CARE HOME ADULTS 18-65
Springfield House Wheyrigg Wigton Cumbria CA7 0DH Lead Inspector
Cath Wilson Unannounced Inspection 19th September 2006 10:30 Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 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 House DS0000022611.V304202.R02.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 3 SERVICE INFORMATION
Name of service Springfield House Address Wheyrigg Wigton Cumbria CA7 0DH 016973 45530 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) Mrs Margaret Blair Mrs Margaret Blair Care Home 3 Category(ies) of Learning disability (2), Learning disability over registration, with number 65 years of age (1) of places Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. Registered for 2 people over 18 years of age with a learning disability (LD) Registered for 1 named person over 65 years of age with a learning disability (LD(E)). The registration will revert to LD ONLY when the named person is no longer in the home. 20th February 2006 Date of last inspection Brief Description of the Service: Springfield House is a former farmhouse that had been adapted to accommodate up to three people with a learning disability. Accommodation is provided in a domestic setting with service users living as part of the registered manager’s family. The home is located in a rural area and is set in its own grounds. The home provides wheelchair accessible transport. The home is registered to take up to three people with a learning disability. At present one of these is an older adult. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was an unannounced visit to Springfield House that took place during the morning period. During this time all the key standards of the National Minimum Standards were assessed. Service users, their relatives and members of staff had given opinions regarding the services provided by Springfield House to the inspector. Their comments and views have guided the judgements made in this report. The registered manager and senior staff were met during this inspection. A pre-inspection questionnaire was completed by the registered manager and received prior to this visit. This visit included a look around the home and an assessment of the home’s administrative policies and procedures. What the service does well: What has improved since the last inspection?
The home continues to ensure that the identified needs of people in the home are met. This involved the expertise and guidance of other personnel in order that the most appropriate outcomes are achieved for people and are diligent in Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 6 doing this on an ongoing basis. The recording system used in the home continues to be improved so that outcomes are effectively recorded. 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 House DS0000022611.V304202.R02.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,2, 3 and 4 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home has good procedures and paperwork in place to ensure appropriate referrals and that they accept people whose needs they can meet. EVIDENCE: The information available to prospective guests, their family or representatives is well documented. The manager is fully informed of the criteria for needs led assessments and incorporates this information comprehensively in meeting individual need. People are able to visit the home prior to their visit. People are provided with choice and being provided with opportunities to visit the home allows an informed and supported decision to be made. The Statement of Purpose and Service User Guide are appropriately updated. Both documents are accessible and available to family and representatives also. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 Quality in this outcome is good. This judgement has been made using available evidence including a visit to this home. The manager and staff are very focussed on achieving the individual outcomes for people. This is carefully monitored. Risk taking is well managed and a good balance is achieved between promoting independence and ensuring the well-being and safety of people during their stay. EVIDENCE: The manager and staff are developing individual care plans for people in the home. Individual ways of communicating are included and staff are constantly seeking ways of furthering people’s involvement in their daily lives. Information is kept up-to-date and the manager and staff are very well informed of individual needs, wishes and preferences. The information is regularly monitored and assessed and reviewed. In order to further strengthen the care planning used in the home staff continued to monitor the method of recording people’s individual outcomes in their records. The manager and senior staff are diligent in monitoring people’s individual care needs. Risk assessments had been undertaken and are integrated into the everyday life experiences of people. This allows people to be appropriately
Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 10 supported to be included in events in their lives in a safe, manageable and balanced manner. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. People’s rights are very much promoted and their individuality respected. People’s leisure and community involvement is detailed in their records and staff are supportive in people attending these. Staff attended to these in a manner that respected people’s individuality and planned people’s inclusion with this in mind. Staff who met with me displayed a great interest and enthusiasm in encouraging people to have meaningful and enjoyable experiences. Seeking opportunities to further people’s choice and participation in everyday events. Family members are encouraged to have involvement. Mealtimes are arranged to meet individual need whether this be in the home or community. Staff encouraged guests to make their own decisions and their rights and choice are recognised and promoted. It is clear that this is one of the underpinning values of California House. EVIDENCE: People’s leisure and community involvement are detailed in their records and staff are supportive in people attending these. Staff attended to these in a
Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 12 manner that respected people’s individuality and planned people’s inclusion with this in mind. Staff who met with me displayed a great interest and enthusiasm in encouraging people to have meaningful and enjoyable experiences. Seeking opportunities to further people’s choice and participation in everyday events. Family members are encouraged to have involvement. I was informed that they are made very welcome when visiting the home and are appreciate of the care provided. Mealtimes are arranged to meet individual need whether this be in the home or community. Staff encouraged people to make their own decisions and their rights and choices are recognised and promoted. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 Quality in this outcome area is good. This judgement has been made using evidence including a visit to the home. Health care matters are well managed and documented. Medicines management is generally good and are currently under review. EVIDENCE: The manager and staff are informed of people’s healthcare needs and records are kept of these. Staff work positively with local health care professionals when required to offer an attentive and supportive approach to ensure people’s health needs are met and planned for. There is access to specialist advice and guidance. Staff continue to assess the way they record this so that the support and attention provided accurately reflects their practices. There are policies and procedures for medicines management. All medicines were securely stored and medication records are currently under review. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. The home safeguards people’s health, safety and welfare. The home has a satisfactory complaints system. EVIDENCE: Information is available regarding complaints and relatives or representatives have access to this. This information is being updated. Staff are informed of the policies and procedures relating to adult protection matters and how to safeguard the health and welfare of people in the home. The manager and staff are familiar with the multi-disciplinary guidance and this includes arrangements for training to be appropriately renewed. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 26, 27, 28, 29 and 30 Quality in this outcome area is very good. This judgement has been made using available evidence including a visit to the home. Private rooms are comfortable, well maintained and provided with specialist aids and adaptations where appropriate. EVIDENCE: Arrangements are in place for the general health and safety of people in the home and for their environment. There is one personal matter that is receiving attention including the assistance of other professional carers. Guidelines are followed regarding environmental health and fire safety. Specialist equipment is regularly serviced and the home has access to advice and guidance regarding environmental matters. Each person has their own room. Arrangements are in place to upgrade and replace furnishings and the décor when needed. The overall impression is one of a comfortable, relaxing
Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 16 and pleasant environment for people to live. The garden areas are very well maintained. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 17 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35 Quality in this outcome is good. This judgement has been made using available evidence including a visit to the service. Staff are well trained and regularly supervised and training needs are identified. EVIDENCE: Training matters in key subjects had been kept up-to-date along with staff involvement in NVQ qualifications. All new staff had undergone a period of induction and all appropriate checks and references had been undertaken prior to commencing work. The home ensured appropriate levels of support are available for people in the home. The manager and staff are well informed of the individual and comprehensive needs of residents. Staff are well supported in their work and had regular supervision. They meet regularly to discuss their provision and the quality of care they are providing. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 18 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the home. People in this home benefit from an organised and well ran home that places their care and overall welfare first. EVIDENCE: There are health and safety policies and procedures available in the home and staff are well informed of these matters. The records assessed on the day of the inspection were organised, up-to-date, accessible and confidentially stored. The manager and staff was present during this inspection are very clear about their roles and responsibilities and the systems that are organised in the home. The Registered Manager and her senior are involved with the Registered Manager’s Award training and this now requires completion. Arrangements in the home were very focussed on meeting the needs and wishes of people who live here. It is evident that the manager and staff are constantly seeking ways
Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 19 to improve the quality of people’s lives and enlist the help of fellow professionals and colleagues to do so. Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 3 2 3 3 3 4 3 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X X X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 X 3 X 3 X X 3 X Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 21 NO Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 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. Refer to Standard Good Practice Recommendations Springfield House DS0000022611.V304202.R02.S.doc Version 5.2 Page 22 Commission for Social Care Inspection Eamont House Penrith 40 Business Park Gillan Way Penrith Cumbria CA11 9BP National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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