Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Springfield Park Residential Care Home 2 Eastern Villas Forest Hall Newcastle Upon Tyne NE12 9AE The quality rating for this care home is:
three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Thompson
Date: 0 5 0 5 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area.
Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection.
This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 27 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home
Name of care home: Address: Springfield Park Residential Care Home 2 Eastern Villas Forest Hall Newcastle Upon Tyne NE12 9AE 01912702424 01912701238 springfield_park@accreit.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Southern Cross Healthcare (Focus) Limited care home 30 Number of places (if applicable): Under 65 Over 65 30 old age, not falling within any other category Additional conditions: 0 The maximum number of service users who may be accommodated is 30. The registered person may provide the following category of which only: Care home only - Code PC To service users of the following gender: Either Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 30. Date of last inspection Brief description of the care home Springfield Park is a care home which provides residential care for 30 older people. Residents can access all areas of the home through level access or via a passenger lift. All rooms are currently used as singular occupancy. Residents have access to comfortable lounges and dining areas on both floors. Landscaped gardens surround the home and there are sitting areas outside for residents to use. Care Homes for Older People
Page 4 of 27 Brief description of the care home The home is centrally located for shops and local transport links. The fees for the home vary. further information is available from the manager. More information about the home can be obtained from the service users guide, which contains the previous inspection reports. This can be found in the main entrance of the home. Care Homes for Older People Page 5 of 27 Summary
This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: We have reviewed our practice when making requirements to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations. This will only happen when it is considered that people who use the service are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. The quality rating for this service is three stars. This means the people who use the service experience excellent quality outcomes. This was an unannounced inspection. The manager was present at the inspection. Care Homes for Older People
Page 6 of 27 Before the visit we looked at information we have received since the last inspection visit, including how the service dealt with any complaints or concerns. We also looked at any changes to how the home is run and asked for the managers views of how well they care for people. We always seek the views of people who use the service, their relatives, staff and other users of the service. This is usually given to us in the form of questionnaires. At the time of writing this report we had received six responses from questionnaires. During the unannounced visit we talked with people who use the service and some of the staff. We looked at the information about people who use the service and how well their needs are met. We looked at other records the home is required to keep and checked that staff had the knowledge, skills and training to meet the needs of the people they care for. We looked around the building to make sure it was clean, comfortable and safe. and we checked what improvements had been made since the last inspection visit. Feedback was given to the manager at the end of the visit. What the care home does well: What has improved since the last inspection? All requirements made at the previous inspection have been met. Care Homes for Older People Page 8 of 27 The external grounds have been tidied to provide more pleasant sitting areas for residents. More improvements are planned following some essential repair work to a boundary wall. The windows and some French doors have been replaced in some parts of the home. Many areas have been redecorated. The handyman has an ongoing programme of redecoration which has improved all areas for residents. Some new beds and bedroom furniture has also been purchased. New dining room furniture has been purchased, the new furniture is designed to make it easier for residents or staff to move chairs in and out from the table. This has also improved the look of the dining areas. The programme of social activities has improved. Residents are supported to achieve individual goals and maintain their independance as long as they are able. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 27 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 27 Choice of home
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are properly assessed, taking account of their needs and wishes, so that they can be assured this is a suitable home and receive an individual care service. Evidence: There are up to date service user guides and a statement of purpose for the home. These provide potential residents with information about the home and what they can expect from the service. These had been updated to include the new details of the Care Quality Commission and were being distributed on the day of the inspection. Three pre-admission assessments were seen. They contained enough information to enable staff to assess if they could meet the individual needs before admission. Information from other health professionals and carers was included in the assessment. The assessments helped to formulate the pre-admission care plan which was used to help staff meet the immediate care needs of people on admission.
