Inspection on 15/02/07 for Springfield Nursing Home

This inspection was carried out on 15th February 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is (sorry - unknown). 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 Nursing Home 18/10/05

Similar services:

Flint House

St Vincents

The Cotswold Home

Fairways

Newbeech House

Winton House

Treloar College

Rush Court

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

CARE HOMES FOR OLDER PEOPLE Springfield Nursing Home Springfield Nursing Home 26 Arthurs Hill Shanklin Isle of Wight PO37 6EX Lead Inspector Mark Sims Unannounced Inspection 15th February 2007 09:30 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 Nursing Home DS0000064757.V325071.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 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 Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Nursing Home Address Springfield Nursing Home 26 Arthurs Hill Shanklin Isle of Wight PO37 6EX 01983 862934 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) Scio Healthcare Limited Miss Lisa Holmberg Care Home 46 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (46), of places Physical disability over 65 years of age (30), Terminally ill over 65 years of age (15) Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2005 Brief Description of the Service: Springfield is a registered care home providing nursing care and accommodation for up to forty-six people. The home accommodates older people, up to thirty of whom may have a physical disability, up to fifteen of whom may have a terminal illness and up to fifteen of whom may have dementia. The home has ten intermediate care beds, contracted by the NHS, that may accommodate adults over the age of eighteen years, for which separate facilities are available. The home is located near the centre of the town of Shanklin with local bus stops and shops nearby. The home occupies an extended older property in its own grounds with limited car parking available to the front of the property. There have been a number of extensions to the original home, the most recent having been completed in the summer of 2003. All bedroom, with the exception of two twin rooms, are for single occupation with many having en-suite facilities. Various communal facilities including several lounges and pleasant secluded gardens are provided. The home is owned by Scio Healthcare Limited and managed by the matron, Miss Lisa Holmberg. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was the first ‘Key Inspection’ for Springfield Nursing Home, a ‘Key Inspection’ being part of the new inspection programme, which measures the service against the core and/or key National Minimum Standards. The fieldwork visits, the actual visits to the site of the home, was conducted over one days, where in addition to any paperwork that required reviewing the inspector met with service users, relatives and staff and undertook a tour of the premises to gauge its fitness for purpose. The inspection process also involved far more pre fieldwork visit activity, with the inspector gathering information from a variety of professional sources, the Commission’s database, pre-inspection information provided by the service and linking with previous inspectors who have visited the home. The new process is intended to reflect the service delivered at Springfield Nursing Home over a period of time as opposed to being a snapshot. What the service does well: What has improved since the last inspection? The following is an indication of the areas where the service has improved its performance: • • • • • • • New Training Manager Employed New Maintenance Manager Employed 12 Refurbished bedrooms 12 En-suite facilities created Lounge redecorated Creation of a reception area, nursing office and storage facilities All main fire doors fitted with electro-magnetic self-closing devises. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 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. The summary of this inspection report can be made available in other formats on request. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 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 Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standard 3: Service users are fully aware of the services/facilities available at the home and that their needs can be meet by the home prior to admission. Standard 6: The local Primary Care Trust (PCT) via their Intermediate Care Team (ICT) provides comprehensive pre-admission information to Springfield Nursing Home. EVIDENCE: Suitability of Service: The evidence indicates that the providers ensure prospective service users have access to sufficient sources of information and that private and/or local authority funded client’s have their needs assessed prior to admission. • ‘SCIO’ the proprietary company for Springfield Nursing Home, has created several vehicles for prospective service users and/or their DS0000064757.V325071.R01.S.doc Version 5.2 Page 9 Springfield Nursing Home relatives/advocates to access information about its home’s and the services/facilities available at each property, including glossy brochures, which are available in large text if required and a website www.sciohealthcare.co.uk. • In addition to services made available at each of its home’s the company’s brochures also contain copies of National Health Service (NHS) related documentation, as well as information leaflets produced by external bodies, which are intended to provide prospective residents/patients with facts about private health/social care facilities. All private and/or local authority funded/assisted patient’s are visited by either the manager or her deputy prior to admission, when a detailed pre-admission assessment is carried out. Five service user/care planning files were reviewed due the fieldwork visit, two of which were recently admitted service users, whose preadmission assessments were still accessible within the care records and which gave a good insight into the patients abilities, needs and wishes. • In discussion with service users and their relatives it was apparent that people not everyone recalled their experiences of the admission process, however, two relatives discussed having visited the home prior to finalising the arrangements for their next of kin to be admitted, one relative describing how: ‘Prior to admitting father to Springfield my brother and I had been provided with guided tours, my brother accompanying me on the second of two visits to the home’. ‘We were provided with relevant information about the home and have a contact/terms and conditions document agreed’. • Information gleaned via professional sources also indicates that the assessment processes of the home are considered to be satisfactory, a care manager ticking ‘always’ in response to the question: ‘do the care service assessment arrangements ensure that accurate information is gathered and that the right service is planned and given to individuals’. During the inspection it was ascertained that the home produces three slightly different contract/terms and conditions of residency documents: 1. Self-funding 