Inspection on 09/06/06 for Springfield Care Home

This inspection was carried out on 9th June 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Adequate. 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 Care Home 06/05/08

Springfield Care Home 09/05/07

Springfield Care Home 24/11/05

Springfield Care Home 22/07/05

Springfield Care Home 22/03/05

Springfield Care Home 07/07/04

Similar services:

Abbey The

Snydale Care Home

Larchfield Manor

Hawkhills

Beeches The - North Yorkshire County Council

The Grove Waltham

Carentan House

Ravensworth Lodge

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

CARE HOMES FOR OLDER PEOPLE Springfield Nursing Home 17 Western Way Buttershaw Bradford West Yorkshire BD6 2UB Lead Inspector Nadia Jejna Unannounced Inspection 10:00 9 and 13th June 2006 th 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 DS0000055013.V292965.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 DS0000055013.V292965.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Nursing Home Address 17 Western Way Buttershaw Bradford West Yorkshire BD6 2UB 01274 694192 01274 294197 j.butterworth@anchor.org.co.uk sharon.blackwell@anchor.org Anchor Trust 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) Care Home 98 Category(ies) of Dementia - over 65 years of age (4), Old age, registration, with number not falling within any other category (98), of places Physical disability (2) Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The places for PD are for named service users only The 2 places for DE(E) are for the named service users only Date of last inspection 24th November 2005 Brief Description of the Service: Springfield House is a registered care home with nursing. It is situated in a residential area approximately 2 miles from Bradford city centre. Accommodation is provided for up to for 98 male and female service users in single en suite rooms in two wings over three floors. Spacious lounge and dining areas are provided on each floor. There is disabled access to all floors via 2 shaft lifts. Information about services provided by the home is available in the homes brochure and Service User Guide. These are kept in the reception area and can be taken by relatives or visitors or they can be posted. Files containing this information are also kept in each resident’s room. With effect from April 2006 the weekly fees are from £390 per week for residential care, up to £520 per week for nursing care. These charges do not include hairdressing or chiropody and a separate list of charges for these and other services is available from the provider. This information was supplied in the pre inspection questionnaire in May 2006. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The Commission for Social Care Inspection (CSCI) inspects homes at a frequency determined by the assessed quality rating of the home. The inspection process has now become a cycle of activity rather than a series of one-off events. Information is gathered from a variety of sources, one being a visit to the home. All regulated services will have at least one key inspection before 1st July 2007. This is a major evaluation of the quality of a service and any risk it might present. It focuses on the outcomes for people living at the home. All core National Minimum Standards are assessed and this provides the evidence for the outcomes experienced by residents. At times it may be necessary to carry out additional visits, which might focus on specific areas like health care or nutrition and are known as random inspections. The last inspection was in February 2006. At that time fourteen requirements and four recommendations of good practice were made. This along with other information meant the home was given a quality rating of poor. In March 2006 the CSCI met with the providers’ representatives and the homes management team to discuss the lack of progress made meeting requirements made over the last twelve months. They acknowledged that there had been problems with the home and had put detailed plans in place to deal with them. Copies were left with the CSCI and reassurances given that appropriate action would be taken to make sure that residents benefited from a well managed service that met their needs. This visit was unannounced and carried out by two inspectors over two days. It started at 9.30am and finished at 5.00pm on the 9th June 2006 and was completed between 12:15 and 4:45pm on the 13th June 2006. Feedback was given to the management team at the end of the inspection. The purpose of the visit was to make sure the home was being managed for the benefit and well being of the residents and to see what progress had been made meeting requirements made at the last inspection. Information to support the findings in this report was obtained by looking at the pre inspection questionnaire (PIQ). Examples of information gained from this document include details of policies and procedures in place and when they were last reviewed, when maintenance and safety checks were carried out and by who, menus used, staff details and training provided. Records in the home were looked at such as care plans, staff files, and complaints and accidents records. Residents, their relatives and visitors were spoken to as well as members of staff and the management team. CSCI comment cards and post-paid envelopes were sent to the home to be given to residents and their relatives three weeks before the visit was made. Survey cards were also sent to GP’s (General Practioner’s), social workers and district nurses who visit the home to find out their views of care provided. At Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 6 the time of writing this report thirty resident and twelve relative survey responses had been received after the last inspection in March 2006. Of the surveys sent out in May 2006 eighteen resident and seven GP and other healthcare professionals (e.g. social workers and district nurses) have been returned. The