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Inspection on 04/12/07 for Springfield Nursing Home

Also see our care home review for Springfield Nursing Home for more information

This inspection was carried out on 4th December 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 found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

What has improved since the last inspection?

Risk assessments for falls and the use of bedrails were more thorough. This meant that staff were more likely to identify risks to residents` health and be able to reduce them. The manager made sure that new staff had thorough background checks before they started work at the home. This helped to safeguard people living at the home. The records of training were clearer and had been kept up to date. However, not all staff had received refresher training in health and safety topics. This could put people living and working at the home at risk.

What the care home could do better:

Some of the care plans did not give staff enough advice about how to meet people`s individual needs. They were not always changed when the person`sneeds changed. There were good systems for staff to pass on information by word of mouth and there was a communication file for nursing staff. However, the lack of up to date written instructions in care plans could result in people not receiving the right care. The staff generally managed medication safely but some improvements were needed to reduce the risk of errors. Not all the staff were clear about what to do if a resident accused a member of staff of being abusive. The manager must take steps to address this to ensure the safety of residents.

CARE HOMES FOR OLDER PEOPLE Springfield Nursing Home 191 Spendmore Lane Coppull Chorley Lancashire PR7 5BY Lead Inspector Jane Craig Unannounced Inspection 4th December 2007 10:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springfield Nursing Home DS0000025577.V351734.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 DS0000025577.V351734.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Nursing Home Address 191 Spendmore Lane Coppull Chorley Lancashire PR7 5BY 01257 470140 01257 470126 janet.springfield@tiscali.co.uk 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) Mr Ghulam Qadir Mrs Janet Lawes Care Home 40 Category(ies) of Old age, not falling within any other category registration, with number (40), Physical disability (6) of places Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. Up to 40 Service users in the category OP (Old Age, not falling within any other category) who require nursing or personal care. Up to 6 service users in the category PD (Physical Disability) who require nursing care. 20th February 2007 Date of last inspection Brief Description of the Service: Springfield is a care home with nursing, currently registered to accommodate forty residents. The registration allows the home to accommodate forty-two older residents of either sex and six young physically disabled people of either sex. The home is situated on the main road, which passes through the village of Coppull, two miles from Chorley town centre and Standish. Springfield is a purpose built home offering accommodation over two floors, which can be accessed by the passenger lift. There are single and double bedrooms, a lounge/dining room and assisted bathing facilities on each floor. All of the double rooms were being used for single occupancy. The ground floor houses the administrative offices, reception area, kitchen and laundry. There is no smoking anywhere within the home. The home has a large garden to the rear and side of the home that has a large patio and water feature fountain and greenhouse. A brochure about Springfield is sent out to prospective residents when they enquire about admission. Anyone who comes to look around the home has access to more comprehensive information, including the service user’s guide. At 20th February 2007 the weekly fees ranged from £332.00 to £600.00. There were supplements for a single occupant in a double room and for rooms with en-suite facilities. There were additional charges for hairdressing, personal newspapers, none hospital transport and incontinence aids for some residents. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Springfield Nursing Home on 4th December 2007. At the time of the visit there were 40 people living at the home. The inspector met with a number of them and asked about their views and experiences of living at Springfield. Some of their comments are included in this report. Three people living at the home were case tracked. This meant that the inspector looked at their care plans and other records and talked to staff about their care needs. As part of the key inspection a number of surveys were sent out to residents, relatives, staff working at Springfield and visiting health professionals. Information received on the surveys has been taken into account when compiling the report. During the visit discussions were held with the registered manager, the administrator, nursing and care staff. The inspector looked round the home and viewed a number of documents and records. This report also includes information submitted on the Annual Quality Assurance Assessment (AQAA), which is a self-assessment that the registered manager has to fill in and send to the Commission every year. What the service does well: Most people who returned surveys indicated that they were given enough information about the home to help them to make a choice about whether it was the right place. Before anyone moved in the manager visited them to assess what care they needed and to make sure that their needs could be properly met at Springfield. Residents who returned surveys said they received the right care and support. During the inspection one resident said, “I have no complaints about the way they look after me.” Relatives also said the service met the needs of the residents. Staff understood the principles of promoting privacy