2. Continuing Care 3. Intermediate Care. • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 10 • During a conversation the ‘Administration Manager’ she described how the contracts are agreed with the families on admission, this following the assessment by the matron/deputy matron. It is hoped in the near future to introduce more information sharing into the pre-admission visit, with the manager and her deputy being encouraged to take on responsibility for discussing financial issues, such as fee payment arrangements, which are a month in advance and via direct debit means. • Intermediate Care Arrangements: • Intermediate care patient’s, for obvious reasons, are managed or handled slightly differently from private/local authority assisted patients admitted to the home. Patients admitted under the intermediate care umbrella remaining the responsibility of the NHS and discharged to private health & social care facilities to continue the process and/or programme of rehabilitation. As such all potential clients of the intermediate care facility, at Springfield, are assessed by a specific PCT team the ICT, information gathered via their assessments forwarded to the nursing staff at Springfield for information and scrutiny, the home’s staff/management still responsible for ensuring they can meet the prospective service users needs prior to admission. Copies of two referral packs, provided to the home by ICT staff, seen during the fieldwork visit and noted to be informative and comprehensive documents, containing information from a variety of professional sources. • The service users, who by virtue of the hospitalisation, are unable to visit the home prior to admission are provided with information leaflets, designed by the PCT/ICT teams, which give a broad overview of the service and/or roles/objectives of the intermediate care process, although specific information about the home is only made available upon arrival at the home, each room within the home supplied with a copy of the ‘service users guide’. A tour of the premises established that the intermediate care facility and the main care home, whilst linked, are separate entities with staff allocated to work independently within the intermediate care wings. One staff member interviewed during the fieldwork visit confirming that she had been allocated solely to work within the intermediate care facility; and that this was a standard practice. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 11 • Access to the home is via the main reception area, which is staffed continuously throughout the day and provides both a security and administrative function, the administrator/receptionists responsible for directing visitors to the right location and for ensuring they sign in, etc. In the last report the intermediate care facility was described in terms of delivering: ‘Service users admitted for intermediate care are helped to maximise their independence and wherever possible return home’. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 12 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is Excellent. This judgement has been made using available evidence including a visit to this service. Standard 7: The needs of the service users are clearly set out within individualised care planning files. Standard 8: The health care needs of the service users are appropriately identified, managed and documented. Standard 9: The medication management arrangements of the home meet the needs of the service users. Standard 10: Privacy, dignity and respect are afforded the service users by the staff and the design/setup of the home. EVIDENCE: Care Planning: The evidence indicates that the care plans of the service users are individually drafted and based upon their initial assessments, on-going assessments and any changes in their health and/or social care needs. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 13 • Five care planning records were scrutinised as part of the fieldwork visit and found to contain a variety of documents, including: 1. 2. 3. 4. 5. • • • • • • • • 6. New patient admission checklists Inventory’s Pre-admission assessments St Marys Hospital Discharge summaries Records, including Waterlow assessments. Nutritional screening Running record Risk Assessments Moving & Handling assessments Wound chart Specialist feed (Jevity) regime Blood Pressure, Pulse and Temperature recordings Medical contacts (listed within the running records – under separate columns). 7. Evidence of allied health professional visits (Dentist, chiropody, etc). 8. Falls assessment documents. 9. Local Authority referral documentation. 10. Local Authority review documentation. Clear links between the pre-admission information gathered and/or provided by allied professionals, were evident on reading through the service users plans, including Percutaneous Endoscopic Gastrostomy (PEG), wound care information, etc. As mentioned above the care manager’s also consider the home’s assessment arrangements to be through and to lead to individualised plans of care being created. • The views of the care manager’s involved with the service were also supported by health professional staff to visit the home, people ticking ‘always’ in response to the question ‘are individuals health care needs met by the care service’, one person adding ‘Springfield takes thorough holistic care of all residents health’. A General Practitioner (GP) involved in the home also provided evidence, via a comment card, to support that people’s health care needs are transferred to their care plans, the GP ticking ‘yes’ in response to the question: ‘if you give any specialist advice is this incorporated into the service users plan’. The home’s statement of purpose/brochure documentation also advises that: ‘Each resident has an individual ‘plan of care’ tailored to their • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 14 needs, residents and their families are encouraged to participate in the development of each plan’. ‘All residents have an individual ‘plan of care’, in which the involvement of families and friends is appropriate and greatly valued’. Health Care: The evidence indicates that the health and social care needs of the service users are being appropriately met. • The information mentioned above indicates that health and social care professionals, involved with the home, are satisfied with the care provided at Springfield Nursing Home. Previous inspectors have reported that: ‘The care plan details the nursing and care the service user requires ensuring all aspects of health, personal and social care needs are met’. Again supporting the findings of this visit, which as identified above, established that health care records are maintained and that efficient monitoring of the service users health care needs, etc are undertaken. • The pre-inspection questionnaire, submitted prior to the fieldwork visit, also established that each resident is registered with a GP surgery and that 65 of the residents have an allocated care manager. This information supporting the statement within the ‘Service Users Guide’ that: ‘You will have access to a General