This inspection was carried out on 23rd September 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.
CARE HOMES FOR OLDER PEOPLE
Springfield House 6 Stoke Road Cobham Surrey KT11 3AS Lead Inspector
Kathy Martin Announced 23 September 2005
rd 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 House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Springfield House Address 6 Stoke Road, Cobham, Surrey,KT11 3AS 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) 01932 862580 Mr & Mrs Fothergill T/A The Springfield Partnership Ann Higgins CRH N 27 Category(ies) of OP - Old Age - 27 registration, with number of places Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: Up to 3 beds in the above category may be used for respite and short stay care Date of last inspection 9th May 2005 Brief Description of the Service: Springfield House is a privately owned care home which provides nursing care for 27 residents with old age. The home is a large detached property situated on a busy road in Cobham and within good road links to main routes and motorways. The home is well maintained and decorated in a homely way. It also has a car park for visitors and a garden. The home engages the community in providing useful activities and outings for those able to take part. There are many other health care professionals who help the care staff to deliver care in the home. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This was the second CSCI inspection this year. The first inspection was undertaken in May. All the key national minimum standards have now been assessed over both visits. This was an announced inspection meaning that the manager, staff and residents were made aware in advance. The manager was sent a pre-inspection questionnaire relating to how the home operates ahead of the inspection. This document provided information that has been used in this report. The inspector spoke with several residents during the visit and to some members of staff. The CSCI sent out feedback cards that the home distributed to residents, their visitors and visiting professionals. Several comments were received most very complimentary of the way the home run and how residents were cared for. During the course of the inspection the inspector looked at records and also toured the building. The home was running efficiently during the visit. The staff rapport towards the residents was friendly and relaxed. The residents were in various areas of the communal rooms and some were in their bedrooms. The home was clean and tidy and well maintained. Residents received regular activities, which is organised by the activities organiser. The staff were very supportive towards each other. A new member of staff spoke highly of the manager and her supervisors and felt she fitted in the team well. The manager was present throughout the inspection. The inspector wishes to thank all the residents, their relatives and the visiting professionals who either completed the written feedback or spoke directly to the inspector on the day, to contribute to this report. What the service does well:
These comments were received from residents, their visitors and visiting professionals who come to the home: “Springfield House is 5 star! My (relative) was only there for the final (number of weeks)…but they could not have been more kind or caring. I could not fault it in any way” (from a relative) “An extremely good and caring home” (from a relative)
Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 6 “very pleasant, professional staff. Some excellent examples of extremely dedicated and high standards of nursing care with patients of the practice” (from a visiting GP) “In this home residents are loved as well as cared for, and support to relatives is great too”” (from a relative) “The home has a good reputation in Cobham. The matron, in particular is excellent” (from a resident) “I always find the home friendly and residents well cared for. The home is clean and staff caring towards service users” (from a visiting professional) These comments were re-enforced during conversations between the residents and the inspector on the day. Residents said they were happy living in Springfield house and felt comfortable. The interactions between staff and residents were friendly and respectful. Staff knew their needs well and responded to them in a knowledgeable and competent manner. What has improved since the last inspection? What they could do better:
These comments were made to the Inspector via the feedback cards and were raised with the manager who will look into resolving the issues in due course: “My (relative) is hard of hearing and is not consulted about meals” There was evidence to suggest that choice would need to be promoted in the menu planning and a recommendation has been made to this effect. Another comment was regarding agency staff who did not speak good English and made communications difficult and don’t always remember to return the resident’s private articles in the correct place in this particular resident’s bedroom. One requirement was made regarding staff recruitment and documentation, which needs to be in line with regulations.
Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 7 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 h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 8 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 House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 9 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) This section was inspected during the inspection in May 2005. The comments made then remained current. EVIDENCE: Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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 standard(s) 9 The policies and procedures for the management of medication were sound. EVIDENCE: The policies and procedures for medication management were inspected and found to reflect the new changes of regulations, regarding the returns of medicines. The registered nurses are solely in charge of medication administration. They have all received a City and Guilds training this year in medication. There were no residents who currently self-medicated. The staff reported that the supplying chemist has a good rapport with the staff who were able to offer guidance to them. The storage of medication was appropriate. The Medication Administration Records were maintained clear and without unexplained gaps. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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) 15 The food offered was of good quality and wholesome. However there were issues regarding choice which will need to be incorporated in the menu planning. EVIDENCE: Comments received from residents evidenced they generally liked the food offered to them and had plenty to eat at the correct times. However two comments were made regarding the lack of choice of the main meals. There was a main meal on the menu for lunch and supper with a choice offered if the resident preferred an alternative rather than being given the choice from a selection of main meals in the first instance. This was discussed at length with the manager. The manager and the deputy were aware that the menu needed to be addressed after consultation with residents. It is acknowledged that the other preferences besides the main meal included omelettes or sandwiches but not an actual main meal to offer a proper choice. Snacks and beverages can be obtained any time day or night. There are regular drinks rounds and staff encouraged residents to keep hydrated. A recommendation has been made for the home to actively promote choice on their menus in future and to send a sample copy to the CSCI when done.
Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 12 The home is able to seek advice from a dietician. There are residents who are on special diets and who require constant monitoring in terms of weight loss especially. The nurses recorded weights and monitored these closely. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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 and 18 The home has procedures to deal with complaints and for referring any suspected cases of abuse under the vulnerable adults procedures. EVIDENCE: The home had a complaints procedure although it is worth mentioning that some relatives may not have a recent copy and may have misplaced the ones obtained when residents were first admitted. Some relatives had indicated this on the comments card completed for the inspector suggesting they were not all aware of how to use the complaints procedures. The home uses the Surrey Multi-Agency Policy and Procedures for the protection of vulnerable adults (POVA). Staff were police checked prior to commencing work in Springfield House. All staff received regular updates in POVA. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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) 26 The home was clean and tidy. There was a possible issue relating to infection control and the inappropriate use of gloves for some tasks around the house. EVIDENCE: The home was clean and tidy and offered a very pleasant and homely environment. There were dedicated staff who were responsible for the bulk of the cleaning. The inspector noted a couple of times that staff appeared to be using gloves around the home and asked the manager to ensure these are being used appropriately. Staff may need to be reminded on the use of gloves around the house when they don’t actually need to be wearing protective clothing if they are not attending to tasks that require them to wear these. 15 care staff were booked to attend an infection control training soon. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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 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) 29 The procedures for the recruitment of staff were in the main well maintained. However there were documents missing from files inspected that were needed for regulatory purposes and to evidence staff fitness. EVIDENCE: Staff files were sampled and found maintained appropriately for the exception of details such as signatures on important documents. One application form was also missing. A requirement was made for the recruitment paperwork to be maintained in accordance with regulations. All staff were subject to police checks and POVA checks. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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 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) 33, 35 and 38 There was evidence that the residents were well care for and that the home made every effort to ensure that it ran in the best interest of its residents. The residents’ monies were held in accordance with the home’s procedures to ensure they were safeguarded from financial abuse. The home’s procedures for health and safety were good. EVIDENCE: Residents spoke directly to the inspector and stated that they felt they were looked after well in Springfield House. The home responded to any comments and suggestions made from relatives and during residents’ reviews in a positive and proactive manner. They have actioned all requirements and recommendations made during previous CSCI inspections and showed genuine concern for ensuring that they met all the National Minimum Standards for Older People. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 17 Staff reviewed the care of residents regularly including their care plans and interests for participating in activities inside the home and externally. The relatives reported that they felt able to contribute to the lives of those in care and felt that the staff welcomed their input. The home received a visit at least once a month from the business manager who acted on behalf of the owners and her comments are sent to the CSCI and the registered manager to report on the conduct of the home in accordance with Regulation 26 of the Care Homes Regulations. The home has procedures for helping staff to deal with residents’ finances. Residents were encouraged to maintain control over their own finances or with help of their appointed solicitors or next of kin. The home can hold a small amount of money for newspapers, hairdressers, clothing and toiletries, etc…on behalf of residents who wish this to happen. The receipts were maintained for each amounts spent and clear audits were maintained showing the exact money in and out of each account. The money was kept individually rather than pooled and it was easily tracked. Staff knew that they were not allowed to receive gifts and the home had a policy about this. There were procedures for health and safety. Staff received training in all relevant aspects of health and safety including fire, basic food hygiene, first aid and infection control. Repairs were undertaken promptly by the on site maintenance man. External contractors regularly serviced all equipment for fire, hoisting, bathing, catering and clinical appliances. Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 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 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 x 8 x 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 x 14 x 15 3
COMPLAINTS AND PROTECTION x x x x x x x 3 STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x 3 x x 3 Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 19 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 29 Regulation 19 Requirement Staff files to contain all documentation in accordance with this regulation Timescale for action 11/11/05 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 15 Good Practice Recommendations Actively promote choice in menus offered to the residents Springfield House h09-h58 s13352 Springfield House v241195 230905 stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection The Wharf Abbey Mill Business Park Eashing Surrey GU7 2QN National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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