and dignity. They made sure that residents were treated with respect. Residents were happy with the routines in the home and said they could make their own choices about when to get up and what to do during the day. The Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 6 level of organised activities suited people. One resident said, “There are things going on if you want them, especially at this time of the year, it’s hectic.” Residents and relatives appreciated the open visiting arrangements. One relative wrote, “Relatives are welcomed to visit at any time and for any length of time.” Residents were offered a varied diet with a choice of two dishes at each mealtime. One person said, “I told them I liked black puddings so they put them on the menu.” There was a complaints procedure, which meant that residents could expect any complaints to be dealt with properly. Residents said they knew who to speak to if they were not happy with the service. The environment was clean and tidy. Furnishings and décor were comfortable and homely. A resident said the home was, “very clean and no smell.” Just over half of the care staff had a nationally recognised qualification in care, called a National Vocational Qualification (NVQ). This training helped staff to understand the needs of residents and improved their skills in caring for them. Residents had opportunities to make their views known about various aspects of the service. One resident said, “they have meetings where you can put propositions forward.” The manager said that residents’ suggestions were always considered. The manager made sure that all the equipment in the home was serviced regularly. This helped to protect residents, staff and visitors. What has improved since the last inspection? What they could do better: Some of the care plans did not give staff enough advice about how to meet people’s individual needs. They were not always changed when the person’s Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 7 needs changed. There were good systems for staff to pass on information by word of mouth and there was a communication file for nursing staff. However, the lack of up to date written instructions in care plans could result in people not receiving the right care. The staff generally managed medication safely but some improvements were needed to reduce the risk of errors. Not all the staff were clear about what to do if a resident accused a member of staff of being abusive. The manager must take steps to address this to ensure the safety of residents. 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 DS0000025577.V351734.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 3 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People thinking of moving into the home received sufficient information to help them to make a decision and staff received sufficient information to understand the person’s needs. EVIDENCE: The Annual Quality Assurance Assessment (AQAA) indicated that people thinking of moving into the home were given written information about the service. They were able to look round and talk to staff and people living in the home to get their views first hand. Most people who completed surveys indicated that they received enough information about the home. The manager assessed anyone thinking of moving into the home. This meant that she could be sure that the staff and facilities at Springfield could meet the person’s needs. Assessments carried out by health and social services’ Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 10 professionals were also available on people’s files, which gave staff access to even more information about the person’s needs. One resident said that the manager visited her in hospital and gave her a brochure. Standard 6 was not applicable. Intermediate care was not provided at Springfield. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Despite shortfalls in care plan records, people’s health and personal care needs were met in accordance with their wishes. Some shortfalls in the management of medicines increased the risk of errors. EVIDENCE: The care files for three people were looked at as part of the case tracking process. The files all included a set of assessments, risk assessments, care plans, reviews and daily notes of care given. Although care plans addressed people’s health and personal care needs, the standard of the plans varied. The care plans for one person were quite personalised and included information about how the person wanted to be assisted. The directions for staff were detailed enough to ensure that care was given in a consistent manner. Other plans were brief and task oriented rather than person centred. Plans showed evidence that residents, or their relatives, were given opportunities to be involved in drawing them up. One resident said that staff talked to her about her care plans and that she could make Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 12 suggestions for changes. Relatives who returned surveys all indicated that they were informed of any issues affecting their relatives’ health. There were lists of dates to show that care plans and risk assessments were checked every month. There were no summaries or notes to indicate whether residents had made progress towards meeting their goals. Some care plans had not been re-written for a number of years. Despite being reviewed, assessments and plans were not always changed when the person’s care needs changed. For example, the moving and handling assessment for one person indicated that they used a ‘banana board’ to assist them to transfer but on the mobility plan this direction had been discontinued. Both documents had been reviewed at the same time. There were other instances where staff were working from conflicting or out of date information. Despite these shortfalls in written information, staff said they received good verbal instructions. One person, who was working at the home in a temporary capacity, said that the verbal