CARE HOMES FOR OLDER PEOPLE
Springfield House Residential Home Bunker Hill Philadelphia Houghton le Spring DH4 4TN Lead Inspector
Elsie Allnutt Announced 1 September 2005 09:30am
st 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 Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION
Name of service Springfield House Residential Home Address Bunker Hill Philadelphia Houghton le Spring DH4 4TN 0191 512 0613 0191 512 0614 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) Northumbria Care Limited Penelope Jane Kristiansen Care home only 36 Category(ies) of OP Old age (36) registration, with number PD(E) Physical dis - over 65 (1) of places DE(E) Dementia - over 65 (4) MD Mental Disorder (1) MD(E) Mental Disorder -over 65 (5) Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION
Conditions of registration: None Date of last inspection 1st March 2005 Brief Description of the Service: Springfield House provides care to older people over the age of 65 years some of whom, may have dementia or mental health needs and there is one place for a person who may have a physical disability It has a variation to its registration to enable it to take one person under the age of 65 years.The home provides personal care only and any health needs are dealt with by the Community Nursing Services.The house is purpose built and offers ground floor accommodation to all areas with staff facilities being sited on the first floor.The home is detached and stands in its own grounds.There is a large garden to the rear of the home that is used by service users and their visitors. The home is situated in a cul-de-sac, which overlooks the cricket field, as well as being close to a local college and housing estate. There are a number of other community facilities within the area. A regular bus service operates from the front of the home enabling easy access to the Galleries in Washington or to Sunderland City Centre. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This announced inspection took place over one day in September 2005 and took 7 hours. The view of service users and relatives were sought via pre inspection questionnaires. 19 service users returned questionnaires and all indicated that they were happy with the service provided and had no issues that they wished to discuss. 14 relatives returned questionnaires and all indicated that they were satisfied with the service, one person commented, “myself and my family are all happy with …….. care and attention in Springfield.” A tour of the building was made as well as an examination of a number of records and a midday meal was taken with service users. What the service does well:
A great strength of this home is its lively, bustling atmosphere that is both warm and welcoming. Staff interact with service users in a lively and stimulating way, encouraging conversation and response by using the knowledge of the service users’ interests and also using humour with respect and sensitivity. As a result of effective cleaning and maintenance routines the home is clean and tidy. Service users were proud to show their home and individual rooms. The home has an enthusiastic staff team who aim to provide a good and supportive service. When talking to service users many made complimentary comments about the staff and their attitudes. They said; “they are kind,” “lovely people,” “they will do anything,” “It’s a wonderful place, I have never looked back since moving here.” Service users confirmed that they are offered choices in relation to meals. The meals are well planned nutritious and nicely presented and service users with special dietary needs are effectively catered for. One service user commented, “you get a choice of meals, and they’re good.” Service users are well cared for and this is reflected in their appearance, this promotes their dignity and self-respect. Service users discussed the good standards of care in the home, some comments included; “help is there when you need it, but they let you get on with it if you can.” Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 6 In an attempt to keep service users occupied and avoid being bored, the home provides opportunities to promote an active lifestyle this includes organised activities in the home and outside in the community. What has improved since the last inspection? What they could do better:
So that service users have an opportunity of taking part in the review of their care an annual review should be organised where all involved in the care of the service users are invited to discuss how the needs are being met and whether the service user is happy with their placement. So that staff are guided to address any specialist needs appropriately clinical guidelines should be included in the care plan for example when someone has diabetes. Service users individual risk assessments should be supported with risk management plans clearly identifying how staff can reduce the risk. This will reduce the risk of harm to service users. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 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 Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 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 Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 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) 3,4,5,6 Service users are admitted to the home only after a comprehensive preadmission assessment and an opportunity to experience life in the home. However the assessed needs are not always consistently addressed in the care plans. This home is not equipped for and does not provide intermediate care. EVIDENCE: Preadmission assessments were in place and generally the care plans sampled reflected the assessed needs of the service users, however one did not. One person recently admitted to the home was assessed as being diabetic but there were no guidelines in relation to this condition in the care plan for staff to follow. This was brought to the manager’s attention who addressed it directly and pointed out another care plan where a person had the same condition and where appropriate guidelines were in place. Staff demonstrated a good understanding of the needs of the individual service users and confirmed that they had recently attended training in relation to dementia care. Service users who signed their care plans confirmed that their needs were addressed adequately. One person said, “I looked at six homes and chose this
Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 10 one, I made the right decision.” Another also confirmed that they had looked at other homes prior to choosing this one and said, “ this couldn’t be better, it’s perfect.” Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 11 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) 7,8,910 While respecting the privacy and dignity of the service users their healthcare needs are generally well met. However improvements can be made to ensure that all risks are identified and care management plans are put in place to reduce the risk, so that service users receive appropriate care and are protected from harm. EVIDENCE: Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 12 The manager confirmed that care plans are in place for all service users and although those sampled included appropriate detail some were lacking in detail in relation to where clinical needs required specialist guidelines. However when discussing this with the manager and staff it was confirmed that they were aware of the needs and how they would be met. To ensure consistency of care this knowledge needs to be recorded in the care plan. Observation of care practice confirmed that the service users’ privacy and dignity is respected, one person commented that, “staff are good and know the way I like things done.” Another confirmed that staff assisted them to hospital appointments when necessary. Although some risk assessments were appropriately in place, the document currently in use to record them does not provide an area to record the risk management plan that is needed to guide staff in relation to how to reduce the risk. Appropriate procedures were observed when medication was being administered and staff confirmed that they had attended training in relation to this. One service user confirmed that they administer their own medication and identified the locked facility they use for safe storage. Records in the care plan confirmed that a risk assessment had been carried out in relation to this. Although it was evident that care plans are reviewed monthly, and the Social Services Department, being the contracting agency, carry out a mail questionnaire to address whether the home continues to meet the individual’s needs, there is no opportunity where people interested in the care of the service user are brought together with the service user to discuss their needs. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 13 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) 12,13,15 Service users are offered the opportunity of participating in a wide range of leisure and social activities enabling them to lead active and fulfilled lives, and are offered a choice of nutritious meals, to help promote their health and general well being. EVIDENCE: The home employs an Activities Coordinator who is responsible for organising a varied activity programme with the support of care staff. A stimulating environment was observed during the inspection process. Service users were engaged in lively conversation and discussions. Some were listening to a tape of Sir Winston Churchill’s speeches while others in a different area of the home were listening to music of their era. Old pictures of the area on the walls stimulated discussions and reminiscence, as did the old pictures of local football and rugby teams. One service user was proud to show their completed and framed jigsaw displayed on their room wall, of the Millenium Bridge over the river Tyne and was enthusiastic to discuss a trip the home had organised for a group of service users to visit and cross the bridge. Other service users confirmed that they were often engaged in activity and trips out. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 14 The meal that was taken with the service users was nutritious and nicely presented, as well as being surrounded with laughter and chatter. Service users commented that the meals were generally good and there was always a choice. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 15 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) 18 Local adult protection procedures have been implemented and instigated to help contribute to the protection of service users from abuse. EVIDENCE: Staff confirmed that they have received awareness training regarding abuse and adult protection, as well as training in relation to handling verbal and aggressive behaviour. In discussion staff were able to appropriately describe what action to take in a situation where they witnessed abuse. The local authority’s adult protection procedure is available within the home, to guide staff on what to do and the people to contact in the event of witnessing abuse or having an alleged abusive situation reported to them. The manager confirmed that two members of staff are to attend the local authority’s Responsible Persons training in September. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 16 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) 19,26 The home is clean, warm and well maintained offering service users a homely and safe environment in which to live. EVIDENCE: Since the last inspection many areas of the home have been redecorated and refurbished resulting in a bright and attractive environment. The dining room has been decorated and provided with a new carpet and matching curtains, the corridors have a new carpet and the hairdressing room has been completely refurbished to provide a facility equal to a good hairdressing salon. The manager explained that individual bedrooms are decorated and refurbished as they are vacated, except for one that is currently in use and previously had a stained carpet so while renewing the carpet advantage was taken to refurbish it. The home has a clear and detailed maintenance programme that identifies the area, the maintenance requirements and the date it is to be addressed. This identified that the bathrooms are the next areas to be addressed.
Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 17 All areas of the home that were viewed reflected good cleaning schedules that provided a clean and hygienic environment for service users to live. Garden areas surround all sides of the building with a large garden to the rear where fruit trees and other attractive plants grow. Unfortunately this area is not directly viewed from the lounge areas nor accessed from the back of the building but service users can access it by walking around from the front. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 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) 27,29,30 The home employs a competent and qualified staff complement via robust recruitment and selection processes, who are supervised regularly, which means that service users are effectively supported and protected by staff. EVIDENCE: Through observation and by examining staff rotas it was demonstrated that there are an adequate number of staff on duty to meet the needs of the service users. The examination of staff files provides evidence that good recruitment procedures are in place including the request of two references and clear CRB checks. Staff supervision sessions were also recorded. Staff discussed the needs of the service users with respect and understanding. When observing staffs’ social interaction with service users, their response, and the way they addressed service users’ needs, it was evident that positive relationships have developed between them. Service users spoke positively about staff and one said, “they look after us well, they’re wonderful.” Staff discussed their training with enthusiasm and confirmed that 67 were qualified in NVQ and that they had recently worked through a distant learning training package in relation to working with people with dementia needs. The manager commented that they are now more aware of the issues surrounding dementia, for example behaviours and how to deal with them. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 19 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 38 Although the health, safety and welfare of service users and staff are promoted and protected this could be improved further by developing risk management plans in relation to the care of service users. EVIDENCE: On the day of the inspection the home was free from any noticeable hazards. Records examined confirmed that accidents are recorded appropriately. Staff training was up to date in respect of moving and assisting and first aid and discussions held with the manager confirmed that staff receive regular updated training. Examination of the fire logbook took place and this confirmed that fire drills are carried out appropriately with the names of staff receiving fire instruction now being recorded separately. A comprehensive fire risk assessment with management plans is in place.
Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 20 There is also a risk assessment for the home that is clear and comprehensive. A discussion took place with the manager in relation to the risk assessment format currently being used in service users’ care plans and how this could be improved. Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 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 2 3 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 x 15 3
COMPLAINTS AND PROTECTION 3 x x x x x x 3 STAFFING Standard No Score 27 3 28 3 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score x x 3 x x x x x x x 2 Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 22 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 3&7 Regulation 15(1) Requirement Timescale for action 31.10.06 2. 3&7&38 13(4) The assessed needs of service users must be reflected in their plan of care so that staff are guided to address the need appropriately, this may be in the form of clinical guidelines. Risk assessments must be 31.10.06 supported by risk management plans so that staff have guidelines to follow to reduce the risk and protect the service user from harm. 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 7 Good Practice Recommendations The home should consisder carrying out an annual review where the service user, their family and other persons involved in their care, are invited to discuss the needs of the serivce user and how they are being addressed. The plans to refurbish the bathrooms and the rest of the building should go ahead. 2. 19 Springfield House Residential Home B52 B02 S15764 Springfield House V219411 1 Sep 2005 Stage 4.doc Version 1.40 Page 23 Commission for Social Care Inspection Baltic House Port of Tyne, Tyne Dock South Shields NE34 9PT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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