evidence gathered at this inspection means that the quality rating for this home is now adequate. What the service does well: What has improved since the last inspection? Following on from the inspections that took place in November 2005 and March 2006 the provider has taken action to make sure that the way the home was being run and managed was reviewed. Comprehensive internal audits have been carried out, which included getting the views and opinions of residents, their relatives and other people who visit the home. Detailed action plans have been put in place to rectify the shortfalls identified and improve the quality of services provided. A project manager has been implementing changes and supporting staff through this process. An experienced care home manager, who is a registered nurse, has been employed and had been at the home three weeks when the Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 7 inspection was done. It was very encouraging to see that the action plans were being followed and had resulted in better outcomes for residents in the home and a more positive and supported staff team. Staff said that they were enjoying the extra training that had been provided and felt better equipped to look after residents. They were positive about the changes that had been made and said that communication in the home was better and that they felt supported by the management team. At least 50 of care staff have achieved qualifications equivalent to NVQ (National Vocational Qualification) 2 or higher. Good progress has been made with meeting outstanding requirements and these have reduced from fourteen to eight. The management team were aware of those that had not been met yet. Target dates for meeting them were in place. When feedback was given at the end of the inspection it was positive to see that that areas for improvement found by the inspectors had already been identified by the management team and added to the action plans. This shows that they are committed to making sure that the home will be run in the best interests of the residents. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield Nursing Home DS0000055013.V292965.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 DS0000055013.V292965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 3, 4 and 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents and their relatives have access to information about the home and services provided and have the opportunity to visit before making any decisions. The management team has recognised that the admission process needs to be more structured in order to identify resident’s needs. This will make sure that resident’s needs are met. EVIDENCE: The manager said that she will do all pre-admision assessments and will make sure that the home can meet the needs of all residents admitted. A new preadmission assessment form will be used to help her do this. In the short time she has been at the home she has identified that there are some residents with dementia whose needs are not being met properly. She is working with the relatives and social services to find places in homes more suited to their Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 10 specialist needs. For those residents with dementia whose needs are being met by the home an application for a variation registration has been made. One of the residents seen had been at the home for nearly seven weeks. They said that their relatives had been to look around the home on their behalf and been given all the information needed to make a decision. They had been offered a trial visit and stay but refused choosing to come in and stay. Their pre-admission assessment was looked at and it gave a clear picture of their needs. The homes Statement of Purpose and Service User Guide are available in the reception area and all bedrooms. The manager said that the documents were being revised to make sure that the information they gave was up to date. Springfield Nursing Home DS0000055013.V292965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Resident’s health, personal and social care needs and how to meet them are not set out clearly in care plans. Residents and or their relatives are not routinely involved in this process. There are gaps in information around looking after people at risk of falling or losing weight. There is a risk that residents care needs will not be properly identified and dealt with. EVIDENCE: Resident survey cards were received in March 2006 and May/June 2006. These showed that most residents felt well cared for, that the staff treated them well and that they received medical support when it was needed. Relatives surveys received said that overall they were happy with the care provided. The manager said that the care plans had not been changed yet. The organisation are introducing new forms to be used which would be introduced in July 2006 after staff have been shown how to use them properly. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 12 Five care plans were looked at. These showed that even though residents needs had been identified through pre admission and other health care assessments, clear information about how to meet individuals identified needs was not always written down. Examples included information about residents at risk of losing weight and of falling. The nutritional risk assessment tool was difficult to follow and understand. In one case it did not show that a resident clearly needing a lot of help to eat and drink was at risk of losing weight. A nurse was asked how it worked but they did not know and in turn asked a care assistant about it. The carer said they had not done the training and could not answer. For an assessment tool to be meaningful and useful all staff must be able to understand and use it effectively. Professional advice and support had not always been sought for residents who had been identified as at risk of falling (two had had a high number of falls over the