Inspection on 09/11/05 for Springfields Care Centre

This inspection was carried out on 9th November 2005.

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.

Other inspections for this house

Springfields Care Centre 13/02/09

Springfields Care Centre 15/12/08

Springfields Care Centre 07/02/07

Springfields Care Centre 06/07/05

Springfields Care Centre 03/02/05

Springfields Care Centre 01/09/04

Springfields Care Centre 25/02/04

Similar services:

The Vicarage

Fairfields Country Rest Home

7 Hyde Road

5 Seafield Road

Poldhu

Queensmount

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 Care Centre Springfields Care Centre 33 Springfield Road Elburton Plymouth Devon PL9 8EJ Lead Inspector Doug Endean Unannounced Inspection 9th November 2005 12:25 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 Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 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 Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Springfields Care Centre Address Springfields Care Centre 33 Springfield Road Elburton Plymouth Devon PL9 8EJ 01752 482662 01752 482210 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) Four Seasons (DFK) Limited Care Home 85 Category(ies) of Dementia (20), Dementia - over 65 years of age registration, with number (20), Mental disorder, excluding learning of places disability or dementia (20), Mental Disorder, excluding learning disability or dementia - over 65 years of age (20), Old age, not falling within any other category (25), Physical disability (10), Physical disability over 65 years of age (65), Terminally ill (4) Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. There will be no more than the maximum of eighty five (85) service users in the home at any time. 06/07/05 Date of last inspection Brief Description of the Service: Springfield Care Centre is an 85 bedded purpose built home that provides nursing and personal care to adults who suffer from physical or mental health problems, predominantly dementia. There are presently 20 registered nursing beds on the dementia care unit that can be used for adults or the elderly. The remaining beds are to be found in two other distinct units, one providing nursing care, and one that provides residential (personal) care. Each unit is separately staffed and has its own unit manager. The units are arranged over two floors with shaft lift’s between each floor. There is an enclosed garden at the rear of the home lying between the wings of the home. Each of the two nursing units have a registered nurse on duty 24 hours a day. The residential care unit is managed by an experienced Senior Carer who may call on the District Nurses for any nursing needs the clients might have that do not warrant placement in a nursing home bed. The company has now recruited an experienced Home Manager who has recently started at the home. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report should be read along side of the previous report in order to establish the homes performance against the National Minimum Standards during this inspection year. The inspection was unannounced and took place on the 9th November 2005, lasting 3 hours and 35 minutes. During this time the inspector spent time in discussion with the new manager, looked at training and maintenance records, toured the home and talked to 3 staff and 4 clients. The requirements raised at the last inspection were reviewed although some have not yet passed the time scale to be addressed What the service does well: What has improved since the last inspection? What they could do better: The environment has a reasonably good floor design with many facilities being available to the clients that should make tasks easier and less of a risk to them, i.e. a wide range of communal spaces throughout the building of various sizes, shaft lifts to each floor, hoists and disabled bathing facilities. Some facilities and equipment however need to be reconsidered to make better use Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 6 of them such as the bathrooms in the mental health unit that have not been well thought out when originally designed and equipped. The décor in some areas of the home is not good and should be planned with some thought given to the sensory disabilities affecting present and future clients. This thought should be further considered in the mental health unit to avoid improper interpretation of colour and shape by those with dementia and other problems. The up-dating of staff training needs to include a process of follow through such as fire drills to assess the level of understanding by those who have been trained. This can also be beneficial in areas of care. 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. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 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 Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 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 & 5. The level of professionally prepared information available to visitors and clients is of a good standard. EVIDENCE: The inspector reviewed this section during the last inspection and found the standards had been met. The standards were not fully reviewed again on this occasion. However the Statement of Purpose was read and found to include all the information required of it that does inform the reader of the services and facilities available at the home, the aims and objectives and how to make a complaint should a client or their advocate feel that they have not been met. In addition to the Statement of Purpose there is a number of professionally prepared leaflets on a wide variety of subjects readily available to clients and visitors at the signing in book. The leaflets include information about care planning, care issues such as diabetes and tissue viability, and National Vocational Qualifications in Care. Clients and their advocates may visit the home prior to any placement if this is their wish, either by appointment or unannounced. When by appointment they Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 9 will be more able to tour the facility and have questions answered by the manager or staff who will have been allocated to that task. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 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): 8 The training package provided to the staff is sufficient to enable them to meet the needs of the clients once it has been completed. EVIDENCE: The new manager told the inspector that all the staff have gone through the new companies induction program to address any short falls in there knowledge about what is expected of them and how to meet the aims and objectives of the home. In addition to this the inspector was provided with evidence that more targeted training has commenced with each member of staff being given a training pack that is to be completed with the manager monitoring the staffs progress. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 11 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): EVIDENCE: The inspector reviewed this section during the last inspection and found the standards had been met. The standards were not fully reviewed again on this occasion. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 12 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 The homes procedure for investigating complaints is satisfactory and if followed should bring any complaint to a timely conclusion. EVIDENCE: There have been no complaints made to the Commission for Social Care Inspection since the last inspection. The home has its complaints procedure displayed in a conspicuous place and it is also in the Statement of Purpose that can be found displayed immediately on entering the home. The procedure includes time scales and the address of the Ashburton office of the Commission for Social Care Inspection. The other core standard was met, and reported on during the last inspection. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 13 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, 21 & 26. The environment provides ample space to meet the social, domestic and nursing needs of the clients. The décor in some areas is poor and unsuitable for those with visual problems. Bathing equipment in the dementia care unit is not suitable for this group of clients. EVIDENCE: The comments regarding the decoration of the home from the last inspection remain the same, “The décor of the home is damaged in some areas and showing signs of age with wallpaper being torn and of old design making some areas dark. This may have an effect on those clients who have a visual impairment”. The time scale for addressing this problem has not yet expired. The comments regarding the bathing facilities remain the same as the last inspection “the facilities in the dementia care unit are not in a good state of decoration and the actual type of bath provided is not suitable for this client group”. The time scale for addressing this problem has not yet expired. The manager did comment that the company do have plans to address these issues in their business plan for the home. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 14 The floor covering in a small number of rooms were heavily stained and had a strong unpleasant smell. The numbers, which identify the rooms affected, were noted by the manager. It was recommended that the rooms should not be used if they become vacant until the problem is overcome, or, if another room becomes vacant, and the client is willing to move, this should occur and the room not be used until the problem is overcome. One room in the mental health unit was converted back to a bedroom from a lounge following discussions with the Commission for Social Care Inspection. The conversion is not totally suitable due to the provision of natural light and the restricted view from a seated position with the room. It would appear that there may be a simple solution to this problem and this needs to be addressed. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 15 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): 30 The company has commenced a program of training that should benefit the clients. The checking of staff skills, in their understanding of what has been taught, is not satisfactory in the area of fire training. EVIDENCE: There was evidence to show that all the staff have now had induction training to introduce them to the new company and to address any short falls in there knowledge about what is expected of them and how to meet the aims and objectives of the home. In addition to this all staff have their own training pack, which is being worked through, and the manager will monitor their progress. The fire training records show a poor response to a fire drill that was carried out at the end of June 2005. Fire training took place to address this during August 2005 but there is no record of any further drills to check the knowledge of the staff has improved in this procedure. The overseas staff are independently attending English lessons to improve their communication skills. The inspector will make training issues a priority during the next inspection. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 16 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, 35 & 38. The new manager is suitably qualified and experienced to manage the home and all that happens within it. Maintenance has improved at the home but the follow trough for fire training needs to be better (as recorded for standard 30). EVIDENCE: The company has recruited a new manager to the home who has proven skills in this area. The Commission for Social Care Inspection has successfully processed her application for the position of Registered Manager in her previous post but she will need to submit a new application form for this employment. During the inspection the manager discussed her observations about the home and her style of management. The inspector felt that her approach was supportive and empowering, enabling staff and the clients to have responsibility for the care given and received and highlighting good and bad practices. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 17 The home does not accept responsibility for the control of any of the client’s financial affairs. There is information about advocacy and the clients are at liberty to meet with their solicitors or financial advisors. There are facilities for the safe keeping of money and valuables on a short-term basis. The home is maintained by an in house maintenance man and outside contractors and full records are kept of all work undertaken. A sample of these records was seen. The staff training has been dealt with in standard 30 with an area for improvement being raised during the inspection with regard to fire drills. The fire training records and fire drill records were seen by the inspector. The hot water system is regulated as the water circulates around the building and there are thermostatic mixer valves for each bath. Each unit has available to them a range of hoists, suitably serviced, disabled bathing facilities, and a nurse call system in each bedroom and every room accessible to clients. There is evidence that the staff have received training in the operation of the equipment. Accidents have been recorded in the accident record book that was seen by the inspector. Where it is appropriate to do so, a Regulation 37 has been completed and sent to the Commission for Social Care Inspection to inform them of accidents, incidents and deaths. The manager discussed how she would audit the accidents and also the way that they are recorded. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 18 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 X X 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 X 8 3 9 X 10 X 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 X 13 X 14 X 15 X COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 X 2 X 2 X X X X 2 STAFFING Standard No Score 27 X 28 X 29 X 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X X X 3 X X 2 Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 19 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 OP19 Regulation 23(2)(d) Timescale for action The registered person shall, 30/11/05 having regard to the number and needs of the service users ensure that all parts of the home are kept clean and reasonably decorated. Dementia care dining room is in poor decorative state and some corridors with dark stripped wallpaper may not be suitably decorated for those with visual deficiency. The registered person shall 30/11/05 having regard to the number and needs of the service users ensure that suitable adaptations are made, and such support, equipment and facilities as may be required for service users who are old, infirmed or physically disabled. The bathing facilities in the dementia care unit are not suitable and the bathrooms are poorly decorated. The Registered Person shall keep 20/12/05 the home free of offensive odours. Four rooms had carpets that were heavily stained and that had an offensive odour coming from them and will need replacing. DS0000003605.V251566.R01.S.doc Version 5.0 Page 20 Requirement 2. OP21 23(2)(n) 3 OP26 16(2)(k) Springfields Care Centre 4 OP30 23(4)(e) 5 OP38 23(4)(e) The registered person shall 30/11/05 ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home are aware of the procedure to be followed in case of fire. The registered person shall 30/11/05 ensure, by means of fire drills and practices at suitable intervals, that the persons working at the care home are aware of the procedure to be followed in case of fire. 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 OP25 Good Practice Recommendations The reclaimed bedroom in the mental health unit should have attention paid to the issue of light and a view from a seated position as soon as possible for the benefit of the client using that room. Springfields Care Centre DS0000003605.V251566.R01.S.doc Version 5.0 Page 21 Commission for Social Care Inspection Ashburton Office Unit D1 Linhay Business Park Ashburton TQ13 7UP 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. 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