handovers were very thorough. As recommended following the last key inspection everyone had a risk assessment for falls. All three people who were case tracked required bed rails but only two had risk assessments in place. The manager said this was an oversight and would be addressed. Everyone who returned surveys and those spoken with during the visit said the staff looked after their health. One relative wrote that their mother’s medical needs were looked after well. Plans showed that ongoing health care needs were monitored. One person said that staff checked his pulse and blood pressure which, he said, was very important because he had a pacemaker fitted. People were referred to appropriate health care specialists when necessary and any advice was acted upon. For example, nursing staff working at the home liaised with the Tissue Viability Nurse to ensure that they gave the right wound care. The health professionals who returned surveys indicated that their patients’ healthcare needs were met at the home. Some of the requirements made at the last inspection to improve the way medicines were handled had been addressed but there were still a number of shortfalls. Registered nurses managed all the medicines. Not all of them had received refresher training. There were complete records of medicines received into the home and medicines for disposal. Administration records were not always clear or complete. There were a number of gaps on Medication Administration Record (MAR) charts, with no explanation as to why the medicines were not given. Handwritten additions to MAR charts were not always signed and witnessed. A few did not accurately reflect the instructions on the packaging. One Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 13 handwritten entry was not clear enough to prevent errors. In some cases instructions had been altered instead of making a new entry. This could increase the risk of confusion and can lead to errors. A number of people had documents indicating that they were administering some of their own medication. These were out of date. Some of the preparations were no longer prescribed and the manager said that there was no-one self-administering at the time of the visit. The manager had implemented systems to ensure that there was a complete audit trail of medicines. Only one discrepancy was identified in medicines that were not in the monitored dose system. There were directions for staff to alert them when to administer medication that was prescribed “to be given when required”. This reduced the risk of under or over medicating. Variable doses were recorded. GPs had signed lists of medicines that could be given as homely remedies and staff recorded any that were administered. Medicines were stored safely and storage areas were clean and maintained at the correct temperature. Controlled drugs were stored safely and stocks were accurate as per the controlled drug register although there had been a previous recording error that had not been reported to the manager. There were some controlled drugs belonging to a person no longer at the home. It was discussed that these should be checked regularly in order to reduce the risk of mishandling. The registered manager carried out an audit of medicines every two months and had highlighted a number of the above issues. She said she was addressing them via supervision. Staff received training in core care values, including promoting residents’ privacy and dignity, during induction and NVQ training. Staff gave examples of how they respected privacy by ensuring they closed doors when they were assisting with personal care. Residents said that staff always knocked before entering their bedrooms. This practice was observed at the time of the visit. During the course of the inspection staff were also observed speaking to residents politely and with respect. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 14 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): 12, 13, 14 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The routines in the home revolved around the residents, who said they were happy with their lifestyle. EVIDENCE: Only one of the care files looked at had any information about the resident’s social history, interests and likes and dislikes. Discussions took place with the registered manager as to how that could be improved to ensure that staff had sufficient information if they had to plan and deliver care to people who could not make their wishes known. All the residents spoken with during the visit said they were happy with the home. One person said, “I didn’t think I would, but I like it here.” Another said, “It’s a contented kind of place.” Residents said they could please themselves what time they got up and went to bed. One person said, “You can stay up as long as you like.” Staff talked about the importance of giving people as many choices as possible about their daily lives. During the course of the visit residents were observed being consulted about meals, personal care and what they wished to do with Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 15 their time. A relative wrote that their mother preferred to spend almost all her time in her room and there had never been any problem with that. There was an activity co-ordinator three times per week. There were opportunities for residents to join in games and large group activities. A resident said, “The exercises are very good, they keep our joints going.” The care plan for one person, who was unable to join planned activities, indicted that staff should provide one to one social care. Directions included talking to the resident and doing manicures and facials. Several residents had been on trips out in the mini bus, which they said they enjoyed. One resident was very involved in gardening. He talked about how he had helped the gardener to win the award for the gardens. Residents said the level of activities suited them. One person said, “there is quite a lot going on downstairs