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Inspection on 15/08/05 for Springfield Nursing & Residential Care Home

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

This inspection was carried out on 15th August 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

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

The home provides high standards of care in a well-maintained environment.

What has improved since the last inspection?

Since the last inspection the home has been extended two of the bedrooms to provide better ensuite toilet facilities and access to the garden. There is an ongoing redecoration programme that maintains the environment to a high standard.

What the care home could do better:

The residents spoken with could not think of anything that the home could do better. The home would benefit from completion of the programme to have the radiators covered.

CARE HOMES FOR OLDER PEOPLE Springfield Nursing & Residential Care Home 74 Havant Road Emsworth Hampshire PO10 7LH Lead Inspector Martin Bayne Unannounced 15.08.05 9:00am 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 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 & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springfield Nursing & Residential Care Home Address 74 Havant Road, Emsworth, PO10 7LH Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01243 372445 Springfield Health Services Mrs D Redmond CRH 25 Category(ies) of OP - 25; registration, with number of places TI(E) - 25 Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. Staffing levels apply 2. No more than 6 beds may be used at any one time for service users who are only in need of personal care Date of last inspection 23.11.04 Brief Description of the Service: The home is owned by Springfield Health Services Ltd and is registered to provide accommodation and personal care for 25 people with frailty of old age or people over 65 with a terminal illness. The registered manager also manages the residential home of 35 beds situated across the small access road that separates the buildings. The home has three floors accessed by stairs and also a passenger lift. The home has one shared room, the others being for single occupancy. Residents of the home share communal areas of two shared lounge/dining areas. A wellmaintained garden leads from the lounges on the ground floor. Two of the downstairs bedrooms also lead into the garden. The home has sufficient bathrooms and toilets to meet needs of residents. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The paper work pertaining to one resident was chosen to track through admission procedures, care planning and other required recordings that the home is required to maintain. All the paperwork was found to be in order, coherently formatted and reflected good practice. Health needs of residents were found to addressed appropriately. During the inspection 6 residents were spoken with and positive comments were made about the quality of food provided, the friendliness of the staff, the cleanliness of the home and the high standards maintained on the home. Residents also felt that there were sufficient staff to meet their needs and to answer their call bells. The recruitment records for one member of staff were inspected and the required checks and procedures had been carried through. What the service does well: What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 6 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 Standards Statutory Requirements Identified During the Inspection Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 7 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 standard(s) 2, 3 &5 Residents’ benefit from being appropriately assessed before being offered a trial period at the home. The are also informed about the home through a contract detailing the terms and conditions of residence. EVIDENCE: A pre-admission assessment is carried out with all prospective residents. They are invited to visit the home when the assessment is carried out with the. In cases where it is not possible for the person to visit, the manager or deputy carries the assessment process in the persons home or hospital. Should the person choose to move to the home, they are offered a four week trial, to see if there needs can be met and also for the person to decide whether they like living at the home. The home has a procedure that within 48 hours of admission a full assessment is carried out and a care plan developed with that person. The records concerning one resident were inspected and it was found that these procedures had been carried through. The preadmission assessment covered health, social and emotion needs and a Bartel scoring system to provide a baseline scoring of their care needs. The full assessment carried out once the person is Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 8 admitted gave a fuller and more detailed account of the person’s needs than the pre-admission assessment. A resident spoken with said that their relative had helped find the home on their behalf. All of those spoken with said that their needs were met at the home and were very happy with the service they received. A copy of the contract for the resident tracked through the inspection was on file. The resident and a representative of the home had signed this document, which detailed the terms and conditions of residence and the fees to be charged. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 9 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 standard(s) 7, 8 & 9 Residents’ health needs are fully met and medication administered safely through comprehensive care plans and risk assessments. EVIDENCE: A care plan is developed within 48 hours of a person being admitted to the home and risk assessments also carried out. The care plan for the resident tracked throughout the inspection provided a full account of their care needs and provided sufficient information for a new member of staff to provide care to that person. It was agreed that a front sheet would be included in this documentation, which a resident or their relative would be invited to sign to verify their involvement in this process. The residents spoken with said that the staff were aware of their needs and the assistance that they required. Residents who were unable to communicate looked well cared for and relaxed with the staff. A generic risk assessment form covering issues that affect all residents is completed, such as risk of falls and then additional specific risk assessments particular to that person are added. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 10 All of the residents are registered with a GP. With the majority of the residents coming from within the local community, they retain their family GP. The nurses within the home carry out nursing needs concerning residents. Springfield Health Services employs a physiotherapist each Tuesday, who advises and works with the staff. A record of falls is kept with respect to each person and an in depth assessment carried out should a person have a succession of falls. The staff then work with the physiotherapist to assist this person. The deputy manager reported that the home had good links with community psychiatric nurses and other statutory agencies. One resident in the home has been referred to a dietician. Other health needs, such as chiropody, dentistry and eye care were documented on the care plans and attended to. The medication administration procedures were discussed, the storage areas inspected and the records for the resident tracked, inspected. The home has a system for the ordering of medication from the local pharmacist. Medicines are administered from the bottles and packages supplied by the pharmacist. The trained nurses in the home administer medicines to residents and their sample signatures are kept on the front of the recording book. The home has a medication trolley that is kept locked and also locked to the wall when not in use. There is also a locked cupboard where surplus medication is stored. A small fridge for storing medicines that require refrigeration is sited in the nursing office. The trained nurse on duty has responsibility for the keys each shift to the trolley and the medication cupboard. The medication administration record for one resident was inspected and it was found that this had been completed correctly with no gaps within the record. A record is also maintained of medicines returned to the pharmacist. The system therefore allows for a full audit trail of all medicines that enter the home. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 11 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 standard(s) 12 & 15 Residents are provided with opportunity for occupation and activities as well as a good standard of food. EVIDENCE: A list of activities for the month ahead is displayed on the notice board in the home as well as a fuller notice of all activities and things of interest being held for the week ahead. One member of staff at the home has the responsibility of organising activities and outings. For the month of August entertainers were booked to entertain in the home, trips out arranged as well as weekly activities such as music and movement organised within the home. A resident spoken with said that since moving to the home they had progressed from being bed bound to being able to go out on trips from the home. On the day of inspection a Holy Communion service was being held within the home by visiting clergy. Residents spoken with all said that the food was of a good standard and that there was plenty to eat. Menus are prepared the day before for the main meal for the following day. Residents can choose from a choice of two hot meals or a cold meal. A starter is also offered, either home made soup or fruit juice. Residents can also choose their dessert, either a homemade pudding, a yogurt or cheese and biscuits. Specialist diets are catered for if these are required. Residents can have breakfast when they choose and hot evening meal is offered. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 12 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 standard(s) 16 Residents’ benefit from a well publicised complaints procedure. EVIDENCE: A copy of the complaints procedure is detailed within the contract, a copy of which is given to each resident. The complaints procedure is also displayed on the residents’ notice board in the home. The procedure gives the address of CSCI should a person be unhappy with the way the home has managed their complaint. Since the last inspection there have been no complaints made to the management of the home and none have been brought to the attention of CSCI. The management of the home has demonstrated commitment to ensuring safety and protection of residents from any form of abuse through enacting adult protection policies and procedures. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 13 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 standard(s) 19 Residents’ benefit from a well-maintained, clean and well decorated environment appropriate to their needs. EVIDENCE: Since the last inspection the home has extended two of the downstairs bedrooms to provide better ensuite toilet facilities and to also to provide access to the garden area. The home is well maintained and was found to be in good decorative order throughout. The home was also found to be clean and residents remarked that this was always the case. The building is suited to meet it aims and objectives with a passenger lift to the floors above the ground level. There is a well-maintained garden that accessible to the residents from the lounge area. The inspector was invited into one resident’s room during the inspection and it was evident that residents are able to bring their own personal possessions and items of furniture into the home. A vacant room was also seen, which contained the required furniture. Bedrooms have door locks and residents are able to lock their room if they choose. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 14 Hot water outlets to the shower and baths have been fitted with thermostatic mixer valves to protect residents from scalding from hot water. The home has agreed a programme with CSCI for the covering of radiators and all of the high-risk radiators have now been covered. The directors gave an assurance that all radiators would be covered by the end of the year. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 15 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 & 29 Residents’ benefit from a caring staff team recruited through appropriate procedures. EVIDENCE: The registered manager and deputy manager of the home also have responsibility for the management of the residential home, No. 72 across the roadway. The home employs six registered nurses and a team of health care assistants. Between 8am and 8pm there is a registered nurse and three health care assistants on duty. From 8pm until 8am there is a registered nurse and a health care worker on duty. The home also employs between 8am to 4pm a cook and two kitchen assistants and then one kitchen assistant from 5pm to 8pm. In addition the home employs laundry staff, a financial clerk and an administrator across No. 72 & 74. Residents spoken with said that the levels of staff were sufficient to meet their needs and to answer their call bells when they required assistance. They also spoke highly of the staff in terms of their being polite and kindly. The recruitment records for one member of staff were inspected. Recruitment is by was of completion of an application form, taking up of two references, obtaining a Criminal Records Bureau check and validating a person’s identity against recognised documentation. It was agreed that the staff application form be updated to request a full employment history and a reference from the applicants last place of work with vulnerable adults. All the records were on file for the staff member’s file sampled. There was also a record of the training undertaken by this member of staff, which was appropriate to their role. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 16 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 The home is well managed. EVIDENCE: The home is owned by Springfield Heath Services Ltd. Each month a report required under Regulation about the conduct of the home is sent to CSCI. It was reported that the directors also maintain a high profile in the home, visiting at least twice a week. On the day of inspection the inspector met with two of the directors who were visiting that day. The deputy manager of the home assisted the inspector throughout the inspection. The registered manager has an NVQ level 5 in operational management and completed the registered manager’s award. The deputy has also just completed the registered managers award and is awaiting verification for NVQ level 4. The residents spoken with said the home was managed well and that there was a positive feel within the home. Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 17 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x 3 3 x 3 x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 3 x x x x x x x STAFFING Standard No Score 27 3 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x x x x Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 18 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 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. Refer to Standard Good Practice Recommendations Springfield Nursing & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 19 Commission for Social Care Inspection 4th Floor, Overline House Blechynden Terrace Southampton SO15 1GW 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 & Residential Care Home H54 S11519 Springfield Nursing V245395 150805 Stage 4.doc Version 1.40 Page 20 - 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. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!