Practitioner (GP) from Shanklin Medical Practice or a GP of your own choice with that GP’s agreement and other NHS services where provided, including sight and hearing tests and appropriate aids or referral by a GP to hospital for further treatment as needed’. • During the fieldwork visit numerous health and social care professionals were observed visiting the home, including a Care Manager, members of ICT team and a member of the PCT funded nursing care team, who was undertaking service user reviews. • Medications: The evidence indicates that the home afford service users the opportunity to manage their own medications and where the home is responsible for handling residents medications this is appropriately and safely managed. • The home’s ‘service users guide’ states ‘Should you wish to administer your own medication you will be ‘risk assessed’ by us and if the assessment concludes that you are capable of being responsible for selfadministering your medication, then you will be entitled to do so and will be asked to sign a self-medication agreement form. DS0000064757.V325071.R01.S.doc Version 5.2 Page 15 Springfield Nursing Home ‘You will be given access to a lockable cupboard for the medication to be kept in. You must ensure that the medication is always kept in the cupboard and that the cupboard is kept locked. Failure to observe this rule may result in you being prohibited from self-administering your medication. The findings from the last inspection suggest that whilst this option is made available to service users, it is largely the intermediate care clients that are encouraged to use the system: ‘Intermediate care service users are encouraged to self-administer their medication as part of their rehabilitation programme. A suitable lockable facility is provided within all intermediate care bedrooms. The home undertakes and records the assessment of the service user’s ability to self-administer their medication and samples of these were seen during the inspection’. • The indication from the professional sources is that service users are appropriately supported when administering their own medication: The GP, health care professionals and social care professionals all ticking ‘always or yes’ when asked ‘does the care service support individuals to administer their own medication or manage it correctly where this is not possible’. Generally no concerns were identified with the home’s approach to managing service users medications, all medicines appropriately accounted for on arrival at the home, all medication administration record appropriately completed and storage facilities noted to comply with the relevant regulation. The pre-inspection questionnaire, completed by the management prior to the fieldwork visit being undertaken, also establishes that staff have access to policies, procedures and guidance documents around the safe handling and storage of medications. All similar findings to those reported at previous inspection visits: ‘The home has a policy and procedure for the administration of medications, with medication found to be stored in an appropriate locked facility. Qualified nurses administer all medication within the home. Records are kept in regard to all medications. The inspector saw the arrangements for controlled medication, the storage and recording of which was found to be appropriate. Following changes in the pharmacy laws the home has now arranged a contract for the disposal of unused medication and has introduced an appropriate recording system. Medication awaiting disposal is appropriately stored within the provided containers and a locked facility. The home has a lockable fridge to ensure that medications that must be kept cool may be. Maximum and minimum Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 16 • temperatures are registered by an appropriate thermometer and recorded daily’. Privacy and Dignity: The evidence indicates that the home is committed to ensuring that the service users rights to privacy, dignity and respect are upheld. • During the last inspection the visiting inspector noted and recorded in her report that: ‘During the inspection care and nursing staff were observed knocking on service users’ doors and to treat people with respect. Visitors and service users confirmed this to be the case, stating that the home’s staff are pleasant and helpful. The registered nurse responsible for training confirmed that new staff are instructed during their induction period as to how to appropriately treat residents and service users with respect at all times. Screening is provided within the two twin bedrooms’. • Since the last inspection improvement and/or developmental work has been undertaken at the home with the service no longer having any shared accommodation available. The proprietary company have also increased the number of single bedrooms with en-suite facilities by twelve taking the home’s total number of en-suite rooms to forty, which significantly increases people’s ability to undertake personal hygiene, etc in private. It was also interesting to note that when asked all of the health and social care professionals felt the home promoted privacy and dignity, people ticking ‘always’ when asked: ‘does the care service respect individuals’ privacy and dignity’. The home’s brochure documentation is also littered with words such as privacy, dignity, choice, rights, independence, quality, security, respect and equality, with the one of the homes opening statements being: ‘We strive to preserve and maintain the dignity, individuality and privacy of all residents within a warm and caring atmosphere and in so doing will be sensitive to the residents changing needs’. • The ‘service users guide’, also makes reference, within its objectives to privacy and dignity issues, the service aiming to: ‘ensure that the care service is delivered flexibly, attentively and in a non discriminatory • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 17 fashion while respecting each clients’ right to independence, privacy, dignity, fulfilment and right to make informed choices and to take risks’. The latter principles reflect within the home’s approach to encouraging people to self-medicate, (as reported above), which firstly acknowledges the need to ensure the person can safely and appropriately manage their medication needs. • In practice the home’s approach to managing issues of privacy would appear appropriate, with both relatives and GP’s confirming via their comment cards that they are able to visit their relatives’/patients’ in private. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 12: The service users enjoy a varied social activities programme, which meets their needs and preferences. Standard 13: The visiting arrangements at the home meet the needs of both the residents and their relatives and good community links are maintained. Standard 14: The service users are helped to exercise choice and control over their lives. Standard 15: The meals are nutritionally well balanced and appetising. The menus varied and appealing, however there is a lack of dining space. EVIDENCE: Entertainments and Social Activities: The evidence indicates that the home’s social activities programme is meeting the needs of the people accommodated. • During the fieldwork visit the inspector met and discussed social activities and entertainment with the home’s activities co-ordinator. DS0000064757.V325071.R01.S.doc Version 5.2 Page 19 Springfield Nursing Home During the conversation the co-ordinator described how she provides a mixture of group and individual activities and how she uses her knowledge of what is popular, etc, to determine the range or type of entertainment to undertake with clients. It was understood that there is no formalised or structured programme of entertainments and that activities are arranged or organised on a daily basis, although on saying this, it is the type of activity which is not predetermined, not the dates activities are scheduled for, i.e. an activity may be schedule for the lounge on a Monday morning, etc but the type of activity bingo, quiz, arts and crafts, etc is flexible. Service user can also, if they please/choose, experience a range of massages and therapeutic treatments provided by ‘Fit2Relax’, although a fee accompanies the delivery of the treatment, copies of the cost and range of treatments available are included in the home’s brochure documentation. • Within its brochure documentation the proprietary company states: ‘To enable residents to adapt to a different daily routine and to maintain independence, mobility, dexterity and choices in daily living SCIO Healthcare (the proprietary company) offers entertainments and a range of activities. A SCIO Healthcare Activities Organiser is available to arrange social activities for example, coffee mornings, painting and playing games, according to individual requests’. • At the last inspection it was reported that: ‘The pre-admission assessments seen included information about residents’ social and leisure interests and this is included in care plans. The home has an activities co-ordinator who is employed three days per week and was seen undertaking individual activities with service users during the unannounced inspection’. In addition to the work undertaken by the Activities Organiser the proprietary company also advertises that pastoral visits occur every third Friday of the month, that hairdressing visits are undertaken weekly, that all bedrooms are fitted with televisions and each room is supplied with a telephone system, which aids communications with families and friends, etc. • Visiting Arrangements: The evidence indicates that the visiting arrangements at the home met both the service users and/or their relatives/visitors needs: Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 20 • During the last inspection visit the inspector noted and recorded within her report that: ‘The inspector was able to meet with a number of visitors during the unannounced inspection who confirmed that they are welcomed to the home and able to visit at any reasonable time’. A statement supported via the relatives comment cards, returned in the build up to the fieldwork visit, which were ticked ‘yes’ in response to the question: ‘do staff/owners welcome you in the home at any time’. • The previous report also established that: ‘Information about visitors is included in the service users’ guide and additional information provided at the time of admission’. A statement again supported by the findings of this inspection, the brochure documentation and ‘service users’ guide’ referred to earlier in the report stating: ‘Visitors are welcome at our Homes preferably between the hours of 11:00am and 8:00pm, however, other times are acceptable by arrangement. Residents have the right to receive visitors in the privacy of their own room or in one of the lounges around the Homes. Should it be the express wish of the resident, staff reserve the right to restrict or deny visits. ‘Service users’ guide’: ‘Visitors are welcome at Springfield at anytime throughout the day or early evening, but preferably from 11:00am to allow time for personal care. Earlier visits can be arranged with the nurse on duty, so please telephone if making visits before 11:00am. Should it be the expressed wish of the client, we reserve the right to restrict or deny visits. ‘Visitors are welcome to stay for meals with our clients by prior arrangement and at a nominal charge’. Details of the charges are also contained within the ‘service users’ guide’. • Throughout the fieldwork visit the inspector observed numerous people arriving at the home to call upon their next of kin and/or friends, people stopping at the reception desk to sign into the home and to check on their relatives whereabouts and general condition. It was also interesting to note on the health and social care professional’s comment cards how they perceive the staff at the home to promote choice, etc for service users, the comment cards ticked ‘always’ in response to the question: ‘does the care service support individuals to live the life they choose’. • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 21 This is important in the context of social integration, community contacts and receiving visitors, etc, as it suggests the home and/or the staff encourage and the service users to decide for themselves how to manage/structure such occurrences/activities. • It was also noted that the visit GP’s also find visiting arrangements to be satisfactory, with the comment card ticked ‘yes’ to both the following questions: ‘Is there always a senior member of staff to confer with’ & ‘ are you able to see your patients in private’. The evidence indicating that the GP’s are always appropriately received into the home and consultations undertaken in private, etc. Choice and Independence: The evidence indicates that service users are being provided with the opportunities to make choices and independent decisions on a daily basis. • The home’s approach to supporting people exercise their rights to choice and self-determination have already been evidenced throughout the report: The comments/observations made by the visiting health and social care professionals, as reported above. Participation in activities and/or the choice of activities arranged internally and externally, when the weather permits. The evidence or commitment to promoting choice, dignity, respect, privacy and independence, spelt out within the services own documentation. • The previous inspector also picked up on an issue of choice recording within the last report how: ‘The contract/terms and conditions information makes it clear that service users can bring in items of a personal nature and includes advice about insurance of valuable objects. During a tour of the building it was evident that many people had brought personal items with them into the home’. In addition to the information already contained within the report the inspector also found that: 1. Care planning files include details of service users preferred rising and retiring times and/or preferred forms of address, etc. 2. Menus were available and that the catering staff visited all new service users discussing meal preferences, likes and dislikes, etc. • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 