Care Homes for Older People Page 11 of 27 Care Homes for Older People Page 12 of 27 Health and personal care
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive personal care that is well planned and takes account of their diverse needs. Evidence: Residents looked clean and well cared for. The manager has recently sent out some surveys to relatives. We examined the ones that were returned in April and they all indicated that they were happy with the level of care. We noted that staff reminded residents to wash their hands and helped them to keep hearing aids and spectacles clean. One resident was refusing a bath, after gentle persuasion did not work, her wishes were respected. Staff stated that they would try again later. There are bathing records in place to show when residents receive a bath or shower. These were not up to date. In one case the records did not show a bath for over two weeks. We observed that this resident did look clean, which indicated the chart had not been completed. Three care plans were examined and case tracked. This means that we spoke to the individual residents or observed their care then matched our observations to what was
Care Homes for Older People Page 13 of 27 Evidence: written in the care plan. All three case tracked care plans did reflect the actual care needed by the residents. Care plans took account of peoples diverse and differing needs and were very personal. Peoples wishes were respected, one resident wished to not be disturbed by night checks, this was recorded and a night time care plan put in place. There were care plans relating to an individuals pain and corresponding medication and another for an unusual medication that required a different eating plan. One care plan showed that a resident was at risk of losing weight and at risk of pressure damage. The care plan showed that her skin was intact and that her weight was monitored weekly. The manager has always analysed the weights of all residents in the home. She keeps statistics which show the loss and gain of weight of each person, the type of diet they are on and any contributing factors to weight loss. The manager also holds a monthly nutritional meeting with the catering staff where dietary issues and the weights of residents are discussed. This is good practice. The records showed that some people in the home had lost weight, all of these had been given a fortified diet, their weight was checked more regularly and all had a reason for the weight loss. Individual GPs were contacted to inform them of any weight loss. Some information in the plans was repeated unnecessarily, for example, one resident had two different care plans for moving and handling which gave differing advice about her capabilities. The manager stated this was because her needs had changed, staff had rewritten her care plan but failed to remove the older one. She agreed to address this with staff. One resident presented some challenging behavior which staff appeared to manage well. It did result in an altered environment for that resident as the room had to be made safe, this should have been documented and agreed in the care plan and was not. Medication ordering, administration, storage and disposal were examined. All medicines were accounted for and all those administered were signed for. Two amounts of controlled drug were checked and were correct. Medication requiring cool storage was stored in a refrigerator. This was kept locked. Eye drops and lotions were labeled with the opening date. Staff confirmed that they had received training to administer medication. Generally the medication systems were well organised. Staff were seen to treat residents politely and respectfully. Minutes of staff meetings showed that they are reminded about issues to do with residents privacy and dignity. Care Homes for Older People Page 14 of 27 Daily life and social activities
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are supported to lead a healthy and fulfilling personal lifestyle. This takes account of their wishes and diverse abilities. Evidence: Each resident has a social care plan. This describes each individuals likes, dislikes and fears, religion and beliefs, leisure, sport, hobbies and preferred relaxation. Two activities co-ordinators share a full time post. They overlap one day per week and use this period to take residents out of the home. They support residents to use a range of services within the local community. Residents are encouraged to be in control of their own lives and enjoy their own interests and hobbies. The weekly activities are posted to residents in their own rooms at the beginning of the week. There are also boards displaying activities on a daily basis, around the home. A monthly newsletter is given to residents and displayed around the home. This contains details of forthcoming events, changes in the home, items if interest, cooking recipes and quiz or word search puzzles. During the inspection relatives were discussing a recent outing with staff members. They appeared to be well informed of events in the home. Staff and the manager were
Care Homes for Older People Page 15 of 27 Evidence: seen to give good feedback to relatives about the social care people were receiving. We noted that staff did give people choice within the constraints of the running of the home. Residents were gently persuaded to eat, drink or bathe. Staff reassured residents easily and appeared to cope with some mild challenging behavior very well. Residents are encouraged to be independent, if they are able, to handle their own personal and financial affairs for as long as possible. Residents said they liked the food and that it was always good. The manager issued some quality questionnaires to relatives in April this year. The results of these showed that everyone was happy with the quality of the food and standard of catering. We ate the food at the home. It was well presented. The food was hot enough and very tasty. The standard of the cooking was very good. The home has menus based on an independent nutritional tool that devises balanced menus and promotes healthy living. Staff assisted residents to eat in a discreet and sensitive way. The dining room was very nicely set. Each table had a linen cloth, folded napkin, condiments and flowers. Menus were displayed on each table. Jugs of juice were available in all public areas. Fortifying milk drinks were also given at regular intervals throughout the day. When we arrived at the home in the morning every single orientation board, menu and information signs was up to date with the correct day, activity and menu. This is a small but important task which helps residents to remain orientated and included in daily life. Care Homes for Older People Page 16 of 27 Complaints and protection
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People who use the service are protected from harm through thorough policies, procedures and staff training. Evidence: The complaints procedure is located in the main entrance of the home. Residents told us that they knew how to make a complaint but had none to make. The manager operates an open door policy, she believes that regular communication with relatives and visitors prevents small niggles escalating into complaints. There have not been any complaints since February 2008. Staff have recieved training in the managment of complaints and adult protection issues. Adult protection training had been given to nearly all staff. The manager has a computerised prompt system to remind her when training in this area is due. There has been one issue requiring the intervention of the safeguarding team since the last inspection. This was about finances and did not involve staff in any way. The issue was reported and investigated appropriately. Care Homes for Older People Page 17 of 27 Environment