last two months) or of losing weight. The manager was advised to contact the falls prevention team. Information requested about residents weights, whether they had been referred to their GP or seen by a dietician was looked at. It was clear that residents were weighed monthly but if they had lost weight or were low weight to start with specialist advice had not always been requested. The manager said that appropriate action would be taken. Information about maintaining resident safety was repeated in different care plans and in one case did not reflect what was actually taking place. For example the care plan said the resident was being nursed in bed with bed rails in place as well as being nursed on a mattress on the floor. On checking the resident went to bed at night and had one bed rail raised and the other one down. Care assistants were aware of the care plans but said they did not always look at them because they did not have time and it was the nurses who wrote in them. They said they find out about changes at shift handover periods and from each other. Some care plans had been signed by the resident and or their relatives. Not all had been evaluated monthly or had an annual review and not all documents were signed or dated. The manager said that this will be dealt with when the new care plan forms are put into use. Survey cards were sent out to social workers, GPs and other healthcare professionals. Some of these were returned and contained the following comments: * The home communicates clearly with them * They can see the residents in private * Staff show an understanding of the needs of the residents. * They were satisfied with the overall care provided to residents. The manager found that there were problems with the systems for ordering, receiving and storing medications in the home. She carried out an audit and Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 13 put new systems in place. All nurses have received training about medication from the supplying pharmacist. She has also spoken to GPs to find out if they had any concerns about the home in order to put them right. Some of the medication administration records (MAR) had not been signed even though the tablets had been given. Another MAR showed that twenty three capsules had been signed for for a twenty one capsule course of antibiotics. The manager said that this would be investigated. Residents said that staff respected privacy and said they always knocked before entering their rooms. They said that staff were hard working, kind and caring. Springfield Nursing Home DS0000055013.V292965.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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Information about individuals social, recreational and leisure interests are not clearly set out in the care plans or used to plan activities that take into account individual preferences. There is a risk that these needs will not be met. Residents are able to maintain links with family, friends and community groups if they wish. EVIDENCE: An activity organiser is employed in the home. They have been at the home for a number of years doing other jobs and it was not clear if they had received training in order to carry out this important role. A weekly diary of planned actvities is displayed in the lounge and dining rooms. Most sessions take place in the afternoons. The mornings are set aside for constructive time which is spending time with individual residents doing things with them and finding out what they would like to do. The organised activities take place in one area of the home and residents are taken to the nominated lounge. It was seen that the activity organiser needed to ask for help to move and work with residents. Care staff should be aware that social and leisure activities are an important part of a residents normal daily routine. One resident who spends a lot time in Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 15 their room said that staff would come to see them when they had time to play a game of cards or dominoes, but they were often very busy. On the first day of the visit some residents wanted to sit outside but were told that most residents wanted to play bingo inside and it was the majority who got what they wanted. This was reported to the manager during feedback and she asked why those who wanted to be outside had not done so and that the care staff could have helped with this. She said that this would looked at. On the second day of the visit it was good to see that after lunch residents were sat outside enjoying the sunny weather. The planned activities throughout the week are varied and residents can choose whether or not they want to join in. The care plans seen contained details of individuals social and life histories but some were not as detailed as they could have been. For example information given to one of the inspectors showed that two residents liked opera, one loved dance and another had a keen interest in religious matters. Their care plans did not show this amount of detail and activity records said joined in with daily activities. The individuals personal life and social history profiles should be more detailed and then used to help plan activities that suit the individuals needs. The organisation has got policies in place around recognising equality and diversity of residents. Two members of staff have enrolled on a training course about equality and diversity. One of them said that they had found it very interesting and was looking forward to being able to put what they had learned into practice. Residents said that they could choose when to get up, go to bed and whether or not to stay in their own rooms or go to one of the communal lounges. Residents said that they were settled in the home and satisfied with the care and services given to them. Visitors and relatives said that they could visit at any time and that the staff were welcoming, friendly and caring. Resident survey responses to the CSCI showed that the views about the food provided were varied. The management team said that as a result of a resident survey about food and meal times several changes had been made. The main meal was now served at lunchtime and a new menu plan was being introduced over the next week. The chef and the manager said that residents had been consulted for ideas and meal suggestions and each dining room had a comments book for them to record their opinions about meals. The manager said that enriched foods were included to help those residents at risk of losing weight and nourishing snacks would be available in between meals. The chef on duty confirmed this. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 16 The lunchtime meal served at 1pm was seen in one of the dining rooms. Tables were nicely set and one resident who liked tomato sauce had their own bottle. There was little discussion between residents and staff. Drinks were not served with the meal even though it was a warm day. Residents were offered a cup of tea afterwards and again at about 3pm. None of the residents in this room were offered drinks in between these times even though there were facilities to make drinks and staff were helping themselves to cold drinks at regular intervals. When told the manager said that action would be taken to make sure that all residents were given enough to drink. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 17 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents and relatives are supported and protected by the homes complaints and adult protection procedures. EVIDENCE: The complaints procedure is displayed in the main reception area of the home. It is included as part of the Statement of Purpose and Service User Guide. Compliments, concerns and complaints leaflets were also available. Over the last twelve months the home had received fifteen complaints. Five had been made direct to the CSCI. One was investigated by the CSCI and four sent to the provider to investigate using their complaints procedure and investigation processes. The majority of these complaints were about poor standards of nursing and personal care provided to residents and were either fully or partially upheld. Since the last inspection in March 2006 the CSCI has not received any complaints about the home. Some of the residents said that they would speak to the person in charge if they had any concerns. One resident said that their relative had made complaints to the management team and they had been dealt with to their satisfaction. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 18 Copies of both the organisations and the local authorities adult protection procedures were seen in the home. Staff were aware of them but not all had received appropriate training yet. They said that they would not hesitate to report actual or suspected abuse to the person in charge. Some were aware that they could use the whistle blowing policy and report directly to the adult protection unit or to the CSCI. Since the last inspection there has been an allegation of abuse made against a member of staff. The manager responded promptly and appropriately. The incident was reported to the adult protection unit, the CSCI and the residents relatives. The manager has supported and worked with the resident and their relatives to talk about the allegation in order to clearly identify what had happened. Appropriate action will then be taken. Residents said that they felt safe living in the home. This was confirmed in the resident survey forms. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 19 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 24 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Residents live in a clean, tidy and well-maintained home. Aids and equipment are provided to meet their care needs. All bedrooms are single, en suite and of a good size and they are able to bring in their own belongings to personalise their rooms. EVIDENCE: The home is clean, tidy and well maintained. There were no odours in the areas visited. The most recent fire safety officer’s report was in January 2006. Copies were sent to the home and CSCI. The administrative deputy manager said that it has been sent to head office and recommendations made will be carried out. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 20 There are communal lounge and or dining areas on each corridor and residents can choose where to sit. They have been comfortably furnished and provide views of the neighbourhood. There are gardens to the rear of the building that are easily accessible via the ground floor lounge. The gardens have been made safe and secure and plans are in place to enlarge the seating area and make the gardens more attractive to look at. Residents have single, en suite rooms that are furnished and decorated to a high standard. Many residents had brought in small items of furniture as well as pictures and ornaments to personalise their rooms. None of the bedrooms have private bathing facilities but there has been ample provision of assisted bathing, shower and toilet facilities that are accessible to people of all abilities. The laundry is a good size and has been well equipped. The room becomes hot very easily and can be too hot to work in comfortably. The temperature was 84 degrees Fahrenheit and the laundry assistant said that it could be hotter. An electric fan had been provided but this did little to ease the situation. Risk assessments have been carried out and the manager had an invoice for an air conditioning unit that would be fitted as soon as it was delivered. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 21 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30. Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. Residents are generally satisfied with the care that they receive but feel there are times when no one is available to immediately help them. The home has recognised that training provision needed to be increased and is now delivering a programme that will meet needs of residents. EVIDENCE: Staff rotas were provided with the pre-inspection questionnaire. These showed that there were adequate numbers of staff on duty for the number of residents in the home. But resident and relatives survey responses and discussions with residents and visitors indicated that at times they felt there were not enough staff available to meet their needs. One visitor said that staff were ‘very kind and hard working but that at times they were short staffed and agency were often used which made it hard for both residents and regular staff’. The manager said that when staff were not sick or absent the numbers on duty were appropriate but that she would look at how staff are allocated to different sections of the home. The manager has revised the homes employment procedures to make sure that proper checks are carried out on all prospective employees. She has also Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 22 made the decision that carers with two years experience and wherever possible NVQ 2 or higher will be actively recruited. This is part of her action plan to improve standards of care because it is felt that at the present time staff are attending training sessions and might not have the time needed to properly train an inexperienced care worker. Four staff files were looked at. These showed that: • All had completed an application form, but it only asks for ten years employment history when it should be a full employment history. • Two files did not have copies of contracts or terms and conditions of employment. • Three files only had one written reference. • One file showed that there was no proof that Protection of Vulnerable Adults (POVA) or Criminal Records Bureau (CRB) checks had been done. • One file for a registered nurse did not show that the home had checked the Nursing and Midwifery Council (NMC) register to make sure the nurse was able to practise. • Only one had completed an in house induction. The record seen was not to Skills for Care standards. • They had all received back care training and one of the nurses had attended medication training. The manager said that gaps in the employment records were because they had been recruited by an agency who had carried out all the necessary checks. Copies of all checks and references must be requested by the home to keep on file. The manager said that there is an ongoing commitment to making sure that staff receive training that equips them to carry out their role. Action plans have been put in place to make sure that this happens. Training records seen and discussions with staff and the management team showed that training provision has increased over the last four months but not all staff have yet received training in all areas of working safely. Staff said that they enjoyed the training provided to them and felt that it was helping them to provide better care to the residents. They were enthusiastic about attending future training sessions. It was very positive to see that 50 of staff in the home have achieved qualifications equivalent to NVQ 2 or higher. The organisation has policies and procedures in place around equal opportunities for all employees. The manager said she would make sure that all staff were aware of them. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 23 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 and 38 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The home is now being run and managed in the best interests of the residents following internal audits that have taken into account residents and visitor’s views of how the home was being managed and their needs being met. EVIDENCE: A project manager has managed the home since January 2006 as part of the organisations plans to improve the management systems and services provided. A quality assurance/monitoring team have been in and carried out a complete audit of the home and services provided. This has included surveys of residents, relatives and visiting healthcare professionals views. The results have been made available to interested parties. They have been used to put Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 24 together an action plan to improve and raise standards of care and service delivery. A copy was given to the CSCI. It was pleasing and reassuring to see that a lot of work has already taken place and feedback from residents, their visitors and staff confirmed that things were changing for the better. The clinical deputy manager has taken on the responsibility of making sure that staff receive regular formal supervision/one to one sessions. A plan is in place, which includes dates for these meetings, it makes sure that staff will attend at least six sessions per year. Some of the care staff said that this did happen and that they found it useful to talk about training needs and any problems or ideas they might have. A new manager had been in post for three weeks and was working closely with the project and operations manager. She is a registered nurse and an experienced home manager. In the short time she has been at the home she has identified problem areas and put another action plan in place, which has prioritised dealing with issues around care practice and medication. This includes providing support and appropriate training to staff. Staff said that she was approachable and supportive and felt that some changes for the better had taken place, including improved communication systems, which would in turn make things better for the residents. An administrative deputy manager is responsible for making sure that the building is safe and well maintained. Each month he does an audit making sure that all safety checks such as fire alarm testing, hot water outlet temperature checks, bed rail checks are done and recorded properly. He also makes sure that the regular maintenance of equipment and appliances is carried out and kept up to date. He will