22 3. People were observed participating in a range of social activities/situations. Meals and Menus: The evidence indicates that the meals and menus afford service users choice and variety. • In discussion with the chef it was established that the service had changed its process for meals to be ordered, the chef describing how the staff complete individualised menu sheets for each service user, the meals are then individually collected by staff and transported to the clients. In addition to the menu records the trays of the service users also include an information card, which indicates the residents preferences and how the meal is to be presented, pureed/soft, etc. • In discussion with the care staff it was ascertained that independent clients are served their meals first, allowing more time to properly support the dependent clients with their meals. Meal delivery is arranged/undertaken in accordance with the sectioning of the home i.e. the staff allocated to a specific zone are responsible for taking the meals to the clients in that zone. The meals of the service users residing furthest from the kitchen have their meals transported using a heated trolley, whilst people residing closer to the kitchen should have their meals covered by a plate cover, although on occasions staff were noted not to be bothering with the plate covers. Food stocks were noted to be good and the chef stated that stores are ordered and delivered on a weekly basis ensuring that stocks rota effectively and efficiently. Records were viewed for the temperatures of the meals served and the storage/operating temperatures of the fridges and freezers. The chef also stated that the Environmental Health Officers inspects the kitchen regular and/or is keeping in contact contact, advising on safe working and food preparation standards, etc, whilst the kitchen is being revamped. The care plans, as mentioned earlier contained nutritional assessments for all clients admitted to the home. The dataset or pre-inspection questionnaire, also included a sample of the services menus, which appeared appetising and varied, an assumption • • • • • • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 23 supported by the observations of mealtimes, which evidenced that the meals were appropriate for the service users and enjoyed. • The only problem for the home is that it has very limited dining space, a small dedicated dining area having been created within the intermediate care lounge. This However, appears not to be an issue for the service users or their relatives all of whom focused on the positive aspects of the homes, meals, describing them as ‘tasty, good, well presented’, etc, etc. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 24 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 16: The service users and/or their relatives feel they are listened to and can approach the staff and management with concerns or complaints. Standard 18: Service users are protected from abuse, the staff trained in managing allegations of abuse and the company committed to openness and transparency. EVIDENCE: Complaints and Concerns: The evidence indicates that generally the service users and/or their relatives are happy to raise concerns or complaints with the home and are confident that the issues will be appropriately handled and addressed. • The services documentation is very specific about how to raise concerns or complaints the brochure documents stating: ‘if during a residents stay a situation or problem arises, however small, which gives cause for concern, it is important to inform the Matron. This could be anything connected with health, the home, clothing, the room, a member of staff, family problems, the care or meals. Should the home not be able to resolve the problem, the procedure would be to contact our regulators’. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 25 • The ‘service users’ guide’ also contains details of how to raise a concern or complaint, the proprietary company including copies of its complaint procedure within each copy of the guide. The complaints procedure for the service was found to be fully compliant with the care homes regulations 2001. • Details of the home’s complaints process were also included within the pre-inspection questions, along with a summary of the home’s complaints activity over the last twelve months: 1. 2. 3. 4. 5. One complaint was received over the last twelve months No complaints were substantiated No complaints were partially unsubstantiated The complaint was responded to within the 28 day timescale The complaint was resolved. Information relating to each of the complaints is maintained by the home within its complaints log, along with details of the investigation and copies of the response to the complainant, id applicable. • At the last inspection the visiting inspector noted and recorded within her report: ‘discussions with service users and visitors indicated that they felt able to complain and indicated that they would do so to either the manager or administrator. Care and nursing staff spoken with during the inspection were aware of what they should do if a service user or relative wished to complain’. • The latter statement was found, during this inspection process to remain the case, with the care staff indicating via questionnaires that they still appreciate how to handle clients concerns, one staff member recording: ‘I would listen to what their complaint was and see if I was able to deal with it, if not I would pass it onto the relevant person, after explaining everything to the service user. Then I would document the conversation, complaint made and outcome’. A second staff member added: ‘I would try to sort it out myself if possible, or go to my line manager/matron’. Safeguarding Adults: The evidence indicates that the service users’ welfare is promoted and that the management and/or staff seek to protect people from abuse and harm by their practices. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 26 • The pre-inspection questionnaire provides a clear statement of the fact that the staff are provided with access to an adult protection policy and procedure and that within the last twelve months no adult protection incidents have been referred for investigation. All new employees are required to complete a full and detailed induction programme, which addresses all of the units defined by ‘Skills for Care’ under the new ‘Common Induction Standards’, as evidenced by the training manager during a conversation. In discussion with staff, whilst none specifically mentioned the abuse training, it was established that the company provides access to numerous educational and skills development courses, the company employing a training and development manager who oversees a specific team of co-ordinators. Unfortunately, as with the staff, the training matrix/schedule, etc, supplied with the pre-inspection bundle, does not make specific reference to adult protection training or development, although this is addressed as a unit via National Vocational Qualifications (NVQ’s). The professional comment cards and service