have been vetted before their employment and who receive regular training. EVIDENCE: The staffing levels are adequate to meet the needs of the current service user population. The manager is aware that she must monitor the dependency levels of the service user to ensure the staffing level remains appropriate within the home. North Yorkshire has a rigorous recruitment procedure and the manager follows this in the employment of new staff. CRB checks are carried out on all new staff, and the staff files seen contained all the documentation required by the Care Homes Regulations 2001. Staff confirmed that they have received personal copies of the General Social Care Council codes of conduct. All new staff undertake induction and foundation training. There was evidence on staff files to support this and staff confirmed that they had participated in the training. Staff receive regular supervision with the exception of the relief resource worker and it is recommended that some form of regular supervision is provided for them. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.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, 33, 35, 36 and 38. The service users live in a well managed home. Policies and procedures are in place to ensure their financial interests are safeguarded. The health and safety of the service users and staff is promoted. EVIDENCE: The manager has several years management/supervisory experience. She has completed both the NVQ level 4 in Management and the one in Care.Service users and staff spoken with confirmed that they could go to her if they needed to. There are monthly visits carried out by the home’s line manager. Service Users’ meetings are held every 6 weeks and the minutes demonstrate that a wide range of issues are discussed, that service users are enabled to contribute their views and action is taken to implement their ideas. An informative quarterly newsletter is also produced. Staff meetings also take
Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 17 place monthly and issues affecting the service provided are discussed. The information gathered during the year is used to inform in-house decisionmaking. A comprehensive quality assurance tool has been developed and the manager has to assess the service provided against the National Minimum Standards for Older People. This information is used at a higher management level to inform the decision making process of the County Council. The service users’ financial interests are safeguarded. Staff handle the personal allowance for several service users and the appropriate records were accurate and up to date. The staff spoken with during the inspection said that they had received training in, back care, first aid, food hygiene, COSHH, and fire training. The equipment used in the home is serviced at the prescribed intervals. Health and safety notices were displayed around the building. Accidents are properly recorded and where necessary reported to the Commission for Social Care Inspection. Information from the accident records is used in the care planning process. All staff can access Induction and Foundation training, this provides them with basic skills required to undertake the role of resource worker. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 18 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 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X X Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 19 Are there any outstanding requirements from the last inspection? No 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. Standard Regulation Requirement Timescale for action 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 19 36 Good Practice Recommendations The exterior of the building looks tatty and would benefit from being painted. Relief staff used regularly should receive some form of supervision. Springfield Garth - North Yorkshire County Council DS0000034398.V253829.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection York Area Office Unit 4 Triune Court Monks Cross York YO32 9GZ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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