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Inspection on 20/02/06 for Springfield Residential Care Home

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

This inspection was carried out on 20th February 2006.

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

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

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

What the care home does well

Springfield continues to offer service users a good standard of care in a comfortable and homely environment. The manager and care staff are clearly committed to provide service users with care and support to meet individual need. Service users bedrooms are personalised to meet individual tastes, and can include their own furniture and possessions. Service users, met during the inspection, were complimentary about the care, food and services that are provided in the home.

What has improved since the last inspection?

The system for checking whether new staff members are suitable to work with vulnerable people (POVA) has been improved. There is a new bath hoist in place, which now gives service users access to another bath.

What the care home could do better:

The kitchen facilities still need to be improved, however the manager did confirm that work is due to commence in the next two weeks to completely refurbish the kitchen. Areas of paintwork and wallpaper in the dining room and hallways and corridors need to be attended to. Two of the dining tables also need to be renovated or replaced. The providers still need to undertake unannounced recorded visits to the home. The inspector agreed to send the manager samples of two formats, which the providers may consider using for recording their visits. Fire record testing needs to be improved.

CARE HOMES FOR OLDER PEOPLE Springfield Residential Care Home 63 The Causeway March Cambridgeshire PE15 9NY Lead Inspector Andy Green Unannounced Inspection 20th February 2006 11:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 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 Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Springfield Residential Care Home Address 63 The Causeway March Cambridgeshire PE15 9NY 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) 01354 652451 01354 652451 Orchid Care Homes Ltd Mrs Carole Wood Care Home 29 Category(ies) of Dementia - over 65 years of age (29), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (29), Old age, not falling within any other category (29) Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 19th August 2005 Brief Description of the Service: Springfield provides accommodation, care, and support for up to 29 older people including those with dementia or a mental disorder. The home is a large detached property near to the centre of March. The building has been extended and equipped to meet the needs of older people, some of whom may have difficulty with mobility. Accommodation is on two floors, the upper floor being accessed via a stair lift. The home has 25 single and 2 double rooms; four bedrooms have en suite facilities. Service users have access to 8 toilets and there are 4 bathrooms, though a number are unsuitable for their purpose and the proprietor plans to remove one bath and provide a walk-in shower. Shared accommodation comprises 4 sitting rooms and 3 dining areas. There is a large well-maintained garden, which is enclosed and suitable for the needs of older people. Care staff are employed to support service users by day, and two waking staff are on duty overnight in case help is needed. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. Regulation Inspector, Andy Green undertook this unannounced inspection on 20th February 2006. The inspector met with the manager, members of care staff and service users to gather views regarding the services provided in the home. A number of records were inspected including care plans, training records and staff files. A tour of the building and grounds was also undertaken. What the service does well: What has improved since the last inspection? What they could do better: The kitchen facilities still need to be improved, however the manager did confirm that work is due to commence in the next two weeks to completely refurbish the kitchen. Areas of paintwork and wallpaper in the dining room and hallways and corridors need to be attended to. Two of the dining tables also need to be renovated or replaced. The providers still need to undertake unannounced recorded visits to the home. The inspector agreed to send the manager samples of two formats, which the providers may consider using for recording their visits. Fire record testing needs to be improved. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 6 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 Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1,3,5 The home produces a variety of information to ensure that prospective service users can decide if they wish to live in the home. Service users’ needs are assessed prior to their moving into the home, and the service is able to meet the needs of older people including those with dementia. EVIDENCE: The home has a Statement of Purpose and a service User Guide and these documents are reviewed as part of an ongoing process. The home produces information, which outlines the services provided for prospective service users who may be interested in moving into the home. The manager and a senior carer visits the person concerned and meets with family members and any professionals who may be involved, to ensure that information about the individual’s needs are obtained. Service user’s files contained information that had been gathered on each person’s needs, including pre-admission assessments along with details of the person’s history, hobbies and interests. Staff are experienced and competent and have a good level of knowledge about the general needs of older people and the people living at the home. There are aids and adaptations are available to assist service users’ needs, and Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 9 discussions with staff and residents indicated that the home is capable of meeting the needs of older people. The home is not registered to provide nursing care however, the manager stated that district nurses continue to be very supportive and carry out nursing tasks when required. New service users are admitted for a trial period of up to four weeks, after which the arrangements are reviewed to see how the person feels about the placement and ensure that the home is meeting their needs. This trial period can be extended depending upon individual need. Families of prospective service users are encouraged to make visits to the home as part of the referral process, and to stay for a meal if they wish. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 10 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): 7,8,9,10 Service users receive appropriate health and personal care to meet their assessed needs. Medication administered in the home is recorded accurately. EVIDENCE: Four service user files were inspected and they showed sufficient detail to ensure assessed needs are being met. Any changes in care are clearly documented. There was evidence that reviews are carried out regularly with any changes recorded in the care plan. It was recommended that the review sheets should be in more detail and that all entries need to be signed and dated. It is recommended that service users files should have an “Information Sheet” at the front to give more accessible information regarding each service user. A variety of healthcare professionals visit the home on a regular basis and these include district nurses, GPs and a chiropodist. The home is committed to the prevention of pressure sores and there is a supply of appropriate mattresses. The manager stated that district nurses are immediately informed if there is any concern regarding the treatment of pressure sores. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 11 Medication records were inspected and they are accurately recorded. The manager stated that training updates for staff who administer medication are organised throughout the year. It was observed during the inspection that staff assisted and spoke to service users in a respectful and friendly manner at all times. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 12 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): 12,13,15 Staff provide appropriate support to ensure that service users have access to activities appropriate to their needs. EVIDENCE: Since the last inspection the activities co-ordinator has left and the manager is currently recruiting to the post. Service users are encouraged to take part in a range of activities in the home, and trips out to places of interest. Forthcoming trips and outings are posted on the notice board, which regularly include trips to the coast, exercise sessions and games. Relatives and friends are welcome to visit at any time in accordance with service users wishes. Records relating to food show that each resident is getting a balanced, healthy diet, and the kitchen staff record individual preferences. Meals are served in the two dining areas, which provide a homely and relaxed atmosphere, though some people choose to eat some meals in their rooms. Service users said that the food was generally very good and that they were happy with the quality and quantity of the food provided. More choices are now offered at teatime and the manager stated that menus have been altered to accommodate more choice. Service users confirmed that choices were given and that snacks and drinks were available during the day and evening. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 13 Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 14 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): 16,18 The arrangements for ensuring the protection of service users from neglect or harm are satisfactory and a complaints procedure is in place. Training needs to updated regarding adult protection issues. EVIDENCE: The home has a complaints procedure to ensure that all complaints are investigated and actioned appropriately. The home has not received any complaints since the last inspection. CSCI has also not received any complaints regarding the home. The home has an adult protection policy to guide staff in dealing with allegations of abuse or mistreatment, and there is also a whistle blowing policy aimed at encouraging staff to voice any concerns. However, staff need to receive training in adult protection issues to update their knowledge and skills. Employment checks are in place, via CRB and POVA, before staff commence their post to ensure that service users are protected from potential harm or abuse. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 15 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): 19,20,21,23,25,26 The home is suitable for the needs of those living there, and sufficient equipment is provided so that service users’ independence is maximised. The home is clean and hygienic and there are no unpleasant odours. EVIDENCE: The home is close to the market town of March. The home is on two floors, with access to the upper floor via two stair lifts. The building is equipped with aids and adaptations to meet the needs of older people. The kitchen area is well organised, and generally clean, however a number of cupboard doors are worn as is the work surface. The manager stated that the required refurbishments are due to be carried out by the end of March 2006. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 16 The home has four bathrooms and eight toilets, however, not all of the bathrooms provided are accessible to older people with mobility problems and only two are currently being used. The manager said that work was still awaited to convert one of the baths into a walk-in shower. Ensuite facilities are provided in three single rooms and one double room, and each resident has a toilet near to their bedroom. The premises were clean and appeared hygienic, and there were no unpleasant odours. Bedrooms are well maintained, tidy and clean. Furniture provided appears to be comfortable and appropriate to the needs of individuals. Service users can bring personal possessions into the home including items of furniture and electrical equipment as long as they meet the relevant health and safety standards. The home is generally reasonably maintained and has a homely and comfortable atmosphere. There is however a need to upgrade a number of areas in the home which are showing signs of wear. This includes paintwork in corridors and hallways which is chipped and deteriorating and is need of redecoration with more up to date and brighter colours. It was also noted during the inspection that the two large tables in the dining area have badly worn and scratched surfaces, which gives an unkempt appearance to the room. These tables need to be replaced or appropriately renovated to give the dining area a more respectful appearance for service users and visitors. Areas of wallpaper in the dining area also need attention. It was recommended by the inspector that the manager and providers should carry out a maintenance audit and devise a programme to prioritise refurbishment and decoration that is needed on an ongoing basis throughout the year. The manager stated that she would raise this with the providers during their next visit. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 17 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): 27,28,29,30 Sufficient staff were on duty to meet the service users’ needs. Staff were clear about their roles and were competent and properly trained and experienced, so that they could meet residents’ needs. EVIDENCE: There were 4 care staff in the home including the manager, which was adequate for the number of people who they were supporting. Domestic and catering staff were also on duty, and two waking staff are on duty overnight with an on-call system to provide management support when needed. The home’s training files were seen and there was evidence to show that staff members regularly receive a variety of training in health and safety and elderly care issues as part of an ongoing process throughout the year. The manager monitors training and records showed updates to ensure safe working practice. Staff spoken to stated that they had received regular training and information including infection control, moving & handling, dementia care, medication awareness, fire safety and NVQ courses. The manager has completed an NVQ Level 4 in Management & Care and offers ongoing support to the care staff that are undertaking NVQ courses. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 18 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): 31,32,36,37,38 The home is well managed and the manager provides supportive leadership and guidance to staff to ensure that service users receive good quality care. However the providers need to record their visits to the home. EVIDENCE: The manager has worked in the home for a number of years and continues to provide a clear and inclusive style of management. She has recently completed an NVQ level 4 in Management & Care. Staff receive regular supervision to ensure their work and development needs are monitored. Staff spoken to during the inspection confirmed this and that they felt able to raise issues with the manager and they were complimentary about her management style. They also stated that they were very happy to be working in a home with a good local reputation. The providers make regular visits to support the manager but there is no recorded evidence of their visit. The providers must make unannounced visits, Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 19 which need to be recorded covering all aspects of the services provided. This was a requirement from the last inspection and needs to be actioned immediately. The inspector agreed to send copies of two report formats, which the provider may consider using to record their visits as required in Regulation 26 of The Care Homes Regulations 2001. It was also evident through conversations with care staff that they have had little contact with the providers. It is recommended that the providers should make efforts to meet with care staff when visiting the home throughout the year to gather their views about the home and the services provided. Fire records were inspected and improvements in alarm testing need to be made as there were a number of gaps in recording. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 20 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 3 X 3 X 3 X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 X 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 2 2 3 3 X 3 X 2 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 X X 3 X 2 2 Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 21 Are there any outstanding requirements from the last inspection? Yes STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1` Standard OP38OP19 Regulation 16 (2) (g) Requirement The kitchen facilities must be renewed and the requirements made by the environmental health officer must be met. This was a requirement from the last inspection; failure to comply with this requirement may result in legal action being taken against the home. The registered provider must visit the home on an unannounced basis at least once a month and a report must be provided to the registered manager and to CSCI. This was a requirement from the last inspection; failure to comply with this requirement may result in legal action being taken against the home. Staff must receive training regarding the protection of vulnerable adults to ensure that service users are protected from abuse. All entries in care plans need to be signed and dated. Timescale for action 31/03/06 2 OP37 26 31/03/06 3 OP30 13 (6) 30/04/06 4 OP7 15 31/03/06 Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 22 5 OP19 6 OP38 The home must be kept in a 30/04/06 good state of repair and decoration including furniture. The provider needs to implement a maintenance audit and devise a refurbishment programme to ensure that all areas of the home are in kept in good condition on an ongoing basis. 23 (4)( c ) Weekly fire alarm tests must be 20/02/06 (v) carried out. 23 (2) (b) 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 It is recommended that service users files should have an “Information Sheet” at the front to give more accessible information. Springfield Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Cambridgeshire & Peterborough Area Office CPC1 Capital Park Fulbourn Cambridge CB1 5XE 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 Residential Care Home DS0000037329.V277344.R01.S.doc Version 5.1 Page 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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