user relative comment cards also indicate that people are confident in the home’s/services ability to manage concerns, complaints and allegations appropriately. The above findings were also mirrored by the previous inspector, who recorded within her report: ‘The home has an adult protection policy which links to the Isle of Wight Adult Protection policy and procedure. The home has appropriate policies for whistle blowing and gifts to staff. Discussions with the matron, nurses and care staff showed that they had an understanding of adult protection issues and were clear about their responsibilities and actions that should be taken if abuse is suspected. Discussion with staff confirmed that they had received training about adult protection during both induction and NVQ courses’. It would be worth the company and the training team considering how to develop and rollout to staff specific training around protection issues, especially given that this is an ever changing field within the social care sector. • • • • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 27 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standard 19: The home is well maintained both internally and externally and evidence exists of the ongoing refurbishment and redecoration programme. Standard 26: The home was found to be clean and tidy throughout and domestic staff observed on duty during both days of the fieldwork visits. EVIDENCE: Environment and cleanliness: The evidence indicates that all service users live within a well maintained, clean and tidy environment that meets their immediate and long-term care needs. • The tour of the premise highlighted no concerns with all areas of the home being well maintained and decorated. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 28 • Significant capital has been invested into the home over recent months, with the following improvements obvious at this visit: 1. 2. 3. 4. 5. 6. 12 Refurbished bedrooms 12 En-suite facilities created Lounge redecorated Creation of a reception area, nursing office and storage facilities All main fire doors fitted with electro-magnetic self-closing devises A re-equipped laundry with macerators and sluicing equipment. • It was established during the inspection of The Elms, one of Springfield Nursing Home’s, sister services that the company employs both a central maintenance team, under the direct control of an ‘Estates Manager’, as well as individual maintenance personnel within each of its properties, ensuring both minor and major jobs/works can be addressed immediately. During the last inspection visit it was noted and recorded: ‘the home was found to be clean, tidy and free from offensive odours at the time of the unannounced inspection with visitors and service users spoken with confirming that this was always the case. The home employs a domestic staff team who work under the direct supervision of the housekeeper. The housekeeper has been provided with a large lockable storage room where all cleaning chemicals and supplies were seen to be stored. Appropriate policies are in place for the infection control and management of clinical waste with sluicing facilities in place. A new second sluice room including facilities for soiled laundry is being provided and should be completed shortly after the inspection. Liquid soap, paper towels, plastic disposable aprons and gloves were seen located around the home’. • • Observational information gathered during the fieldwork visit and documented information contained within the pre-inspection questionnaire, again mirrored the finds following the last inspection. The pre-inspection questionnaire indicating that a full range of infection control policies and procedures are available to the staff. The tour of the premises establishing that a large walk-in cleaning cupboard is in use and that all chemicals are suitably stored and locked away. The bathrooms and communal toilets, noted to contain liquid soaps, gels and paper towels. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 29 • Throughout the fieldwork visit members of the home’s domestic staff team were observed around the home, cleaning and tidying both communal areas and individual people’s bedrooms. The work of the domestic staff team being overseen by the ‘Housekeeper’ and the company’s ‘Hotel Manager’. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 30 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Standard 27: Staffing levels are sufficient to meet the needs of the service users. Standard 28: The home has achieved the target of 50 of the care staff trained to National Vocational Qualification (NVQ) level 2 or above. Standard 29: The recruitment and selection practices of the home are sufficiently robust and designed to ensure that the wellbeing and safety of service users is assured. Standard 30: In-house training and development opportunities for staff are good. EVIDENCE: Staff Deployment: The evidence indicates that the needs of the service users are being meet by the supply and deployment of staff. • Copies of the staffing rosters, supplied as part of the pre-inspection questionnaire, suggest that the home is sufficiently well staffed and that carers and nurses are available, across the twenty-four hour period to meet the service users’ needs. DS0000064757.V325071.R01.S.doc Version 5.2 Page 31 Springfield Nursing Home • Observations further evidence the fact that adequate staff are available to meet people’s health and social care needs, the staff on duty comprising: 1. 2. 3. 4. 5. 6. 7. 8. 9. The deputy matron/manager The training manager The administrative manager Nine care staff Two qualified Nurses Activities organiser Three catering staff Two ancillary/Domestic staff Two maintenance personnel • The relatives of service users, also seem to feel there are sufficient staff available, the comment cards ticked ‘yes’ in response to the question: ‘in your opinion are there always sufficient numbers of staff on duty’. A view supported by the health and social care professional whose comments on the staffs abilities to respond to the differing needs of the clients and their skills and experiences, as reported earlier, indicates that people feel the home has the resources to meet the clients needs. Other issues which tend to suggest that sufficient staff are available within the home are: o The activities programme o Observations during the visit o Observations of the previous inspector who recorded: ‘service users and visitors spoken with during the inspection reported that staff are prompt in answering call bells and that they felt care staff had sufficient time to meet their needs. Staffing rotas seen during the inspection confirmed the manager’s statement concerning staffing numbers’. • • Training & Development: The evidence indicates that the training opportunities for the staff are good. • As part of the pre-inspection questionnaire the training manager included copies of the home’s forthcoming training events and details of both the mandatory and non-mandatory courses completed by all staff over the last few months: Mandatory: o Fire safety o Moving and