but I don’t like to go.” Another person said, “There are things going on if you want them. Especially at this time of the year, it’s hectic.” There was an open visiting policy. A relative wrote, “Relatives are welcomed to visit at any time and for any length of time.” Visitors had access to tea and coffee making facilities. Information submitted in the AQAA and staff surveys indicated that families were included in the care of their relative as much as they wished to be. One resident, who was talking about residents’ meetings, said, “They invite your relatives so they can have their say.” Residents’ views about the meals were mixed. Some made slightly negative comments including, “I can’t say they are bad but they are not always that good either,” and, “the meals are variable, not always excellent.” Other residents said, “I’ve always found the food to be very good,” and “the food’s all right, quite good really.” The records of meals showed that residents had variety and meals were nutritionally balanced. There were choices at each mealtime and residents could have something different if they didn’t like either meal. The cook on duty was aware of the current healthy eating initiatives. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 16 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): 16 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were confident that complaints would be dealt with appropriately. Not all staff understood procedures for reporting suspected abuse, which could result in allegations being mishandled. EVIDENCE: There was a clear complaints procedure on display in the home. Residents and relatives, who completed surveys, indicated that they knew who to speak to if they were unhappy about anything. They all said they knew how to make a complaint. One relative wrote, “My concerns have always been addressed promptly and professionally to a satisfactory conclusion.” Staff who completed surveys indicated that they knew what to do if residents or relatives raised concerns. The Commission had received one complaint about the home, which was passed on to the registered manager. Records showed that the manager conducted a thorough investigation and tried to resolve the issues to the satisfaction of all concerned. Staff had access to guidance about safeguarding vulnerable adults. The majority of staff had a training session with the registered manager, which included discussions about the procedure for reporting suspected abuse outside the home. Staff were aware of their responsibilities to report suspected abuse Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 17 to the manager, who was clear about the protocol for reporting to the local authority. However, not all senior staff were aware of what to do if they were in charge of the home in the absence of the manager. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 18 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): 19 and 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and well maintained. It provided residents with a safe, comfortable and homely place to live. EVIDENCE: A tour of the premises evidenced that the home was safe and well maintained. Records showed that minor repairs were carried out promptly. Although the downstairs corridor carpet had recently been cleaned it had several water stains on it, which looked unsightly. Most areas of the home were comfortable and homely. Following the annual survey carried out in the home, residents suggested that the décor in some areas and some of the soft furnishings should be upgraded. Relatives also mentioned this. Information included on the AQAA indicated that the manager Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 19 planned to look at points raised on the recent residents’ surveys, “finances permitting.” The home had very attractive grounds. The gardens had won awards in the best-kept nursing home competition for a number of years. Most of the bedrooms were personalised. One resident said, “I might as well make it as comfy as possible, like home.” Another said, “I have a nice room, very comfortable.” At the time of the visit the home was clean and tidy. There were no unpleasant odours. One resident said, “It’s always lovely and clean,” and another commented, “I don’t know how they keep on top of it.” The laundry was adequately equipped for the size of the home. At the time of the visit it was tidy and well organised. There were no complaints about the laundry. Staff had written guidance on infection control procedures. There were suitable procedures for handling laundry and clinical waste. Protective clothing was available. The manager is the infection control link nurse and she planned to carry out training with staff to improve their awareness of infection control procedures. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 20 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): 27, 28, 29 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents were protected by the recruitment practices. There were sufficient staff, with training, to meet the needs of people using the service. EVIDENCE: A few people who returned surveys commented that there had been a period where the home was short of regular staff and were using agency. Problems in retaining staff were also highlighted in the AQAA. One relative remarked that the changes in staff were difficult for the residents but the regular staff had gone out of their way to minimise disruption. The manager had tried to ensure some continuity of agency staff. Staff spoken with said that the staffing situation had improved and there were usually enough regular staff on duty to meet the current needs of the residents. None of the residents spoken with had any complaints about being kept waiting for attention. Three staff files were inspected. As required following the last key inspection, staff were not allowed to start work at the home until after their POVA first check. One of the three staff was still working under