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Inspection on 12/09/05 for Springfields Residential Home

Also see our care home review for Springfields Residential Home for more information

This inspection was carried out on 12th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Poor. 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.

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

What the care home does well

The management and care staff consult all service users on a regular basis regarding changes being made within the home. Feedback from service users is actively sought. Service users receive care and support from a dedicated staff team. Care Plans clearly document the level of support each individual service user requires.

What has improved since the last inspection?

Not Applicable

What the care home could do better:

The home must ensure a statement of purpose and service user guide is in place and easily accessible by both prospective and existing service users. Up to date activity schedules should be in place and available to all service users.The home must provide a complaints book in which to record all complaints made by service users, visitors, staff and health professionals.

CARE HOMES FOR OLDER PEOPLE Springfield Residential Home Hengist Road Westgate-on-Sea Kent CT8 8RH Lead Inspector Elizabeth Hendry Announced 12/09/2005 at 9:30hrs 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. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springfield Residential Home Address Hengist Road, Westgate-on-sea, Kent CT6 8RH 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) 01227 362398 Care Home 20 Category(ies) of Older People 20 registration, with number of places Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: No Date of last inspection NA Brief Description of the Service: Springfield is a detached three storey property, which provides personal care and support for up to twenty older people. Accommodation is provided in both single and double bedrooms. There is a non smoking lounge and a smoking lounge and two dining rooms. Communal areas are large and furnished in a domestic nature. To the front,side and rear of property there are considerable gardens that provide residnets with additional seating during summer months. The home is located within a short walk from the sea front and local ammenities. The home aims to provide a safe, clean and warm environment within comforatble surroundings. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This was the homes first annual announced inspection under new ownership. The home was found to be undergoing extensive renovation and redecoration throughout. Service users were relaxed and comfortable within their surroundings and spoke favourably of the new owners and manager. What the service does well: What has improved since the last inspection? What they could do better: The home must ensure a statement of purpose and service user guide is in place and easily accessible by both prospective and existing service users. Up to date activity schedules should be in place and available to all service users. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 6 The home must provide a complaints book in which to record all complaints made by service users, visitors, staff and health professionals. Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 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 Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 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 and 3 The home’s statement of purpose and service user guide is inadequate and does not provide prospective service users with sufficient information to be sure that the home is suitable. Service users move into the home knowing that their needs have been fully assessed. EVIDENCE: A copy of the current statement of purpose was viewed and found to be out of date. No changes have been made since the home has been under new ownership and still refers to the previous owner. The acting manager confirmed that at present there is no service user guide. Individual care plans examined contained copies of the initial assessment undertaken by care management teams, and were found to provide an accurate account of their needs and wishes. Each service user undergoes a through pre admission assessment by the home to determine their suitability and ensure there needs can be met. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 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 and 9 The care planning system is clear and consistent, providing staff with information they need to meet the service users needs. The health needs of service users are well met with evidence of good multi disciplinary working taking place on a regular basis. The systems in place for medication administration require review to ensure service users are not placed at risk. EVIDENCE: Care plans viewed contained detailed information in a manner that was easy to follow, were well written and easy to understand. Staff on duty appeared to have a sound understanding of individual service users needs. No service user signatures were in place within care plans to illustrate involvement in the care planning and review process. Records viewed evidenced regular contact with health care professionals. Service users spoken with confirmed that should they have any health worries or concerns, staff would assist and provide reassurance in addressing the problem. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 10 Medication was found to stored correctly within a locked cabinet. The acting manager confirmed that only the senior care staff on duty hold keys and are involved in the administration of medication. Medication administration records viewed were generally well completed with the exception of three omissions. On investigation it was found that a signature had not been recorded despite a service user receiving the medication. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 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 standard(s) 12,13 and 15 Service users find the lifestyle on offer within the home matches their personal expectations and preferences. Service users are supported to maintain contact with family and friends. The meals in this home are good offering both choice and variety and catering for special diets. EVIDENCE: Service users spoke of enjoying going out into the local community to do a bit of shopping, watching television, and relaxing in the garden. One service user spoke of the home organising an annual garden party during the summer months where members of the local community and families are invited to attend. The acting manager spoke of the majority of activities taking place during the afternoon. Daily records viewed did not identify activities taking place on a regular basis and little information was provided as to service users involvement. No activity schedule could be seen on the day of the inspection. Individual interests are recorded within each care plan. Service users confirmed that family and friends are welcome to visit at any time, and treated courteously by all members of staff. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 12 Copies of weekly menus were viewed. The home provides a well-balanced, nutritious selection of meals to service users. One service user said that they can ask for an alternative if they do not like what is offered. The acting manager confirmed that special diets are fully catered for. For those residents requiring additional support with mealtimes, a smaller dining room is made available where individuals can receive one to one support in a more private environment. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 13 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 and 18 Service users know that their views will be listened to and acted upon. Arrangements for protecting service users are not satisfactory EVIDENCE: A copy of the homes complaints policy was on display within the entrance hall. The acting manager confirmed that the home does not hold a complaints book at the time of the inspection. Service users spoke of all members of staff being approachable and they felt confident that should they have any problems or complaints regarding the home they would be able to raise them without fear of reproach. One service user added that since the home has been under new management they feel more involved in the day to day running and are encouraged to pass comment and make suggestions. Records viewed identified only two members of staff have attended formal adult protection training. The management of the home confirmed that there is not currently an adult protection policy and procedure within the home. When questioned the acting manager was aware of the steps to follow when reporting possible abuse. Of the staff files examined, all contained up to date criminal records bureau checks. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 14 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 and 26 The owner and acting manager have a good understanding of the areas in which the home needs to improve. Planning is in place and sets out how the improvement will be resourced and managed. Infection control measures in place require review in order to ensure the wellbeing and health of service users and staff. EVIDENCE: A tour of the home was undertaken, many areas of the home were found to be in need of redecoration and furnishing. The majority of fixtures and fittings in place were domestic in nature. Within the home there are two lounges, at the time of the inspection both lounges were smoking rooms. The acting manager confirmed that once the redecoration had taken place one lounge would become non-smoking. The management of the home confirmed that there is a comprehensive programme of redecoration and refurbishment in place. The dining room was in the process of being decorated on the day of the inspection, and when Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 15 finished it will provide service users with a bright, clean and welcoming environment. Carpets in many bedrooms were badly stained and held strong odours, the management of the home confirmed that these carpets were scheduled to be replaced once the communal areas had been completed. Liquid hand soap and paper towels were absent from a number of bathrooms and toilets. The kitchen and bathrooms were found to be in need of a through deep clean. The acting manager confirmed that the home does not currently employ any domestic staff, considering the size of the home and the number of service users it is necessary for the home to employ domestic staff. The acting manager added that these posts have been advertised and interviews were being scheduled to take place. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 16 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) 27,29 and 30 The home has an enthusiastic workforce that works positively with service users to improve their whole quality of life. Recruitment policies and procedures have not been consistently followed resulting in service users receiving care from some staff who have not been fully checked. Staff training is needed to ensure that service users receive care from fully trained staff. EVIDENCE: Copies of the staff rotas were seen, a minimum of two care staff are on duty at any one time. While service users care needs are currently being met, little time is available for the development of social and recreational activities. The home does not currently employ any domestic staff and as a result all care staff are required to undertake household duties and laundry during their shift. Because of the layout of the home it is necessary for the management to employ domestic staff. Since the home has been under new management the acting manager has worked hard to ensure individual needs of service users are being met. To date no progress has been made in ensuring staff files contain the required information. The acting manager confirmed that staff files would be reviewed as a matter of urgency. Of the staff files viewed, all but one contained a criminal records bureau check and written references. Staff training is a key priority for the new management and progress has been made to identify training needs of all members of staff, the acting manager Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 17 spoke of contacting local training agencies to obtain in house and external training in key areas. The responsible individual spoke of encouraging all members of staff to achieve NVQ Level 2 in Care, and has been in contact with the local college to organise places. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 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) 31,35 and 38 The home is well managed having a positive impact on all aspects of service users care and support. Improvements need to be made to ensure service users finances are safeguarded. Health and safety improvements need to be made to ensure the wellbeing of service users and staff. EVIDENCE: The home does not currently have a registered manager in post, the acting manager confirmed that she works two to three days per week at the home and is contactable at all other times. Service users spoke very highly of the acting manager and find her to be approachable and caring. Service users monies held within the home were checked and were found not to tally with records kept. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 19 The acting manager explained that a service users finances had been used to pay for communal activities without this being agreed with the individual or recorded appropriately within their book. It was made clear that this is not an acceptable practice and the home must ensure they have sufficient petty cash to cover such eventualities. The acting manager explained that only the seniors or herself are able to access service user finances. During the tour of the home, it was noted that thermostats and radiator covers were missing form many bedrooms and corridors. Hot water temperatures were unregulated within individual bedrooms. Window restrictors were absent on all windows inspected. Fire extinguishers viewed showed evidence of recent inspection. Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 1 x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 2 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 2 STAFFING Standard No Score 27 2 28 x 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 1 x 1 2 x x x 2 x x 2 Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 21 NA 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 1 Regulation 4 Requirement The registered person shall compile in relation to the care home a written statement which shall consist of a) a statement of aims and objectives of care home, b) a statement as to the facilities and services which are to be provided and c)a statement as to the matters in schedule 1. The registered person shall ensure that all service users are involved in the review of their individual care plans and signatures are in place. The registered person shall make suitable arrangements for the recording, handling. safekeeping, safe administration and disposal of medicines received into care home. The registered person shall ensure that any complaint made under the complaints procedure is fully investigated. (Complaints Book) The registered person shall make arrangements, by training staff or by other measures to prevent service users being harmed or suffering abuse or being placed H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Timescale for action 15th October 2005 2. 7 15 1st November 2005 13th September 2005 3. 9 13 4. 16 22 15th October 2005 15th October 2005 5. 18 13 Springfield Residential Home Version 1.40 Page 22 at risk of harm or abuse. 6. 19 23 The registered person shall having regard to the number and needs of the service users ensur ethat all parts of care home are kept clean and reasonably decorated. (replace soiled carpets and continue redecoration programme) The registered person shall ensure that suitable arrangements have been made to prevent infection, toxic conditions and the spread of infection.(provide paper hand towels and liquid hand soap in all bathrooms,w.cs and all areas receive a through clean.) The registered person shall having regard to the size of the home, the statement of purpose and the number and needs of the service users ensure that at all times suitably qualified and experienced persons are working at the care home in such numbers as are appropriate for health and welfare of service users. The registered person shall not employ a person to work at the acre home unless the person is fit to work at the care home and subject to paragraph (6), he has obtained in respect of that person the information and documents specified in paragraphs 1 to 7 of schedule 2. The registered person shall mainatin in the care home records specified in schedule 4 The registered person shall ensure that all parts of the home to which service users have access are so far as reasonably practicable free from hazards to their safety, avoidable risks and H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc 1st January 2006 7. 26 13 1st November 2005 8. 27 18 2005 15th October 9. 29 19 1st November 2005 10. 11. 35 38 17 13 15th October 2005 1st November 2005 Springfield Residential Home Version 1.40 Page 23 are wherever possible eliminated. (window restrictors, thermostats on radiators, and regulated water temperatures within bathrooms and bedroom sinks and baths. 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 Good Practice Recommendations Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 Page 24 Commission for Social Care Inspection 11th Floor, International House Dover Place Ashford 3Kent, TN23 1HU National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Springfield Residential Home H56-H05 S64212 Springfield V240389 12092005 Stage 4.doc Version 1.40 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. 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