Handling Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 32 o Common Induction Standards o First Aid Non-mandatory: o o o o o o o o Appraisal Awareness Falls & Older Persons Dealing with negative attitudes Customer Excellence Stroke Care Care of the Dying (Liverpool Care Pathway) Basic IT NVQ’s Forthcoming Mandatory events: o o o o o Fire safety Health and Safety Moving and Handling Food Hygiene Common Induction Standards Forthcoming Mandatory events: o o o o o o o o o o • Mental Capacity Bill Training Mentorship Course (qualified) Syringe Driver update Blood Glucose Monitoring MAST (moving & Handling) training for trainers Fire Marshalling Food safety Certificates Advanced food hygiene certificate (catering manager) Assessors Award NVQ’s In discussion with staff it was quickly established that training opportunities are continuously made available at Springfield Nursing Home, events are arranged by the training manager and overseen either by one of the co-ordinators she manages or the training manager herself. In discussion with the training manager it was established that the Matron/manager and/or their deputies provide a lot of information with regards to the training need of the staff, this information come largely from supervision and appraisal sessions. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 33 The inspector provided with copies of appraisal documentation, which clear has a large focus on training and development needs/opportunities. • The questionnaires returned by the staff largely support the feedback from the staff seen during the fieldwork visit, the staff ticking ‘yes’ in response to the question: ‘does the home provide funding and time for you to receive relevant training’. Two of the staff also listed courses completed this year including: ‘manual handling, fire safety, stroke awareness, medication in the elderly and managing people’. It was also clear, given the pre-inspection information and feedback from staff during the visit, that they are also being supported when accessing National Vocational Qualifications (NVQ) level 2 courses or equivalent. The evidence within the pre-inspection questionnaire indicating that the home has met and surpassed the 50 ratio recommended within the National Minimum Standards, the actual percentage holding an NVQ 2 or above being 54 . • • • Recruitment and Selection: The evidence indicates that the recruitment and selection process of the company is well structured and operated. • At this visit the files of four recently appointed staff were reviewed and found to contain the following information: o o o o o o o o • An application form Details of interview Contracts Employment correspondents Two references Protection Of Vulnerable Adults (POVA) clearance Criminal Records Bureau (CRB) check outcome Supporting identification and documents Feedback taken from the staff questionnaire, supports the findings of the inspector, people’s experience of the recruitment process being largely positive, the staff acknowledging that they had: o o o o o o Completed application forms Provided two references Been required to submit to CRB and POVA checks Received and induction Received a Contract Been supplied with a job description. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 34 • It was also noted whilst researching the files prior to visiting the home that the home has a recent history of compliance with the regulations guiding recruitment and selection. However, one issue that the Commission feels the proprietary company should review is the use of ‘orientation shifts’, which appear to allow prospective staff member/employees to work in the home without having undergone any safeguarding checks CRB, POVA, references or either a declaration of criminal background (DCB) statement or individual risk assessment having been completed. Although it should be acknowledged that the individual undertaking the ‘orientation shift’ is, according to the manager, accompanied/supervised during their entire time in the home. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 35 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. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Standard 31: The manager possesses both relevant nursing and managerial qualifications and is an experienced leader. Standard 33: The home’s quality assurance systems ensure the home is run in the best interests of the service users, although some internal monitoring of the staffs performance is required. Standard 35: The arrangements for handling service users’ monies are satisfactory and designed to ensure people’s financial interests are safeguarded. Standard 38: The health, safety and welfare of both the service users and staff team are appropriately managed and promoted. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 36 EVIDENCE: Management: The evidence indicates that the home is well run and managed and that the service users, their relatives and staff are appropriately protected from harm and injury. • Information contained within the previous inspection report indicates that the manager possesses both the National Vocational Qualification (NVQ) level 4 in Care and is a Registered General Nurse: ‘The registered manager/matron is a Registered General Nurse and has NVQ level 4 in management. The manager meets all the training requirements to achieve NMC Prep requirements. The manager has successfully managed Springfield for the past three years and stated that she has a full job description’. However, the business card of the manager indicates that she has completed the Registered Managers Award (RMA) and not the NVQ 4 in management. This will need clarifying at the next inspection. • However, regardless of the managers current qualification status, one issue was clear on arriving at the home, was that the manager is keeping up to date on managerial development issues, the manager absent during the visit as she was in Winchester attending a management event. Further evidence of how well run the home is comes from the relatives comment, with people remarking: ‘I am very happy with my mothers care and treatment’ ‘Having recently spent almost five weeks in Springfield, I am writing to say how very much I enjoyed the experience. All the staff from the matron to the cleaners were so pleasant and helpful. Never having stayed in such a place before I was so impressed I almost didn’t return home’. The latter testimony quoted directly from the services brochure documentation. • Feedback taken from the staff questionnaires also indicates that the staff feel the home is well managed, staff ticking ‘yes’ in response to the • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 37 question: do you feel that you have enough support from your manager to help you begin working the service users’. • It has also been demonstrated throughout this inspection report that the management structure of the entire company is designed to promote effective and efficient working and a consistent standard of care delivery to the clients. Quality Audit and Assurance: The evidence indicates that service users and/or their relatives are afforded the opportunity to comment on