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a safe comfortable home that is generally pleasant and clean but requires some updating. Evidence: The home was generally clean and free from odours. The furniture and general decor provides residents with a comfortable homely environment. Some new dining furniture has been purchased. The dining chairs are fitted with skids which enable staff and residents to slide the chairs into the table easier. The dining rooms look very pleasant places for residents to eat. The carpet in both dining rooms present a trip hazard. It appears that they have shrunk away at the joining seem, leaving a substantial gap. Some redecoration of toilets and bathing areas has taken place and these areas continue to be updated. The floor covering in toilets and bathrooms is old. It is starting to crack and lift at the edges. As well as looking unsightly this could be a place to harbor infection and it is difficult to keep this clean. The home is very short of storage space. Two mattresses that were no longer needed were stored temporarily in the office. This is neither hygienic or satisfactory as the office is already small. Care Homes for Older People Page 18 of 27 Evidence: Some new bedroom furniture and new beds have been provided. The manager hopes to increase this to all room as some beds and mattresses are old. Bedrooms were well personalised, nicely decorated and appeared comfortable. Residents said they liked their rooms. The manager has fitted all of the bedroom doors with door knockers and letter boxes. Each resident has their name on the door. The manager reported that the residents like these and she feels it has helped people to feel better ownership of their room. The laundry is very small. There is no suitable space to seperate clean and dirty linen. Staff manage this the best they can by keeping the area very tidy. Dirty laundry is sorted into bins until it is ready to be washed. The laundry area was clean and well organised. Care Homes for Older People Page 19 of 27 Staffing
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using the service are supported and protected through staff numbers, skill and ability. Evidence: On the day of inspection there were the manager, two senior carers and two carers on duty for 29 residents. There was also two staff in the kitchen and an activities coordinator. The staff confirmed that these staffing levels were maintained in the home. Training records showed and staff confirmed that 68 of staff had achieved NVQ level 2 and essential training was up to date. The manager keeps a training plan prompt record which reminds her when training is due for individuals. Staff also have individual training and development files showing their progress and certificates for courses attended. Staff records showed that some staff had received training from the challenging behaviour team about dealing with residents suffering from dementia. There had not been any other vocational training on topics such as Deprivation of Liberty, Person Centered Care or conditions associated with care of elderly people. Three staff recruitment files were examined. These were for one newly employed kitchen assistant and two carers. All contained good information. Thorough background checks had been carried out before employment. Residents were protected
Care Homes for Older People Page 20 of 27 Evidence: through checking of criminal records information for all employees. Interviews were conducted against a person specification list to ensure fair and equal employment. The manager interviews applicants with another person present and both sign the interview record as true and accurate. All staff had received thorough induction training both related to the organisation and specific to Springfield Park. Staff appeared to put their skills acquired in training to good use. All residents spoke highly of staff and staff appeared confident and competent in their role. Care Homes for Older People Page 21 of 27 Management and administration
These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People using this service are protected through reflective management taking account of the diverse needs of the service. Evidence: The home has an experienced registered manager. She has been assessed as having the competency and skills to run the home. The manager has demonstrated good and innovative leadership skills. She has thorough systems of monitoring in place and staff are clear of the standard expected. She appears to be good at motivating staff, encouraging teamwork and rewarding success. The manager has introduced a carer of the month scheme. Staff vote for the carer they think has worked well during the past month, the person receives a gift token and their name is published in the newsletter. Residents and relatives said the home operated like a happy family and the atmosphere was friendly and relaxed. Staff spoken to were clear about their role and responsibilities. Staff were consulted
Care Homes for Older People Page 22 of 27 Evidence: through monthly meetings and the manager carries out random quality audits for staff at which she asks questions about policy and practice. The home does operate a quality assurance system. Residents, their relatives and professionals are consulted about the service provided. Residents meetings are held monthly. We looked at the minutes for these which showed residents are frequently given choices and their opinions sought. The manager also holds a monthly surgery for relatives which is not well attended but offered as an option. Staff supervisions take place bi-monthly. The manager has a system to ensure that all staff are supervised regularly. All supervisions were up to date. Servicing and maintenance agreements are in place for facilities and equipment. Risks in the environment and tasks, including safe working practices are assessed and reviewed. All fire safety checks, tests and instructions to staff are conducted at the required frequency and recorded. Fire exits were clear of obstruction and all hazardous fluids locked away. There were some safety issues raised about an external wall which borders the home and about the upkeep of the electrical systems in the home. The manager has confirmed that work has started on both of these issues. Residents personal monies are held in a pooled account with electronic records. Therefore we were unable to count individual money. The accounts are audited annually and this is about to take place. Care Homes for Older People Page 23 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 24 of 27 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 7 12 Ensure that accurate and up to date records are kept of peoples personal care needs. Ensure that care plans reflect the current needs of individuals. Ensure that any restrictive measures imposed on individuals are recorded and agreed with health professionals. This ensures residents recieve good care according to their need. 01/07/2009 2 19 23 Replace the dining room carpets. Remove the mattresses from the office and ensure they are stored appropriately or discarded. 01/08/2009 Care Homes for Older People Page 25 of 27 The home remains safe for residents to use. 3 26 13 Replace the bathroom and toilet floors. 01/08/2009 The home remains hygienic and the spread of infection is minimised. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No. Refer to Standard Good Practice Recommendations 1 19 Continue to replace beds and bedroom furniture. Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 27 of 27 - 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!
