Inspection on 18/08/05 for Springfield House Nursing Home

This inspection was carried out on 18th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Springfield House Nursing Home 04/04/07

Springfield House Nursing Home 16/11/06

Springfield House Nursing Home 18/01/06

Springfield House Nursing Home 11/08/04

Springfield House Nursing Home 26/02/04

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

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

CARE HOMES FOR OLDER PEOPLE Springfield House Nursing Home Oaken Nr Wolverhampton West Midlands WV8 2EE Lead Inspector Lynne Gammon Unannounced 18th August 2005 9:30 am 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 Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springfield House Address Oaken Nr Wolverhampton West Midlands WV8 2EE 01902 847272 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 House(Oaken)2001 Ltd Mrs Lynda Warden CRH 26 Category(ies) of OP - 3 registration, with number PD - 36 of places Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: It is a condition of the registration that the number of persons received into the home shall be over 60 years. Date of last inspection 8th January 2005 Brief Description of the Service: Springfield House Nursing Home was opened in 1995 sharing the site with a residential facility and Four Seasons Health Care headquarters, accommodating thirty six elderly service users; offering twenty-four hour nursing care for long and short stay visits. The home is set amidst outstanding Staffordshire countryside, convenient for public transport and the local village of Codsall, a few miles from Wolverhampton. Four Seasons Health Care, one of the largest independent care providers in the UK, operates the home offering a high standard of nursing care with maximum comfort and security, in a pleasant and safe environment. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This unannounced visit was made on the 18th August 2005 at 9.30am. The inspection was carried out by one inspector who used the National Minimum Standards for Older People as the basis for the inspection. The total time spent for the inspection, including pre and fieldwork, amounted to 8 hours. The registered care manager, Lynda Warden, an RGN, was in charge of the home on the day of the inspection, plus 2 trained staff, an adaptation nurse and 2 care assistants in the morning, 1 trained staff, an adaptation nurse and 1 care assistant in the afternoon and 1 trained staff and 2 care assistants on night duty. Other ancillary staff on duty that day included: an office administrator, a cook, a kitchen assistant, 2 domestics and a laundry assistant. There were 28 service users living in the home at the time of the inspection and these staffing levels were deemed insufficient during the afternoon to meet their needs. This was due to a member of staff ringing in sick that day and cover must be put in place in this situation. The inspection included a tour of the building, inspection of records, observation, and discussions with residents, staff and the registered manager. Since the last inspection on 8th January 2005, there had been one complaint received by the Commission for Social Care Inspection and been investigated accordingly. No incidents or reports of alleged abuse were made to the home or the Commission since the last inspection. One requirement raised regarding the maintenance of staffing levels at the previous inspection was raised again during this inspection. Service users had been able to make a decision about the home following a pre-admission assessment and some service users informed the inspector that they had been invited to visit the home for a meal prior to moving in. Care plans had been very well written and health, personal and social care needs had been met and well documented, showing a high standard of nursing care. All aspects of service user privacy, dignity and choice were supported and endorsed. Observation evidenced that service users were treated with dignity and respect. The home was well maintained, warm and clean. It had a comfortable, friendly atmosphere and provided a safe and happy environment for the service users. There were adequate toilet and washing facilities within the home but it was noted that a number of soap dispensers needed repairing. Each bedroom was individually personalised with service user’s possessions and the communal areas were pleasant and bright. Most rooms were comfortable, homely and clean, however, a bad odour was found in two bedrooms and this must be Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 6 addressed. The home was well managed and organised and formal staff supervision sessions took place. Recruitment procedures needed to be more robust to ensure the continuing protection of the service users. What the service does well: What has improved since the last inspection? What they could do better: A number of requirements were raised as a result of this inspection and were as follows: • • • • A number of hand soap dispensers in toilets and bathrooms were found to be broken and required repair or replacement Most rooms were clean, homely and bright, but a bad odour was found in two bedrooms and needed attention. Staffing levels were reduced in the afternoon of the inspection and adequate staffing levels must be maintained at all times. Recruitment procedures needed updating to ensure all staff had the appropriate checks prior to employment. It was also recommended that consideration be given to employing an activities co-ordinator to provide more opportunity for the development of social activities, for all new members of staff to receive Adult Protection training as part of their induction, to improve the overall setting of one of the Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 7 dining rooms, particularly in regard to decorating and to consider purchasing a bedpan sanitizer for the benefit of the staff and the service users. 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 Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 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 Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 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) 3 and 5 Pre-admission assessments were carried out for prospective service users who were invited to visit the home prior to moving in to enable them to make an informed choice about the home. EVIDENCE: Records showed that pre-admission assessments were carried out prior to admission by the Manager and were detailed and thorough, covering all aspects of health, social and personal needs. Trial visits were available to all potential service users and some service users who were spoken to confirmed that they had been able to visit the home before choosing to stay, and had lunch provided for them and their relatives. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 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) 7, 8, 9 and 10. The care planning processes within the home were clear and consistent and provided staff with detailed information to meet service user’s needs satisfactorily. All health care needs were met and there was a safe system in place for the receipt, storage and administration of medicines for the protection of service users. Service users were treated respectfully and with dignity. EVIDENCE: All service users had care plans and two service user’s care plans were studied in depth. Each individual plan was seen to be detailed and thorough and covered the assessed needs of the service users. This included admission details, aspects of care, daily report, professional’s visits and risk assessments. Care plans were reviewed monthly and the standard of recording was very good and meaningful, particularly in terms of pressure area treatment and healing. From inspection of records and discussion with staff, it was revealed that service users received a range of health care services according to their need, such as their GP, chiropodist, dentist etc. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 11 Inspection of the Medicine Administration Records, the Controlled Drugs Register and drug stock levels evidenced that procedures were in place for the receipt, storage, administration and disposal of medicines. All records were correct and stock levels balanced. The storage area for medicines was clean and tidy. The Medication Policy was shown to the inspector and the Homely Remedies Policy was signed by a GP and dated for 2004. Temperatures of the fridge containing medication was checked and signed each day. Photocopies of prescriptions were taken and used to check against deliveries. Through observation and discussion with service users, it was evidenced that service users were treated respectfully and their request for privacy upheld. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 13. There were a range of activities available to meet the needs of the service users and family and friends were encouraged to visit. EVIDENCE: The home provided a range of activities for the benefit of the service users such as: trips to the Walsall illuminations and the safari park, a picnic at Shugborough Hall, entertainers, community library providing books and tapes, Celebration Day with a 1920’s theme, high tea and quizzes, etc. The home did not employ an activities co-ordinator and activities were organised by the Manager of the home with care staff providing some activities in the afternoon for the service users. However, it was apparent that more capacity would enhance the social facilities within the home and it is recommended that an activities co-ordinator be considered to provide more opportunity for the development of activities. A hairdresser also visited the home and the inspector noticed that this facility took place in the staff room area. This was more than big enough for both staff and the hairdressing facility, but it is a recommendation of this report that consideration is given to create a partitioned area for the hairdressing service in order to provide a pleasant, pampering experience for the service users and privacy for the staff on their breaks. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 13 Religious needs were also accommodated and Holy Communion took place once per month. Local clergy also attended the home on request. Throughout the inspection, relatives were seen to be welcomed into the home and service users confirmed to the inspector that they were able to see their friends and relatives any time they wished. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 and 18 Complaints were listened to and resolved to the satisfaction of the complainant. The home’s policies and procedures protected service users from aspects of abuse. EVIDENCE: The home had a comprehensive complaints procedure and a copy was located in the entrance hall of the home for the benefit of relatives and visitors alike. Minor complaints were received by the Manager and resolved to the satisfaction of the service users. One complaint had been received by the Commission since the last inspection and was investigated accordingly. A few requirements were made as a result of this. Service users and relatives spoken to informed the inspector that they did not have any complaints about the staff or the service provided within the home, and any minor niggles were dealt with by the Manager promptly. The home had an Adult Protection procedure and each member of staff received Protection of Vulnerable Adults documentation, which included how to recognise different types of abuse. It is recommended that all new members of staff receive Adult Protection training as part of their induction. There had been no allegations or incidents of abuse at the home. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19, 20, 21, 22, 24, 25 and 26. Indoor communal facilities were accessible, and overall, maintained to a satisfactory standard. Parts of the garden needed attention but areas were easily accessible for the service users. Adequate lavatory and washing facilities were in place to meet the needs of the service users. Specialist equipment was used to support service users to promote their independence. Service user’s bedrooms were homely, comfortable and individually personalised. The home was generally very clean but a couple of rooms required attention to remove bad odour. EVIDENCE: The location and layout of the home was well suited for the service users. The rural setting provided a quiet and pleasant environment. The gardens around the home were mostly grassed areas, with seats and benches for service users to enjoy the outdoors. There were also bird tables, shrubberies and planters with flowers at different points around the home. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 16 Some of the shrubberies needed attention and the Manager confirmed that she was having difficulty recruiting a gardener for the home for the number of hours available. There were adequate communal areas for the service users; the lounges were maintained to a good standard and very clean. One lounge in particular was very large but a homely environment had been maintained and there were good quality furnishings and fittings in place. The conservatory was exceptionally pleasant and provided a bright, homely setting for the benefit of the service users. The dining rooms in contrast were in need of redecoration. The nurse in charge stated that the dining rooms had recently been redecorated but one dining room in particular, needed attention and appeared bare and empty. It is recommended that this dining room be given attention in terms of redecorating and setting. There were satisfactory lavatory and washing facilities within the home which were extremely clean. However, a number of soap dispensers in toilets and bathrooms were broken and it is a requirement of this report that these be repaired. Sluices were