CARE HOMES FOR OLDER PEOPLE
Springfield House Residential Home Bunker Hill Philadelphia Houghton-le-spring Tyne And Wear DH4 4TN Lead Inspector
Mrs Elsie Allnutt Unannounced Inspection 25th November 2005 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Springfield House Residential Home Address Bunker Hill Philadelphia Houghton-le-spring Tyne And Wear DH4 4TN 0191 512 0613 0191 512 0614 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) Northumbria Care Limited Mrs Penelope Jane Kristiansen Care Home 36 Category(ies) of Dementia - over 65 years of age (4), Mental registration, with number disorder, excluding learning disability or of places dementia (1), Mental Disorder, excluding learning disability or dementia - over 65 years of age (5), Old age, not falling within any other category (36), Physical disability over 65 years of age (1) Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 1st September 2005 Brief Description of the Service: Springfield House provides care to older people over the age of 65 years some of who 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 in construction 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 DS0000015764.V268920.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was unannounced and took place over 4 hours during one day in November. The views of service users and their relatives were not sought prior to this inspection, however the overall opinion of the service users spoken to on the day of the inspection was that the care and support provided in the home was satisfactory. A tour of the building took place and a number of records were inspected. Three staff on duty during the day, and six service users were spoken to. What the service does well: What has improved since the last inspection?
Since the last inspection there have been improvements made to the care plans regarding the information recorded relating to service users’ needs. Effort has been made by staff to improve risk assessments with the result that more areas of risk are now identified and guidelines for staff to follow, in order
Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 6 to reduce the risk, are in place. This supports service users during various activity and improves their safety. So that the service users and their families have a chance to address and discuss service users’ care and social needs in a formal setting, the home has addressed the recommendation made at the last inspection in relation to organising and carrying out formal reviews. The manager has developed a standard letter that will be sent out to service users’ relatives /representatives and agencies that may be involved in the person’s care, naming the date and time of the meeting with a small amount of dialogue describing the aim of the meeting. Such meetings will ensure that service users’ needs are being addressed appropriately and the service delivered in a way that the service user is happy with. This is to be in addition to the mail questionnaire sent out by Social Services as their annual review. As part of the refurbishing process throughout the home the bathrooms have recently been decorated and now provide a clean and attractive facility for service users to use. 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 Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 Service users are admitted to the home only after a comprehensive preadmission assessment is carried out, after which a care plan is developed to address the assessed needs. EVIDENCE: Preadmission assessments and care plans from the referring agency are in place along with the home’s own assessment. The manager confirmed that the care plan process continues to be developed by the home. Those sampled reflect the assessed needs of the service users and were clearly organised. Staff demonstrate a good understanding of the needs of the individual service users. Observations confirmed that service users needs are addressed appropriately and in relation to guidance in the care plan. Two service users confirmed that their needs were adequately met and they were happy with the care received. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7,8 The healthcare needs of the service users are generally well met and improvements have been made in relation to the development of risk assessments and risk management plans, however staff do not always follow the guidelines in the care plan, therefore service users have been put at risk. EVIDENCE: The manager confirmed that care plans are in place for all service users, a sample of which was examined. All included relevant information in relation to service users’ health care needs. Although improvements have been made in relation to identifying risks, the way the document is completed by staff could be more consistent. A discussion took place with the manager in relation to this. A risk assessment is in place in relation to one service user’s mobility needs, however as a result of an investigation carried out by the home in response to a complaint by the service user, the actual practice carried out regarding manual-handling techniques did not reflect the guidelines recorded in the care plan. To ensure consistency of care and safety to service users, staff must ensure that they keep up to date with any changes to the care plans.
Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 10 One of the service users confirmed that their healthcare needs were addressed appropriately and stated that they are assisted with their care needs the way they prefer. This was also confirmed when observing the interaction of staff and service users. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 14 Service users are supported by staff to make choices about their own lives and as far as possible to take control, both in their daily routines and in the many organised activities on offer in the home. EVIDENCE: The home has an Access to Information Policy and service users are able to access their files and information held about them however, service users’ that were asked during the inspection had not has chosen to do this. The manager stated that service users are supported and encouraged to manage their own finances and where this is not possible families take over. One service confirmed that their family attended to their financial affairs but they had control over their pocket money. Routines observed in the home confirmed that service users were encouraged and supported to make choices about their lives. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 12 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16,18 The local adult protection procedures have been implemented and instigated to help contribute to the protection of service users from abuse. The home also has a satisfactory complaints system, however complaints are not always recorded appropriately therefore service users rights could be jeopardised. EVIDENCE: The home has a Complaints and Compliments book that was examined. Two compliments had been recorded since the last inspection. One was from a relative and the other from a GP, both complimenting the home on the good care delivered to service users. However, although the home has addressed a complaint from a service user following the local adult protection procedures known a MAPPVA (the Multi Agency Panel for the Protection of Vulnerable Adults), the incident was not recorded in the Complaints book. 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. A recent MAPPVA investigation was appropriately carried out and the issue addressed was partly substantiated. The requirements of this report will address some of the outcomes. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 13 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19,26 The home is clean, warm and well maintained offering service users a homely and safe environment in which to live. EVIDENCE: Many areas of the home were redecorated and refurbished prior to the last inspection resulting in a bright and attractive environment. These include the dining room and the hairdressing room that was completely refurbished to provide a facility equal to a good hairdressing salon. The home has a clear and detailed maintenance programme that identifies the area, the maintenance requirements and the date it is to be addressed. At the last inspection this identified that the bathrooms were the next areas to be addressed, these now have been redecorated. All areas of the home that were viewed reflected good cleaning schedules that provide a clean and hygienic environment for service users to live. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 14 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 30 The home provides a training programme that meets the training needs of the staff that equips them to support and address the individual and changing needs of the service users living at the home. EVIDENCE: The staff files include the training records of each member of staff and the sample examined proved that new staff receive planned induction training and later training that is specific to the client group that live at this home for example dementia care. The home exceeds the percentage of staff needed to meet the target in relation to the number of staff to be qualified in NVQ by 2005. Most staff have also recently worked through a distant learning programme in relation to dementia care. The manager confirmed that during the induction period staff receive a copy of the General Social Care Council’s (GSCC) Codes of Practice and the values and principles of care are discussed as part of the induction process. A discussion took place with the manager in relation to the importance of staff working with these values and principles in mind; the manager confirmed that such issues are often discussed at staff meetings. As a result of the MAPPVA investigation re-training was identified for one member of staff. The manager and the social worker agreed to this proposal. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 15 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 38 The health, safety and welfare of the service users and staff could be further promoted and protected if staff remember to keep up to date with the changing needs of the service users. EVIDENCE: The manager stated that at a recent inspection by the Fire Department the home was complemented on their fire safety standards, procedures and frequency of fire training carried out with staff. There were no noticeable hazards during this inspection in relation to health and safety and records confirmed that staff are up to date with training regarding moving and handling and first aid. The manager confirmed that she is an accredited trainer in relation to moving and handling and gave her assurance that, with the recent adult protection incident in mind, all staff would be reminded of appropriate individual moving
Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 16 and handling techniques. Staff would also be reminded of the importance of reading service users’ care plans and keeping up to date with their changing needs. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 17 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 3 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 2 17 X 18 2 3 X 3 X X X X X STAFFING Standard No Score 27 X 28 X 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score X X X X X X X 2 Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 18 Are there any outstanding requirements from the last inspection? no STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP38OP7 Regulation 15 Requirement The registered manager must ensure that care assistants endeavour to read care plans regularly to up date themselves with any changes related to service users needs in particular in relation to manual handling and the use of appropriate communication methods. All concerns or complaints made by service users must follow the homes Complaints Procedure and recorded appropriately in the home’s Complaints Book. In relation to health and safety the training needs of staff regarding manual handling and identified as an outcome of the MAPPVA investigation must be addressed. Timescale for action 31/01/06 2 OP16 17(2) Schedule 4 (11) 31/01/06 3 OP38 13(5) 31/01/06 Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 Refer to Standard OP7 OP29 Good Practice Recommendations Staff should use the risk assessment documents in a consistent way ensuring that the risk is identified and there are guidelines in place to reduce the risk. Staff should continue to be reminded of the Principles of Care outlined in the GSCC’s Code of Conduct. Springfield House Residential Home DS0000015764.V268920.R01.S.doc Version 5.0 Page 20 Commission for Social Care Inspection South of Tyne Area Office 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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