supervision until their CRB disclosure was returned. All other pre-employment checks were carried out and the required information and documents were kept on files. Systems Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 21 were in place to check the registration status of nursing staff. an equal opportunities policy with regard to recruitment. The home had New staff who did not have prior experience or qualifications went through the Skills for Care induction programme. There were records to show how the training had been delivered and a statement of competency. The manager said she would tailor the induction programme for staff who already had an NVQ. Registered nurses went through a short induction, which was specific to the home and included reading the policies and procedures. Information submitted on the AQAA indicated that 55 of care staff were qualified to NVQ level 2 or above, and other staff were working towards the qualification. Following a previous recommendation the manager had updated the training matrix. There had been some improvements in training in the safe working practice topics. For example, all staff had received moving and handling training and a number had done, or were due to attend, first aid and food hygiene. However, there were a significant number of staff who had not had refresher training in these topics. The manager discussed the difficulty of accessing courses in other topics for registered nurses and carers. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 22 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): 31, 33, 35 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and staff benefited from a well managed home. There was a good level of consultation, which meant that people were able to contribute to service development. EVIDENCE: The registered manager is a first level nurse. She also holds a relevant management qualification. The manager said she continued to keep her clinical and managerial skills up to date by attending courses and through selfdirected study. A member of staff said they found the manager to be approachable and supportive. There were systems in place to monitor the quality of the service. The home had recently been reassessed and retained the Investors in People award. The Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 23 manager carried out an annual survey for residents and relatives. Results were on display in the home. There were regular residents’ meetings and staff meetings. According to the AQAA any suggestions were considered. The manager said the development plan for the home was included in the business plan but this was not available at the time of the inspection. None of the staff working at the home acted as agent or appointee for any residents. Those who were able to managed their own money and their families acted on behalf of others. Several residents had various amounts of money in the safe. As recommended, following the last inspection, receipts were given when any money was handed over for safekeeping. Each resident had a separate account sheet which showed income, expenditure and balance. However, all the money was kept together in the safe, therefore it was not possible to audit whether the records were correct. This practice of pooling money reduces the chances of any errors or mishandling being identified. It also meant that residents could not keep a check on their own account and money if they wished or were able. Servicing and testing of the fire system, equipment and alarms was up to date. Fire safety training was due to be delivered in the next month. There were no records of practice drills for some time. However, records showed that the fire alarm had sounded three times in the past six months and staff on duty had followed the emergency procedure. According to the AQAA maintenance and servicing of equipment and installations was up to date. Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 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 2 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 2 X X 3 Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP7 Regulation 15 Requirement Care plans and risk assessments must be kept under review and amendments made so that staff have up to date and accurate directions about the care to be provided. In order to reduce the risk of errors, handwritten entries on MAR charts should accurately reflect the instructions on the medication packets, be dated and clear and show evidence of having been checked. Medication must be given in accordance with the prescriber’s instructions. Written reasons must be given for any omissions. (Timescale of 31/03/07 not met) The registered person must ensure that all staff are aware of how to respond to any allegation of abuse in accordance with the policy of the home. (Timescale of 30/04/07 not met) Timescale for action 31/01/08 2. OP9 13(2) 31/01/08 3. OP9 13(2) 31/01/08 4. OP18 13(6) 31/01/08 Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 26 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP9 Good Practice Recommendations In order to reduce the risk of mishandling, controlled drugs that are not in day-to-day use should be checked regularly. In order to safeguard people living and working at the home, all staff should be trained in the safe working practice topics. The training should be updated in accordance with the recommendations of the training provider. In order to reduce the risk of mishandling and improve systems for checking, each resident who hands money over for safekeeping, should have a separate envelope or wallet in the safe. 2. OP30 3. OP35 Springfield Nursing Home DS0000025577.V351734.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Lancashire Area Office Unit 1 Tustin Court Portway Preston PR2 2YQ 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 DS0000025577.V351734.R01.S.doc Version 5.2 Page 28 - 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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