Inspecting for better lives Key inspection report
Care homes for older people
Name: Address: Springfield Residential Care Home 63 The Causeway March Cambridgeshire PE15 9NY The quality rating for this care home is:
two star good 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: Dragan Cvejic
Date: 2 4 0 9 2 0 0 8 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. the things that people have said are important to them: They reflect 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 25 Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) 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.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home
Name of care home: Address: Springfield Residential Care Home 63 The Causeway March Cambridgeshire PE15 9NY 01354652451 01354652451 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Name of registered manager (if applicable) Mrs Carole Wood Type of registration: Number of places registered: Orchid Care Homes Ltd care home 29 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 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. Care Homes for Older People
Page 4 of 25 Over 65 29 29 29 0 0 0 Brief description of the care home 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. Care Homes for Older People Page 5 of 25 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: two star good 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: The last inspection was carried out on 27/11/2006. After reviewing the service through annual service review on 31/10/07, the home continued to provide very good service for people that were cared for and supported in Springfield. We constanly monitored service through reporting activities. We asked users of the service, their relatives and staff to fill in questionnaires about the quality of service and received a good response. One staff, 4 relatives and 5 users returned their comments. We visited the home on 24/09/08 and spoke to 5 people living there, two visitors and the manager. We case tracked three people, users of the service. This means we checked the information about them contained in records. Care for them at the time of visits was observed and we collected comments from some of their relatives. We also Care Homes for Older People
Page 6 of 25 observed care practices in the home, checked the environment by walking through the home and talked to the manager. Attending the staff meeting during the site visit was a real pleasure, as the approach to individuals, care and details of provisions were outstanding. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking Care Homes for Older People Page 8 of 25 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.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 25 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 25 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. Service users were given the opportunity to decide if the home was to be the place they wanted to move into and that their needs would be met if admitted. Evidence: The information about the home in their statement of pupose and the users guide was reviewed and updated. They also reviewed their admission procedure and this was addressed in the Annual Service Review too: They concluded that the admission process was good, as it indicated to the home and to potential users if their assessed needs could be met. The files checked also showed that initial assessments were carried out comprehensively and covered all relevant areas. All responses received confirmed that users needs were met. On the question of what the care home does well a relative responded simply stating: Everything. The attention to detail was recorded during a staff meeting when staff were instructed to unpack and prepare toilet rolls when they replace them, as some users were not
Care Homes for Older People Page 11 of 25 Evidence: able to do so themselves. Another detail related to how the toilet rolls are hung, facing outward, so that users could more easily use them. Care Homes for Older People Page 12 of 25 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. Service users health care needs were appropriately dealt with and recorded, which enhanced the respect shown to users exceeded minimum standards in some areas. Evidence: Detailed care plans ensured that staff applied the agreed and set procedure each time they helped or supported individuals. For example a description of how the user held his magazine while walking with his walking frame clearly identified when staff needed to intervene to help him. Food preparation adjusted to individual needs was described by the user: I cannot eat solids, so they know that and liquidise my meals. Care plans were signed and regularly reviewed. Potential improvements could be recorded on care plans if the individual users were not able to sign them. Another user stated in regard to health care support: Very good attention from a community nurse attached to my GPs surgery. Medication storage, administering process and records were checked. Apart from the recording of medication brought forward on the same sheet to accommodate easier
Care Homes for Older People Page 13 of 25 Evidence: audit, rather than referring to previous sheets, all the other elements were appropriate. An audit of medication for three case tracked users was carried out and all findings were accurate. Privacy and dignity were highly respected. Observing staff helping three users during the visit confirmed that staff were patient, respectful and knowledgeable. The manager was observed helping a user to fix the stretching bandage on her knee. A relative commented that he obtained a phone for his mother in the home, so they could keep in regular contact in private. Another improvement resulted from a consultation with users of the service and was addressed in the Annual Service Review: The home analysed comments from service users and changed the way in which the laundry service operates. Now, the day carers, who were more familiar with service users than the laundry staff, were returning laundered items to each individual, thus reducing mistakes and potential losses of users items. Care Homes for Older People Page 14 of 25 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. Staff provide appropriate support to ensure that service users have access to activities appropriate to their needs and excellent meals and choice determined the excellent rating. Evidence: The home provided various activities, but, as in many good and excellent homes, this area was considered for further improvements. The majority of responses in questionnaires indicated that the home provided activities, but gave suggestions such as: My mum was offered the choice to join, but she needs more encouragement to take part in activities, rather than to stay in her room to watch TV and to join the church service once a week. A user of the service stated: Activities are good. I dont like bingo, but I have plently of books to read. Community contacts also were good and many visitors were coming in on a daily basis. Some relatives were attending a church service together with users of the service. Individual records of activities helped the home identify which individuals enjoyed a full range of provisions and those who either did not want to join or were incapable of contributing due to their condition. Autonomy and choice were both well recorded in individual files and observed during
