This inspection was carried out on 1st February 2006.
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. These are things the inspector asked to be changed, but found they had not done.
The inspector also made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
CARE HOME ADULTS 18-65
Springfield Lodge Care Home 45 Watcombe Circus Carrington Nottingham NG5 2DU Lead Inspector
Susan Lewis Unannounced Inspection 10:00 1 February 2006
st Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 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 Lodge Care Home DS0000002242.V271653.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 Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION
Name of service Springfield Lodge Care Home Address 45 Watcombe Circus Carrington Nottingham NG5 2DU 0115 962 0745 0115 9620745 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs Yvonne Angela Harris Mrs Yvonne Angela Harris Care Home 15 Category(ies) of Mental disorder, excluding learning disability or registration, with number dementia (15) of places Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION
Conditions of registration: Date of last inspection 13th September 2005 Brief Description of the Service: Springfield Lodge is a converted and extended house, accommodating up to fifteen people with mental health issues, situated in a residential area and is in keeping with other houses in the neighbourhood. It is close to local amenities and is a short walk from the busy Mansfield Road. There is no through floor lift or stair lift, a number of the bedrooms do not have wash hand basins. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. The focus of the inspections undertaken by the Commission for Social Care Inspection is upon outcomes for service users and their views of the service provided. The primary method of Inspection used was ‘case tracking’ which involves selecting clients and tracking the care they received through looking at their records and talking with them where possible. This was the second unannounced inspection during this inspection year and was carried out by one inspector over five hours. A full tour of the building did not take place with only communal areas being inspected at this time. Residents’ records were inspected and three residents and staff on duty were spoken with. What the service does well: What has improved since the last inspection?
The last report set a number of requirements and was critical of some apparent practices within the home. The registered person is a committed and responsible provider and reacted promptly to the report and as such all but one requirement has been met; as a result of that inspection the registered person has modified the care plans and improved the information contained in them. The registered person has carried out work to ensure that all residents who are at risk of self-harm are risk assessed and where restrictions are placed on residents these are recorded and detailed in residents care plans. Residents spoken with were positive about the care they received and felt that all the staff listened to them if they had a complaint or concern. Adult Abuse Awareness Training is being provided to staff to ensure they understand what constitutes abuse.
Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 6 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 Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 8 Choice of Home
The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3 and 4 Information is available to all residents and the admission process is followed consistently for all planned admissions. EVIDENCE: The registered person ensures that a copy of the service users’ is readily available along with a copy of the most recent published report. Residents are only admitted to the home following a full assessment, evidence of which was seen in residents care plans. A requirement was made at the last inspection that where restrictions were placed on residents that the residents was involved and that these were ethically sound. Evidence was seen to show that this standard was met and residents’ rights are protected. The staff are able to demonstrate that they have the knowledge and understanding to meet the residents needs. The registered provider ensures that only people whose needs the service can meet are admitted to the home. Where possible residents are offered trial periods at the home before making a decision to stay. The last two residents were emergency admissions but the evidence provided by care plans and diary notes was that they appear to have settled in well at the home. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 9 Individual Needs and Choices
The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7, 8, 9 and 10 Individual plans address needs and risk with strategies in place to meet them. EVIDENCE: A requirement was made at the last inspection regarding the need to risk assess residents who have the potential to self-harm. Evidence was seen to show that this standard is now met and residents are risk assessed and a care plan linked to what action should be taken to minimise any risk. A requirement was also made to ensure care plans detailed any restrictions to be placed on residents. From care plans viewed this has now been met. Residents spoken with said that they felt involved in the home they could help out with different things depending on how they felt and staff understood if they didn’t want to be involved. Residents spoken with said that they felt that the manager kept them informed and was interested in their views about the home. A requirement was made at the last inspection to involve residents in the running of the home more this is now considered met.
Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 10 The registered person has asked the Community Psychiatric Nurse service to carry out a clinical risk assessment on all residents, evidence was seen where this has already happened. The requirement that was set at the last inspection regarding risk-assessing residents who may self-harm is met. Residents spoken with said that they felt they could talk to staff about anything and they trusted them to keep it confidential. Staff spoken with understood the importance of confidentiality and when there was a need to pass on information to another professional. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 11 Lifestyle
The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 17 Residents are assisted to exercise choice and control over their lives, and are offered a balanced diet in line with dietary requirements and plans of care. EVIDENCE: Throughout the day residents were seen coming and going in the home. Diary notes and care plans provided evidence that residents were supported to be involved in a variety of activities of their choice. Those residents spoken with said that they enjoyed doing different things and it was ‘nice when staff took me to the pub’. ‘I like gong out for a coffee and cake’. Although the meal was not sampled residents were observed enjoying their food in a pleasant dining room. Residents who had come home later had had their meal saved and reheated at a time convenient to them. Residents spoken with said they were happy with this arrangement. Residents said that they enjoyed the food and that they had plenty and a choice. They also confirmed that helped choose the menus and if they wanted to staff would help them bake cakes. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 12 The registered person expressed her concern that day services for people with mental health problems had recently been closed down without alternatives being put in place. This had meant that some residents who used to go out daily and met up with people attending the centre now no longer had that opportunity. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 13 Personal and Healthcare Support
The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 20 Staff follow policies and procedures in medication administration which safeguard residents well-being. EVIDENCE: During the course of the inspection the community pharmacist was carrying out a monitoring visit and went through the homes medication processes and discussed with inspector the outcome. The pharmacist did not raise any concerns and praised the registered person for the quality of provision and confirmed that the staff operate to a high standard. The inspector did not inspect the medication any further. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 14 Concerns, Complaints and Protection
The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Staff have the appropriate information and knowledge on adult protection issues to protect residents. EVIDENCE: At the last inspection a requirement was made to ensure that residents complaints are followed up. Residents spoken with all said that they felt that the registered person listened to their concerns and dealt with them. This requirement is now met. Staff spoken with confirmed that they had either covered Adult Abuse Awareness in their NVQ 2 training or were due to attend training shortly. This had been a requirement at the last inspection to ensure that residents were supported and protected it is now considered met. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 15 Environment
The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24, 25, 27 and 30 Residents live in a homely and clean environment EVIDENCE: Overall the home is well maintained and homely. There are two lounges, one where residents are able to smoke and a second quiet one where no smoking is allowed. A new television has recently been purchased for this room. The quiet lounge has a ‘cottage’ style three piece suite, which is beginning to look shabby. It is recommended that the registered person replace this. Residents spoken with all said that they liked their bedrooms and those that shared said that they were happy with this arrangement. A requirement was made at the last inspection to offer single rooms to residents when they become available. As the home is currently full this cannot be verified and the registered person is reminded that when a single bedroom becomes available next, existing residents who share must be asked if they wish to move to the single room and record the outcome. There are accessible toilets and bathrooms throughout the home to meet the needs of residents. The home is kept very clean and fresh. Residents spoken with said that their laundry was done regularly and staff always made sure that it came back. The laundry facilities are in the cellar and meet appropriate standards to minimise risk of infection. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 16 Staffing
The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 36 Residents are supported by a well trained and consistent staff group. EVIDENCE: Staff spoken with said they understood their role and were provided with training to enable them to carry out their job. Staff understood the need to involve other professionals if residents’ needs changed. Residents spoken with said that staff provided enough support and ‘always give help when I need it’. The home currently has a full compliment of staff with a low turnover in staff. There is a core staff group who have worked in the home for a number of years, this enables consistency of practice and staff are able to develop professional relationships with the residents they act as key worker. The registered provider has a very positive approach to training and enables staff to access appropriate courses to develop their skills. Staff spoken with said that they received regular supervision that covered their personal development and their training needs. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 17 Conduct and Management of the Home
The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 38, 40, 41 and 42 Residents live in a safe well managed environment. EVIDENCE: The registered provider is also the manager in day-to-day charge of the home. She is knowledgeable and well motivated to ensure good quality of care is provided within the home. Staff and residents were very positive about the manager and said that she was ‘approachable and supportive’ ‘It is a well organised home and ‘well run’. Staff spoken with knew where to find all the documents concerned with the running of the home and what to do if they needed to find information. Policies and procedures are reviewed and monitored in light of changing practice to ensure residents’ receive the best possible care. Staff were aware of the importance of maintaining reports and care plans up to date and all documentation inspected was kept in good order, ensuring resident well being was being maintained. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 18 Residents’ safety is maintained by the safe operating procedure within the home. The home has recently undergone a health and safety inspection and the registered person has been meeting the requirements set by that report. The inspector discussed with the registered person what had been meant by a requirement left at the last inspection regarding where residents are involved in food preperation that suitable risk assessments need to take place to minimise the risk of infection and toxic conditions. It is not the intention of the inspector that all residents involved in kitchen activities such as baking a cake to undergo basic food hygiene training but that staff who have undergone this training ensure that residents follow good hygiene practice to minimise any risk of toxic conditions. Due to the misunderstanding this standard has not been met and an extention will be given. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 19 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME CONCERNS AND COMPLAINTS Standard No 1 2 3 4 5 Score 3 3 3 3 3 Standard No 22 23 Score 3 3 ENVIRONMENT INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score 3 3 3 3 3 Standard No 24 25 26 27 28 29 30
STAFFING Score 3 3 X 3 X X 3 LIFESTYLES Standard No Score 11 X 12 X 13 3 14 X 15 X 16 X 17 Standard No 31 32 33 34 35 36 Score 3 X 3 X 3 3 CONDUCT AND MANAGEMENT OF THE HOME 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21
Springfield Lodge Care Home Score X X 3 X Standard No 37 38 39 40 41 42 43 Score 4 3 X 3 3 2 X DS0000002242.V271653.R01.S.doc Version 5.0 Page 20 Are there any outstanding requirements from the last inspection? Yes 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 YA42 Regulation 13 Requirement The registered person must ensure that where residents are involved in food preperation that suiatble risk assessments have taken place to minimise the risk of infection and toxic conditions. Timescale for action 01/04/06 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 YA24 Good Practice Recommendations The furniture in the quiet room is shabby the registered person should consider replacing it. Springfield Lodge Care Home DS0000002242.V271653.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Nottingham Area Office Edgeley House Riverside Business Park Tottle Road Nottingham NG2 1RT National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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