the service provided at the home. • Service users and/or their relatives are afforded the opportunity to comment on the service provided at the home via the internal client satisfaction survey, which it is understood is an annual survey conducted internally by the matron/manager. In addition to this process the heads of each internal department, catering, domestic and the matron/manager, etc., make themselves available to clients on a daily basis thus ensuring that people have a daily opportunity to comment on the service delivered. • Remarks within the comment cards returned by both health and social care professional indicate that staff ‘listen to the service user’s and respond accordingly to their requests. It has also been reported that the professionals consider the home and/or the staff to enable the service users to live their life’s as they choose. Whilst the company’s brochure documentation and the ‘service users guide’ both mention quality care and quality services, etc, neither document makes clear for people how the monitoring of quality is to occur. On arriving at the home the inspector was provided with a document file, which contained huge amounts of evidence, which demonstrated how the home and the company complied with the National Minimum Standards (NMS) and the relevant regulations. Within this file were details of the home’s quality audit or quality questionnaire programme, which the providers should give more consideration to publicising within its documentation. The questionnaires are clearly used, as evidenced by the comments contained within the testimony section of the brochure documents, but • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 38 more mention of the areas assessed and the response received could be made available. • Further evidence of the use of the home’s questionnaires was provided by the last inspector to visit the home, her report indicating: ‘service users and visitors confirmed that they have regular contact with the matron who ensures that they are happy with the service they are receiving. Intermediate care service users are offered the opportunity to complete a questionnaire when they are discharged for quality assurance monitoring. The returned questionnaires were seen during the inspection with discharged service users providing very positive responses about the home’. Another important element of any quality auditing system is the work undertaken with the staff, which from a training and development perspective is very good, as evidenced earlier within the report. Staff also confirmed, during conversations, that team meetings and appraisals are regular occurrences and that generally they found or considered these events useful and productive. • • Service Users Monies: Evidence indicates that no changes have occurred in how service users’ monies are managed and that previously the company’s management of service users’ finances has been considered appropriate and satisfactory. • The administration manager explaining that it is the policy of the company not to become involved in managing the finances of the services users, the company preferring instead to offer people the opportunity to have items purchased on their behalf and invoices sent for these items alongside their monthly fees. No issues or concerns with regards to this system of managing people’s monies has been brought to the attention of the Commission, either prior to the inspection being scheduled or during the research phase of the process, which precedes the fieldwork visit. The company’s ‘service users guide’ makes the position, on monies, very clear for the service users and/or their relatives/advocates: ‘Clients assessed as being able to deal with their finances may do so. If it is decided that a person is unable or unwilling to do so, an advocate should be appointed to manage their affairs. On admission, any large sums of money or valuables should be given to the administrator or nurse- incharge for temporary safe keeping, until they can be passed to family members or advocates. Receipts will be issued for all monies and valuables received by the home. We ask that large amounts of money are not kept by the clients. Our insurance only covers up to £50 in cash DS0000064757.V325071.R01.S.doc Version 5.2 Page 39 • • Springfield Nursing Home per client and would therefore request that this is the maximum amount of money you hold at any one time. We provide a locked facility within our administration office for your personal allowance. Payment of items such as hairdressing, chiropody, newspapers, will be payable from your personal allowance. Payment for telephone calls will be invoiced by administration at the end of each month. Health and Safety: The evidence indicates that the health and safety of the service users and staff is being appropriately managed. • • • No immediate health and safety concerns were identified with regards to the fabric of the premises during the tour of the premises. The pre-inspection questionnaire establishes that full health and safety policies/guidance documents are made available to the staff. Health and safety training is clearly made available to staff, with the preinspection questionnaire evidencing that staff have completed fire safety and moving and handling training and are scheduled to complete other mandatory courses as previously mentioned. Access to paper towels, liquid soaps, hand-gels and aprons have also been mentioned within the report, as has the availability of specific infection control policies and procedures. The availability of the maintenance team and individual personnel is also a benefit to the home, as this ensures that the general fabric of the environment is kept up together and does not pose an immediate risk to people. The tour of the premises also evidenced the wide range of moving and handling equipment available to the staff and that chemicals are stored in accordance with the appropriate regulations. • • • Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 40 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 4 X X 4 HEALTH AND PERSONAL CARE Standard No Score 7 4 8 4 9 3 10 4 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 4 X X X X X X 4 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 4 X X 4 Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 41 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. 1 2 Refer to Standard OP18 OP29 Good Practice Recommendations The training manager should access specific training on the safeguarding of vulnerable adults. The company should review the use of the orientation shift, ensuring that the potential for any harm to come to service users, is assessed and appropriate steps taken to reduce the risks identified. Springfield Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 42 Commission for Social Care Inspection Hampshire Office 4th Floor Overline House Blechynden Terrace Southampton SO15 1GW 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 Nursing Home DS0000064757.V325071.R01.S.doc Version 5.2 Page 43 - 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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