Care Homes for Older People Page 15 of 25 Evidence: the site visit. I want to have milk and a banana for breakfast and they always give it to me, stated a user spoken to during the site visit. Menus were varied and most comments rated food as excellent. All users spoken to considered the food to be excellent. Care Homes for Older People Page 16 of 25 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. The service users felt empowered and trusted and were provided with clear opportunity to voice their potential concerns and complaints. Evidence: There were no complaints since the last inspection, no allegations and no referrals to POVA (Protection of Vulnerable Adults) register. The complaints procedure was displayed in the hall and was clear regarding the procedure and potential investigation, giving a clear time scale for each phase. Two complaints were fully investigated and positive outcomes reached by the time of Annual Service Review, with no further complaints since then. All new users were asked to sign that they received a written complaints procedure. Robust and clear procedures protected users of the service from any kind of abuse. The staff training on protection also helped ensure the safety of users of the service. Care Homes for Older People Page 17 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a pleasant, clean and comfortable environment where service users could retain their level of independence. Evidence: The home offered a comfortable and homely environment to the people that used this service. The home was clean, bright and appropriate for users needs. Users were particularly happy with the fact that they could bring in their own pieces of furniture, creating a homely feeling. The home had infection control measures in place. However, the staff meeting addressed several issues and proposed action on how this could be improved. The Annual Service Review recorded some improvements since the last inspection: A new boiler improved the situation with previously raised hot water problems. New carpets in some areas confirmed that the on-going replacement plan worked well. Some comments, especially from relatives, also provided a constructive suggestion as to improving the cleanliness of rooms flooring, installing sanitising dispensers in toilets and bathrooms and similar areas. The manager was aware and was negotiating with staff how to introduce improvements to ensure the effectiveness of interventions and considering financial implications whilst least affecting service users. Care Homes for Older People Page 18 of 25 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. Well trained and organised staff were able to meet the users needs and to feel satisfied with their terms and conditions of work. Evidence: All comments received in questionnaires stated that staff were excellent. The comments received during the site visit were the same. However, the manager stated that they had just completed a round of recruitment and hoped to see new staff starting when all checks were completed for them. This comment explained the suggestions from relatives that more staff were needed to expand activities and engage users of the service more in the construction of the daily routine in the home. One comment also suggested that users could spend more time together rather than just at weekly meetings, mealtimes and a church service once a week, but carried on by commenting that more staff were needed for this to happen. The home already had about 50 of staff that held NVQs, but new entrants for this training for the forthcoming year was their step to exceeding this standard. Recruitment was done according to the procedure and included all necessary checks on staff. At the Annual Service Review the evidence was concluded with the statement: There was a plan to introduce in-house, DVD facilitated training that would allow the manager and her deputy to conduct training, improve attendance and reduce costs
Care Homes for Older People Page 19 of 25 Evidence: without affecting the quality of training. This was now achieved and both the manager and her deputy were providing in-house training for staff. Care Homes for Older People Page 20 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Service users were well protected by the safe working practices in place. Evidence: The manager completed her RMA (Registered Managers Award) and the training for trainers, thus ensuring better training for the whole staff team. Her skills and knowledge affected the whole atmosphere in the home. Staff felt supported and motivated. This was observed during the site visit. Quality assurance was a tool for the home to collect individual views of users and their relatives, they also asked visiting professionals to comment on the services provided for people living in the home. A user spoken to stated that she was happy to have a small amount of money with her and that the home kept some money securely locked away. Three records of the money belonging to people that use the service were checked and were accurate to the penny, with all receipts kept with the records. Staff supervision was provided regularly. The process was cascaded so that a deputy
Care Homes for Older People Page 21 of 25 Evidence: was providing supervision to the floor staff. Safe working practices were in place. All mandatory training was up to date. Health and safety responsibilities were clearly delegated and the manager and her deputy knew exactly what their individual responsibilities were. Service users were protected by safe working practices that all staff were fully aware of and respected policies and procedures. Care Homes for Older People Page 22 of 25 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 23 of 25 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 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 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk 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 © (2008) 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 25 of 25 - 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!
