Inspection on 03/05/07 for Springfields

This inspection was carried out on 3rd May 2007.

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

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

Other inspections for this house

Springfields 19/05/06

Springfields 24/01/06

Springfields 03/10/05

Springfields 29/09/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Queensmount

Poldhu

Trevaylor Manor

Didsbury Court Rest Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Springfields Bridestowe Okehampton Devon EX20 4ER Lead Inspector Anita Sutcliffe Key Unannounced Inspection 3rd May 2007 07:30 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 Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfields Address Bridestowe Okehampton Devon EX20 4ER 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) 01837 861430 01837 896430 springfields.bridestowe@virgin.net Mr Byrne Mrs Byrne Mrs Byrne Care Home 34 Category(ies) of Dementia - over 65 years of age (34), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (34), Old age, not falling within any other category (34), Physical disability over 65 years of age (34) Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th May 2006 Brief Description of the Service: Springfields is an old Rectory on the edge of the village of Bridestowe, 7 miles from Okehampton. The village has a vibrant community and facilities including, shop/post office, pub and church. The home provides accommodation and personal care for 34 older people who may have additional physical disabilities, dementia or mental disorders. It is privately owned and managed. The district nursing service provides nursing input as necessary. Many of the bedrooms have sufficient space to be used as sitting rooms. All have en-suite toilets and some also have en-suite shower rooms. A number of the bedrooms have French windows on to balconies or patios. There are three large lounges, one with a conservatory extension that is used for dining. A separate dining room and a separate seating area are located at the front of the house. Level access is available throughout the home. Information provided April 2007: Fees are between £306 and £470 per week. Additional charges are made for items other than accommodation, meals, personal care and laundry. This includes personal lockable storage and key operated door locks in bedrooms. Prospective residents are sent copies of the Service User Guide. Then they are invited to visit if they wish, and are informed that CSCI reports are available for inspection either in the office or online. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key inspection was to check the home’s compliance with the National Minimum Standards for Older People. Prior to the inspection the home provided current information on the service. We also sought opinion form health and social care professionals in regular contact with the home, but no response was received. The care of four residents was examined in detail. This involved reading their care records, meeting them and visiting their room. Other residents gave their opinion on the service. Discussion was held with staff and the registered providers and staff were observed going about their duties. Recruitment and medication records were examined. What the service does well: What has improved since the last inspection? All staff now have safety checks completed before they are employed at the home. This protects residents from people unsuitable or unsafe to work with vulnerable adults. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 6 Staff have now received training in protection of vulnerable adults from abuse and training in dementia care is planned for the autumn. This should ensure staff are up to date with current good practice in the care of people with dementia. Security, and the handling of medication, is improved. We made one recommendation for additional resident safety. Care plans examined had all been reviewed and the information within them was up to date. This ensures staff understand what is wanted and needed by the resident and ensures they work in a consistent way. Bedrooms have been redecorated and bathrooms redecorated and retiled to ensure they are kept in a good state of repair and attractive to use. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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 Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 3 & 4 (Standard 6 does not apply to Springfields) Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents know that their needs and wishes are understood prior to admission and that the home will be able to meet them. EVIDENCE: The care of a recently admitted resident was examined. She said had chosen the home because of its good reputation and because she had known some residents and staff. She said the home was very good and could think of no way it could be improved. In particular she liked to see the birds and fowl in the garden, reminding her of farm life; she said she was a “country lass”. Assessment records gave staff sufficient detail that they were able to produce a plan of care, which includes physical and emotional health and activities of Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 9 daily living. There was a record of past ill health and concerns, plus risks that need to be managed. Conversation confirmed that health needs were being met and the written assessment was an accurate record of her needs and wishes. The building is very suitable for accommodating the needs of residents with a physical disability; equipment is available to increase independence. The ethos of Springfields ensures that the emotional needs of residents with mild dementia are well met. Staff were observed interacting with residents in a respectful and kind manner. Initial staff training includes care of people with dementia and the manager said there is further training planned for the autumn. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Residents receive a high standard of health and personal care because it is well planned and organised. They live in a home where they are respected and treated with dignity. The handling of medication is safe and done in the best interest of residents. EVIDENCE: The care of four residents was examined in detail. This involved meeting them and examining their care records. Residents said they felt well cared for and the standard of personal care appeared to be high. One very frail resident was receiving frequent care and the monitoring of her health was of a high standard. Records kept by staff ensured all necessary information was available. The home ensures that Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 11 external health care experts are fully involved where necessary. Staff said how impressed they are with the standard of health care at the home especially the amount of expert advice sought from hospital and community services, such as district nursing, podiatry/chiropody and dentistry. The standard of all health care monitoring at Springfields is very high. This enables residents to maintain their health and wellbeing. Staff know each resident well and are sensitive to their individual needs. This ensures that residents who are less likely to communicate their needs verbally also receive all necessary care. There is now a medicines trolley from which medicines can be administered safely around the home. All medicines were safely stored and handled by staff trained to do so. Where a resident is able and wishes to look after their own medicines the home supports them with this. When a resident wishes the home to do this for them it must be clear that their consent has been given. The medication records were clear with audit of medicines possible. This helps to safeguard residents from mistakes. However, where there is a variable does of tablet the actual dose given must be recorded. Needs may then be properly assessed when their health is being reviewed. Staff show respect for residents, who looked relaxed and happy in their company. They said staff treat them as they wish to be treated. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are supported to enjoy a fulfilling lifestyle and follow interests. Residents enjoy a nutritious varied diet, which meets individual preferences and health care requirements. EVIDENCE: The home has a relaxed atmosphere and residents have the use of several lounge and communal areas/sitting rooms. There are large windows overlooking the manicured lawns on which geese and goslings were seen, the view enjoyed by residents. There is also a patio area with shade and seating, seen being used. Many activities are available. These include card games, quizzes, library books and newspapers, an outing for a cream tea, another to bluebell woods. Staff take residents to the village where there is a shop/post office, village pub and church. There are Anglican services held at the home, meeting all current Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 13 spiritual needs. During the inspection we saw a visitor who brings dogs for resident to pet. Their owner said this is a regular arrangement. The home provides occupational therapy on a daily basis. This includes seated games and cooking. A resident said she likes to help staff by laying the dining tables. Resident’s rooms contain personal items and some have a fridge for personal food storage. Residents are supported to live life as they wish. Residents said they are able to make lifestyle choices, such as when to get up or go to bed. The home sets routines, such as meal times and bathing schedules, but manages to meet any individual preference. Records are kept of activities to ensure each resident has opportunity and their needs met. Staff felt the amount of activities provided was “brilliant”. Residents said they were very satisfied, one saying she likes to spend time alone and staff respect this. Visitors are made welcome at the home and may visit any time. Some stop for meals and all are offered tea and biscuits. Three residents confirmed the meals are “very good”. The main meal is set, but individual preferences are recorded and there is an automatic second choice when the main meal is curry or liver. Fresh vegetables and local meat are used; the quality reported by staff to be very good. On Wednesdays there is a ‘sherry morning’ and wine is served Sundays. Diet is well monitored at the home so as to optimise health. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 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. JUDGEMENT – we looked at outcomes for the following standard(s): 16, 17 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints to the home would be taken seriously and acted upon immediately in the resident’s best interest. Residents’ rights are protected. Residents are protected from abuse through the home’s policies, procedures and staff concern for residents. EVIDENCE: Residents said that they felt safe at the home and watching them with staff confirmed a confidence and friendliness. None could think of why they should need to make a complaint. No resident or staff member could identify any way the home could be improved. Staff said that any concern or issues would be dealt with promptly, and the providers use their quality measuring system to prevent problems arising. We have received no complaints, concerns or allegations about the home and the home have received no complaints in the past 12 months. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 15 Staff have now received training in the protection of residents from abuse. This is also part of staff induction, so all new staff should be aware. Staff said they had found the training useful. Staff knew where to find the Whistle Blowing and Prevention of Abuse policies at the home should they wish to consult them and were aware the Commission could be consulted. Residents wishing to vote in the local elections have mostly chosen the postal vote. One resident, choosing to visit the poling station, was able to do so. Residents are helped to maintain their legal rights as citizens. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 16 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. JUDGEMENT – we looked at outcomes for the following standard(s): 19 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is safe, well maintained and meets current residents needs. Residents enjoy a home which is very clean, and the high standards of hygiene protect them from infection. EVIDENCE: The home is bright, fresh and airy, having many different spaces where residents can meet socially or spend more private time. Residents said it was very good. The home is spotlessly clean and hygiene is very well managed. There is an excellent supply of equipment for residents and staff use, such as liquid soap, Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 17 disposable hand towels and cleansers. The laundry is quite large, providing space to separate soiled laundry from clean. It is very well equipped with commercial washing machines and dryers. Being an old building, the floor and walls of the laundry are of a material not easily cleanable, but the room was clean. Bedrooms are very individual in size and content, some being like miniapartments. They do not have key styled locks or lockable storage space unless requested and paid for. Do date nobody had requested a lock for their door. The space available throughout the building is excellent for residents who must rely on a wheelchair. Adaptations help independence and coloured carpets help those with dementia to find their way about effectively. The majority of radiators have been covered to protect residents from contact burns. Those remaining are in communal rooms. Window opening restrictors, which would protect confused residents from falling out, have now been fitted, but one was found to be faulty. This was dealt with promptly. Bathrooms have been redecorated and retiled in a domestic style and looked attractive and comfortable. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 18 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. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The numbers and competence of care staff ensures the care needs of current residents are well met, but ancillary staff training should also be broad to protect them and help meet residents’ specialist needs. Residents are protected by robust recruitment practice, which prevents people unsuitable to work with vulnerable adults working at the home. EVIDENCE: Residents and staff said the staffing numbers are satisfactory. Staff spoke with passion about the job they do and the care of the residents. They could think of no way the home could be improved and were very satisfied with the training and support they receive, saying: “Any reasonable training we request is permitted; training is very much encouraged”. Staff were observed to be professional in the way they went about their work, and respectful and friendly when interacting with residents. The registered provider reports that 68 of staff have achieved a National Vocational Qualification (NVQ) in care, this being an indicator or their competence. Residents said they had complete confidence in the staff. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 19 Three staff training records were examined. Training for the newly employed had been properly completed and included questions to check how well information had been understood. All staff have now received training in the protection of vulnerable adults from abuse and training in dementia care, planned for the autumn, will further develop their knowledge. Health and safety training is provided, including fire safety and first aid. Care staff receive training in how to assist immobile residents to move. However, a cook has not received training in moving and handling objects, and was observed lifting trays into the dishwasher. All staff should be trained how to move objects safely. Neither had she received training in nutrition for older people or specialist diets for people with diabetes or dementia. Although she does have many years of experience residents would none-the-less benefit from the home utilizing current research and ideas. Recruitment of new staff is now fully robust with all necessary safety checks completed. These provide the manager with enough information to decide whether an applicant is safe and suitable to work at the home. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 20 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. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35, 37 & 38 Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. The home is well managed, run in the bet interest of residents with staff well supported and benefiting from strong leadership. The health and safety of residents are properly attended to in balance with their right to make choices. EVIDENCE: The registered providers / manager run the home efficiently. They provide strong leadership to staff who said: “We know exactly what is expected of us”. The manager talked of her confidence in the staff and the commitment made to the home and business. Her strong ideals and opinion are very well Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 21 demonstrated through the way staff work. Residents knew the providers and said the home is run very well. The aim is to provide a quality service. To this end they survey opinion from all people who have connections with the home and every day each resident is visited so they have the opportunity chat about needs and wants. Staff receive appraisal of their work and regular, formal supervision. All aspects of the home’s workings are organised: yearly spring-cleaning schedule, daily, weekly, monthly checks around the home. Records are checked, an example being accident records. This ensures resident and staff safety and the smooth running of the home to the standard the manager expects. The manager has achieved the Registered Managers Award, has 23 years experience of running a care home and maintains her registration as an Occupational Therapist. Staff express complete confidence in her. They say the providers are very generous, going the extra mile, such as popping to the shop to get something a resident or they request. The home has no involvement is residents’ finances, but ensures that each has money in their pocket should they wish it and will keep valuables safe unless family can take them. Any money spent on a resident’s behalf is invoiced. The home is maintained to a safe standard with all servicing and maintenance well organised. Where an event affects the well being of residents the home must inform the Commission. This includes any incidence of pressure sore, regardless of where it initially occurred. This provides protection for residents and important information of standards/trends in care homes. To date this information has not been provided, but the registered manager confirmed it now would. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 22 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 X X 3 3 X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 3 X X X X X X 4 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 4 X 3 X X 3 Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 2 2 Refer to Standard OP9 OP30 OP30 Good Practice Recommendations When a variable dose of a medication is prescribed the actual amount administered should be recorded, so the needs of the resident can be fully judged. All staff should receive training in moving and handling so they have the knowledge to work safely. Staff should receive training in how to meet the specialist dietary needs of residents with diabetes and dementia. This should ensure the menu choices available provide the best opportunity for an enjoyable, nutritious diet. Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP National Enquiry Line: 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 © 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 Springfields DS0000003808.V333960.R01.S.doc Version 5.2 Page 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!