review risk assessments as needed. A maintenance person is also employed who will do the routine safety checks and minor repairs in the home. The administrator acts as appointee for one resident at the request of the family. It is recommended that the records kept are altered in order to show clearly the amount of benefit cashed, what was paid to the home in fees and how much was given to the family as the residents personal allowance. The administrator also holds some money in safekeeping for residents. The organisations computerised system for recording the amounts of money held is used. On checking the records two residents had large amounts of money, which had been paid into a non-interest bearing account. The administrator said that she had spoken to social services for advice on looking after these people monies safely without success. Appropriate records were kept and she said she would contact advocacy services for more advice. Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 25 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 2 X 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 2 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 4 X X 4 X 3 STAFFING Standard No Score 27 2 28 3 29 2 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 X 2 2 X 3 Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 26 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. 1. Standard OP1 Regulation 4 and 5 Requirement Timescale for action 30/10/06 2. OP7 The manager must make sure that the Statement of Purpose and Service User Guide are made available to all interested parties when they have been revised. 12, 14, 15 A plan of care must be in place 31/12/06 for each service user, which details clearly how all assessed health, psychological, personal and social care needs will be met. These must show all actions taken and provide an accurate picture of the service users medical, physical, psychological and social well-being. The care plans must be kept under review and reflect changing care needs. Service users must be consulted and their wishes and feelings taken into account when planning and providing care. The service user and/or their representatives must be involved in this process where possible. (Previous timescales of March, May, July 2005 and March 2006. These were not met.) 13, 14 Appropriate assessments to DS0000055013.V292965.R01.S.doc 3. OP8 30/09/06 Version 5.2 Page 27 Springfield Nursing Home monitor service users health and psychological care needs must be carried out; this must include falls risk assessments and nutritional risk assessments that staff can understand and use properly. Records must be fully completed. Where a risk is identified appropriate action must be taken, advice sought from appropriate healthcare professionals and records kept. (Previous timescales were made for March, May, July 2005 and March 2006. These were not met.) 4. OP9 13 The registered manager must make sure that practices, procedures and record keeping around the administration of medication make sure that medication administration records are completed correctly and that prescribed medications are given correctly. The manager must make sure that all steps are taken to make sure that residents are given enough to drink. The manager must make sure that all required pre employment checks are carried out for prospective employees. Evidence that these have been done must be available for inspection. The manager must make sure that the planned training programmes are continued. They must make sure that staff receive the required training in subjects related to the health, safety and well being of themselves and residents as well DS0000055013.V292965.R01.S.doc 30/08/06 5. OP15 16 30/08/06 6. OP29 19 30/08/06 7. OP30 18 30/10/06 Springfield Nursing Home Version 5.2 Page 28 as training that is relevant to the specialist needs of residents living in the home. The registered person must take steps to make sure that the nurses are made aware of their personal and professional accountability. The manager must application to CSCI in order to undergo the registration process. 8. OP31 9 30/07/06 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. Refer to Standard OP7 Good Practice Recommendations The registered person should consider using a record sheet in order to document and acknowledge when service users and or their representatives had seen and agreed the care plans, been informed of changes and involved in reviews. (This recommendation was first made in May 2005.) The manager should make sure that the personal history and activity records are fully completed and used by staff to inform them of resident’s individual likes and preferences. This information should then be used to plan activities according to individuals needs. (This recommendation was first made in July 2005.) The manager should continue to make sure that the provision of abuse awareness and adult protection training is given to all staff. The manager should review the allocation of staff in the home in order to make sure that residents do not have to wait over long for attention. Records kept for resident’s benefits cashed by the home should show clearly the amount of benefit cashed, what was paid to the home in fees and how much was given to the family as the residents personal allowance. The start made on providing staff with regular supervision must be continued and make sure that it is given at least six times a year. DS0000055013.V292965.R01.S.doc Version 5.2 Page 29 2. OP12 3. 4. 5. OP18 OP27 OP35 6. OP36 Springfield Nursing Home Springfield Nursing Home DS0000055013.V292965.R01.S.doc Version 5.2 Page 30 Commission for Social Care Inspection Aire House Town Street Rodley Leeds LS13 1HP National Enquiry Line: 0845 015 0120 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 DS0000055013.V292965.R01.S.doc Version 5.2 Page 31 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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