CARE HOMES FOR OLDER PEOPLE
Springfields Easthorpe Road Copford Green Colchester Essex CO6 1DH
Lead Inspector Clare Walker Unannounced 25 May 2005 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. Springfields Version 1.10 Page 3 SERVICE INFORMATION
Name of service Springfields Address Easthorpe Road Copford Green Colchester Essex CO6 1DH 01206 212261 01206 213238 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) Springfields Residential Homes Limited Mrs Patricia Ann Green Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Springfields Version 1.10 Page 4 SERVICE INFORMATION
Conditions of registration: Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) Date of last inspection 17/11/ 2004 Brief Description of the Service: Springfields is a residential home providing care for up to 16 older people. The home is located in the village of Copford, close to Marks Tey where there are shops, a train station and access to the A12.Springfields is a three storey building previously a house. It has 16 single en-suite rooms. On the ground floor are communal rooms two lounges and a dining area. There is a passenger lift to reach the upper floors.The home has extensive, landscaped gardens to the rear of the property and ample visitor parking at the front of the house. This unit does not accommodate wheelchair users.Adjacent to the home is a nursing home managed and owned by the same company. Laundry and catering facilities are shared between the two establishments.. Springfields Version 1.10 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. What the service does well:
Springfields offers a good standard of care to the people who live there. The environment is of a high standard, both the fabric of the building and the fixtures and fittings. The residents said that the staff were “kind and helpful”and “dedicated”. The majority of the staff group have worked within the home for some years and describe the team “getting on well and that nothing is hidden”. The communication between staff and managers and between staff and residents was described as “open and good.” Overall the food was said to be “good” and that sampled on the day was balanced, wholesome and well presented. “Visitors are welcome at anytime” and are made to feel at home, “my son commented on the warmth of this home the first time he came here.” On recent thank-you letter to the manager from a resident about a recent event referred to “Springfields togetherness.” . This was an unannounced inspection that took place over 6 hours. The inspector spoke to 5 resident’s, the manager, the proprietor and 2 care staff. A tour of the premises took place. Care records were inspected as were management records. What has improved since the last inspection? What they could do better:
The main area for improvement is in the area of risk assessment. That is when risks are identified for example self medication that an assessment is made of the risk of allowing an individual to control there own medicines and all actions that have been taken to reduce that risk. These assessments need then to be reviewed on a monthly basis.
Springfields Version 1.10 Page 6 Please contact the provider for advice of actions taken in response to this inspection. The full report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfields Version 1.10 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 Standards Statutory Requirements Identified During the Inspection Springfields Version 1.10 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 standard(s) 1,3,4,5 this service not offered. N.B 6 People wishing to live at Springfields are given clear information to inform their choice. Needs are assessed and the manager will ensure that the needs identified can be met. This is discussed with service users and their representatives prior to moving in. all prospective residents are invited to visit and take up a trial period of accommodation prior to deciding to move in on a permanent basis. EVIDENCE: There is clear information that each person is given when they view and move into the home. Assessments of needs are to be found on service users files. Residents said that they had visited as had their families prior to moving in. Springfields Version 1.10 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) 7,8,9,10 The care needs are met and reviewed. EVIDENCE: The health, social, personal care needs of individuals are set out in care plans and these plans are comprehensive. All care plans are regularly reviewed to ensure that needs are met. Medication training has been undertaken by those staff who manage medication and some residents manage their own medication. Practice observed and feedback from service users demonstrates that individuals are treated with respect and their privacy is upheld. There are risk assessments but these need to be inproved. Springfields Version 1.10 Page 10 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) 12,13,14,15 Residents social and emotional needs are met and service users are encouraged to maintain contacts with people outside the home. Individuals can exercise choice in their lives. Food offered is balanced and wholesome. EVIDENCE: In discussion with service users both individually and in a small group people felt that this home offered them a good standard of care. Several commented that residential care is not the same as being in your own home and that “all of us are different not going to make all of us happy all of the time.” There are activities offered music and movement, crosswords, entertainments, a recent special dinner, and a planned strawberry tea. “Families and friends are welcome at anytime.” Many people have their own telephones. The grounds around the unit offer a safe extensive garden area for walking and enjoying the fresh air. Residents confirmed they have choice over rising and bedtimes and how and where they spend their time. Food sampled was a wholesome, balanced and well presented meal. Residents commented that they would like more fresh vegetables but also that the food had improved over the last 3 months or so. Springfields Version 1.10 Page 11 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) 16,18 Residents have a clear complaints system which is publicised and that they are protected from abuse. EVIDENCE: There is a clear system for complaints and there are currently no outstanding complaints. Several residents said that the manager was supportive and approachable. The manager was seen as the person to approach to make a complaint. Staff have received training about the abuse of older people and were able to discuss their knowledge with the inspector. Springfields Version 1.10 Page 12 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) 19,20,23,24,25,26 The environment of this home is well maintained, providing a safe and accessible space to residents within the home and the grounds. EVIDENCE: The home is bright warm and airy. There is a welcoming atmosphere. All furnishings, fitments and fittings are of a high standard. For example the radiator covers have been individually made to be in keeping with the home. All the rooms within the home are slightly different and all residents whose rooms were seen had personal possessions including pieces of furniture in them. The residents also had their own telephones, tv’s and radio’s. Springfields Version 1.10 Page 13 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) 27,30 There are sufficient number of staff, who have a variety of skills who are competent to their jobs. EVIDENCE: The rota showed that there are 3 staff in the morning shift, 2 on the afternoon shift, 1 waking night staff and 1 person sleeping on the premises. In discussion with the staff and the manager the level of training was clear with all staff having regular and basic training and over 60 of the staff holding an NVQ 2 award or higher. Staff use skills to offer different activities within the home for example on member of staff does music and movement activities another offers hand and nail care. Staff said that they “enjoyed their work, one having recently been recruited choose to apply to this home having worked at several homes on an agency basis. Springfields Version 1.10 Page 14 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) 31,32,33,36 The home is managed in a way that has the needs and interests of the service users as paramount EVIDENCE: The manager is a competent person with the skills and knowledge necessary for the task. Both residents and staff spoke of her “openness and support”. Staff said that she communicated well with them and gave them feedback. There is formal staff supervision. Records and discussion with the manager show this is just beginning and will need to be developed to ensure the standard of 6 formal supervision sessions per year per member of the care staff team is met. l
Springfields Version 1.10 Page 15 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. Where there is no score against a standard it has not been looked at during this inspection. 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 3 x 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 3 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3
COMPLAINTS AND PROTECTION 3 3 x x 3 3 3 3 STAFFING Standard No Score 27 3 28 x 29 x 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 3 3 x x 3 x x Springfields Version 1.10 Page 16 yes 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 OP7 Regulation 13(4) Requirement The registered manager must ensure that 1) where a risk/s is/are identified that a risk assessment is undertaken with the resident and recorded 2) actions to reduce the level of risk identified are also recorded 3) all risk assessments and actions are reviewed monthly alongside the care plans. (Timescale of 30/01/05 not met) Timescale for action 30/08/05 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. 2. Refer to Standard OP16 OP27 Good Practice Recommendations The outcomes of informal matters for example lost items are recorded. the staff rota indicates who is the shift leader for each shift and who is the person on call out of hours. Springfields Version 1.10 Page 17 Commission for Social Care Inspection Fairfax House Causton Road Colchester Essex CO1 1RJ National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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