Inspection on 24/01/07 for Springfield Lodge Care Home

This inspection was carried out on 24th January 2007.

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 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 Lodge Care Home 01/02/06

Springfield Lodge Care Home 02/03/05

Springfield Lodge Care Home 13/07/04

Springfield Lodge Care Home 09/03/04

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

CARE HOME ADULTS 18-65 Springfield Lodge Care Home 45 Watcombe Circus Carrington Nottingham NG5 2DU Lead Inspector Karmon Hawley Key Unannounced Inspection 24th January 2007 10:00 Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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.V327313.R01.S.doc Version 5.2 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.V327313.R01.S.doc Version 5.2 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.V327313.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 1st February 2006 Brief Description of the Service: Springfield Lodge is a converted and extended house, accommodating up to fifteen people with mental health issues. It 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. The manager said that the current weekly fees are £282 - £300; this does not include hairdressing or toiletries. Information of fees are made available upon enquiry. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Prior to the site visit an analysis of the performance of the home over the previous year took place in line with the key national minimum standards. The evidence gained was assessed and the site visit planned in accordance with further evidence required to demonstrate compliance with the national minimum standards. The unannounced site visit took place in five hours and was performed by one inspector. The main method of gaining evidence during the site visit was case tracking, this is a method of sampling the records of four randomly selected service users to ascertain if the needs of service users are appropriately assessed and identified needs are being catered for by the home to maintain optimum health and wellbeing of the service user. Five service users were spoken with so as to give the inspector an insight into the conditions and standards within the home. Those spoken with were pleased with the staff, care received and the standards within the home. The registered manager assisted in the inspection process and two members of staff were spoken with. Staff were able to demonstrate an understanding of service users needs. What the service does well: A warm and welcoming atmosphere was evident on entering the home. Staff were observed to treat service users with respect and maintain dignity. There was evidence of good relations between staff and service users. Service users spoken with spoke positively about the home, the staff and care received. One service user said that ‘the staff were the best’ and another said that ‘staff are so caring.’ Staff spoken with were able to discuss service users needs and the support required to a good standard. Plans of care were in-depth and reflected service users needs and support required to live an independent and quality life as able. Service users are supported in being part of the local community as they wish. Staff supervisions are at a high standard and staff feel very supported in their job role. The manager remains dedicated to ensuring a quality service is maintained. Meals are of a good standard and service users are involved in the planning and preparation of meals if they wish. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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.V327313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Prospective service users individual aspirations and needs are assessed. EVIDENCE: The manager visits prospective service users within the community if required and carries out a preadmission assessment. Specialist assessments from the community psychiatric nurse or social worker are also used. Relevant assessments were service users files case tracked. Prospective service users and relatives may also visit the home and spend time there prior to making a decision. Staff spoken with were able to confirm that this takes place and they showed a good understanding of service users needs. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,and 9 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 supported to take risks as part of an independent lifestyle. EVIDENCE: Four service users plans of care were seen. Following the initial assessments service users undergo an assessment of the daily activities of living. Assessments in place were in-depth and personalised to each individual. Personal preferences and needs were identified and the service users strengths and independence was acknowledged. Care plans in place were in depth and addressed highlighted needs and support required. There was evidence such as service users signatures to demonstrate that service users and relevant others had been involved in the plan of care and their wishes had been acknowledged and upheld. Plans of care were reviewed and evaluated as needed and reflected continuity of care. A key worker system is in place so service users may form relations and trust with staff members, there was evidence of key Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 10 worker reviews taking place. Service users spoken with said that staff were kind and caring and their needs were met. Staff spoken with were able to discuss service users needs and how they are supported in meeting these. Throughout assessments and plans of care risks had been assessed and relevant risk assessments were in place to minimise these. One service user spoken with discussed how a risk assessment had been drawn up so they may visit the town on their own. There was evidence within the plans of care to show that service users had been consulted with as needed and support plans were in place as required. Advocates were in use for one service user. Two service users were seen leaving the home following negotiation on the day of the inspection with the assistance of staff due to the icy road conditions. Service users if able manage their own finances others are supported in this. There was evidence within service users files that this takes place. One service user discussed how they have control of their money but is assisted by staff with budgeting. There is a facility for safe holding should it be required. Four service users accounts were checked and were correct with the accounting sheet. Service users spoken with said that the routine of the home was flexible and they may choose how they spend their time, they felt that they had a say and staff were very kind and considerate and listened to their needs. One service user said they felt involved in the running of the home and they were kept informed of events. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12,13,15,16 and 17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. 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 meal times. EVIDENCE: The manager said that in house activities are offered on a one to one and group basis for service users. These include arts and crafts, games, coffee mornings and baking. Several service users were seen to join in an activity during the afternoon of the visit. Service users also access services such as day centres as able, however some of these services have become restricted, therefore the manager is seeking further guidance of resources available. No one has a job at present but the manager said this would be facilitated if Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 12 required. One service user attends college. Throughout the day residents were seen coming and going in the home as they wished. One service user discussed how they may go to town themselves and entertain themselves as they wished. One service user explained how they did not wish to go out and staff respected this. Other service users spoken with said that they enjoyed activities when on offer and they could choose if they wanted to join in. There is a mini bus available for service users use, which facilitates trips outside the home. The manager said that there is access to the local churches if required. There are no restrictions on visiting and service users may receive visitors in private should they wish. The manager said that service users are supported in maintaining relations as required. Service users spoken with said that they may receive visitors when they wish and these are made welcome. Relatives may also stay for meals on occasion and there are facilities to make drinks if desired in a kitchenette off the quiet room. A wholesome and appealing menu is on offer and there was evidence of choices being available. Service users confirmed that they were given a choice and that meals were of a good standard. Meal times are flexible and the main meal is reheated if service users wish to eat at a later time. Service users following a risk assessment assist staff in the kitchen in the preparation of food and making cakes, they are fully supported by staff during this time. Meal choices are discussed at service users meetings and one service user spoken with confirmed this. The kitchen was clean and tidy and staff are allocated on a daily basis to oversee the cooking. Relevant records such as cleaning rotas and temperature recording was seen. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19 and 20 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. 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 homes policies and procedures for dealing with medicines. EVIDENCE: Evidence was available within service users plans of care to show that service users needs and preferences had been assessed in regard to personal care. Reference was made to ensuring staff maintain independence, privacy and dignity of service users. Changing needs were reflected in the plan of care and evaluation. Service users wishes with regards to how they spend their time and when they get up and retire to bed was also documented and service users spoken with confirmed that their needs were met and their wishes and views were listened to. Staff were able to discuss service users needs and how they are supported in meeting these. There was evidence within plans of care to show that the multidisciplinary team and specialist services are accessed as required. Service users are Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 14 supported to attend to health care checks with staff support if required, one service users was supported by a member of staff on the day of the inspection to attend a doctors appointment. The manager said that age appropriate services are also sought as required such as cervical screening and breast clinics. As specialist psychiatric support services have been reduced the manager is currently advocating on behalf of service users to maintain these service. Relevant policies and procedures were in place for medication. Service users if able may administer their own medication following assessment. Currently only one service user does this, there is safe keeping available for the storage of their medication within their room. Medication was checked with four service users medication charts, these all corresponded. Relevant records such as drugs signed in and out of the building were available. There was evidence of stock control taking place and stock cupboards were well organised. Fridge and room temperatures were available. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 15 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. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users feel their views are listened to and acted upon. Service users are protected from abuse, neglect and self-harm. EVIDENCE: There has been one complaint made since the previous inspection. There were records available to show that this had been investigated appropriately by the manager and relevant others and resolved. Staff were able to discuss how they would deal with complaints should they be received. Service users spoken with expressed no concerns about the care or the home. All staff have Criminal Record Bureau checks in place. The majority of staff have undertaken training in the protection of vulnerable adults whilst completing the National Vocational Qualification (a nationally recognised work and theory based qualification) staff spoken with were able to confirm this and were able to discuss relevant issues. The manager said that further training has been booked for the remaining staff in the near future. One service user spoken with said that they felt safe in the home. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users live in a homely, comfortable and safe environment the home is clean and hygienic. EVIDENCE: Overall the home remains 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 three-piece sofa has been purchased for the quite room. Residents spoken with all said that they liked their bedrooms and those that shared said that they were happy with this arrangement. The manager discussed how the requirement made in regard to service users having the choice of a shared or single room is to be implemented when rooms becomes available. There are accessible toilets and bathrooms throughout the home to meet the needs of service users. The manager said that there are plans in the near future to redecorate and re-carpet the main staircase and landing. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 17 The home is kept very clean and fresh. A bathroom on the first floor has been renovated. The laundry facilities are in the cellar and meet appropriate standards to minimise risk of infection. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 32,34 and 35 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are supported by competent and qualified staff. Service users are supported by the homes recruitment policy and practices. Service users individual and joint needs are met by appropriately trained staff. EVIDENCE: A through induction programme is in use for all new members of staff. The manager is considering changing this in the near future and sending all new staff on an external induction training course. One member of staff has attained the NVQ level 3, one has attained level 2 and three are working towards level 2; staff spoken with were able to confirm this. Staff spoken with were able to discuss service users needs and show understanding of their job role. Duty rotas seen showed that sufficient staff were employed to assist service users needs. Both staff and service users said that enough staff were on duty to meet service users needs. Four staff personnel files were seen; each contained all the required documentation. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 19 The manager has a positive approach to training and staff are working towards completing mandatory training. Within staff files certificate were seen and also an individual training plan and supervision plan for each member of staff. Staff spoken with said that training was at a good standard and they felt supported in their development. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 37,39 and 42 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from a well run home. Service users are confident their views underpin all self-monitoring, review and development by the home. The health, safety and welfare of service users are promoted and protected. EVIDENCE: The registered manager is also the registered provider for the home and she has been in post since the home opened in 1982. She is part way through the registered managers award and said that she keeps up to date with all mandatory training. In addition to this she had also completed a degree in counselling and psychology. Staff spoken with said that the manager was always available and approachable. Service users spoken with said that the home was well run and the manager was very nice. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 21 The manager has sent out questionnaires to service users and relevant others which covered catering, food, personal care and support and daily living. Results have been analysed and displayed on several graphs. The majority of responses were either excellent or good for all outcome areas. Service user and staff meetings are held on a regular basis to enable their views to be taken into account. The manager updates and reviews all policies and procedures as necessary. The manager said that a maintenance programme is in place to address ongoing maintenance. All relevant maintenance certificates and servicing reports such as the electrical certificate, gas and fire system checks were seen. Water temperatures are tested weekly and there was evidence to show when these had been regulated. Weekly alarm tests and monthly emergency light tests were recorded as required. Accident records were maintained and appropriate information recorded. Risk assessments for the environment and fire safety was in place. Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 22 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 Standard No Score 1 X 2 3 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 X Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 23 No 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Springfield Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Lincoln Area Office Unity House, The Point Weaver Road Off Whisby Road Lincoln LN6 3QN National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 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 Lodge Care Home DS0000002242.V327313.R01.S.doc Version 5.2 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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