located separately from service user’s toilets and were clean and tidy. No bedpan sanitizer was located in the home and it is recommended that consideration be given to the purchase of this equipment for the benefit of the staff and the service users. During the inspection it was noted that adaptations and equipment had been provided to meet the assessed need of the service users. These included handrails fitted along the corridor, grab handles in the toilets, access ramps and a lift for wheelchair users. There were also hoists, pressure mattresses and cushions, variable height beds, reclining chairs, a nurse call system and assisted bathrooms for the benefit of the service users. Individual bedrooms were inspected and all contained a toilet, washbasin and fitted wardrobes. Some of the bedrooms were decorated and maintained to a high standard and new carpets had been laid in a number of rooms. Each room contained a variety of personal items and furniture belonging to the individual service user. A locked drawer facility was available in each room for safe keeping of any valuables owned by the service user or for those who were assessed as being able to self medicate safely. All radiators were covered, smoke alarms were fitted in each room and all wardrobes and windows were restricted for the safety of the service users. Most rooms were clean, homely and bright, however, a bad odour was found in two bedrooms and it is a requirement of this report that this be addressed. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 17 Laundry facilities were inspected and found to be well organised, clean and hygienic. Soiled linen was contained within appropriate, easily identifiable, red bags and held separately from other laundry. Foul laundry was washed at the appropriate temperatures to ensure it was thoroughly clean and to control the risk of infection. Hand washing facilities were available in the laundry and the storage area for laundered linen and clothes was tidy and clean. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 18 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 and 29 The skill mix of staff was adequate to meet the assessed needs of service users but insufficient staff were on duty in the afternoon. Staff files and recruitment procedures needed to be audited to ensure the continued protection of service users. EVIDENCE: On the day of the inspection, there were 28 service users living in the home and staffing levels were as follows: 08.00 – 14.30 14.30 – 21.00 21.00 – 08.00 2 trained nurses 1 trained nurse 1 trained nurse 2 care assistants ( 1 adaptation nurse) 1 care assistant ( 1 adaptation nurse) 2 care assistants The daily staff rota had included enough staff to meet the needs of the service users, however, one care assistant was ill on the day of the inspection and the number of staff on duty in the afternoon was not considered adequate to meet the needs of the service users. However, the inspector noticed that staff coped well and worked hard to prevent any reduction in service to the service users. However, it is a requirement of this report that adequate staffing levels are maintained as agreed. Other ancillary staff on duty that day included: an office administrator, a cook, a kitchen assistant, 2 domestics and a laundry assistant. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 19 Two staff files were examined and each contained an application form, CRB clearances, two references and details of qualifications and some training. Appraisal sessions were also documented. However, they were lacking some of the required elements as set out in Schedule 2 of the Care Homes Regulations 2001 e.g. a recent photograph of the member of staff and proof of identity. It is a requirement of this report that the recruitment and selection procedures within the home are updated to prevent future omissions in staff files for any new staff and for all existing staff files to be audited and any gaps identified and corrected. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 20 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) 31 and 36 A professional, experienced and competent person managed the home. Supervision sessions took place and enabled staff to have formal, documented timeslots with their manager. EVIDENCE: The registered care manager, Lynda Warden was a very experienced and qualified nurse who was extremely competent to run the home. She had achieved NVQ Level 4 Registered Manager’s Award and fit to be in charge, of good character and entirely committed to maintaining a high standard of care for the service users living in the home. Documentation evidenced that staff supervision was carried out and provided a regular, documented, one-to-one session for staff with their line manager. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 21 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 4 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 4 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 4 14 x 15 x COMPLAINTS AND PROTECTION 3 2 2 4 x 3 3 2 STAFFING Standard No Score 27 2 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 3 4 x x x x 3 x x Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 22 ONE 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. 2. Standard OP 21 OP 26 Regulation 13 (3) 16 (2)(k) Requirement To repair a number of soap dispensers in toilets and bathrooms which were broken. Most rooms were clean, homely and bright, however, a bad odour was found in two bedrooms and it is a requirement of this report that this be addressed. To maintain adequate staffing levels at all times. All recruitment procedures to be updated and staff files to be reviewed and audited to ensure all staff have the appropriate checks prior to employment. Timescale for action 31/10/05 Immediate 3. 4. OP 27.3 OP 29 18 (1)(a)(b) 19 (1) (b) (i) Immediate & ongoing Immediate 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. 3. Refer to Standard OP 12 OP 18 OP 20 Good Practice Recommendations To consider employing an activities co-ordinator to provide more opportunity for the development of social activities. For all new members of staff to receive Adult Protection training as part of their induction. To improve the overall setting of one of the dining rooms, E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 23 Springfield House Nursing Home 4. OP 21 particularly in regard to decorating and setting. For consideration to be given to the purchase of a bedpan sanitizer for the benefit of the staff and the service users. Springfield House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection Stafford - Dyson Court Staffordshire Technology Park Beaconside Stafford ST18 0ES 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 House Nursing Home E51-E09 S22375 Springfield House V239056 18.08.05 Stage 4.doc Version 1.40 Page 25 - 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. 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