Inspection on 05/03/07 for Springhill House Nursing Home

This inspection was carried out on 5th March 2007.

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

Springhill House Nursing Home 04/02/09

Springhill House Nursing Home 31/01/06

Springhill House Nursing Home 07/07/05

Springhill House Nursing Home 15/12/04

Springhill House Nursing Home 21/07/04

Similar services:

Chirnside House

Keer Sands Residential Home

Ruskin Lodge

Bushell House

Langrigg House

Parkside

Dystlegh Grange

Thornton Lodge

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

CARE HOMES FOR OLDER PEOPLE Springhill House Nursing Home Fairfield Street Accrington Lancashire BB5 0LD Lead Inspector Mrs Susan Hargreaves Unannounced Inspection 1:55 5 & 9 March 2007 th th 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 Springhill House Nursing Home DS0000022487.V327458.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. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springhill House Nursing Home Address Fairfield Street Accrington Lancashire BB5 0LD 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) 01254 381719 01254 872685 kparkinson@springcare.co.uk Springhill House (Accrington) Limited Miss Catherine Dunn Care Home 75 Category(ies) of Dementia - over 65 years of age (17), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (17), Old age, not falling within any other category (75), Physical disability (4), Terminally ill (3) Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home is registered for a maximum of 75 service users to include:Upto 3 service users in the category TI (Terminally Ill) Upto 4 service users in the category of PD( Physical Disability under 65 years of age) Upto 10 service users requiring nursing care in the category of DE(E) (Dementia over 65 years of age) or MD(E) Mental Disorder, excluding learning disability or dementia over 65 years of age) Upto 7 service users erquiring personal care in the category of DE(E) (Dementia over 65 years of age) or MD(E) (Mental disorder, excluding learning disability or dementia over 65 years of age) Upto 71 service users requiring nursing care in the category OP (old age, not falling within any other category) Upto 21 service users requiring personal care (old age, not falling within any other category) Only service users requiring nursing care may be admitted in the categories TI (terminally ill) and PD (Physical disability under 65 years of age) Staffing for service users requiring nursing care will be in accordance with the Notice issued dated 8th March 2002. The service should, at all times, employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 31st January 2006 2. 3. 4. Date of last inspection Brief Description of the Service: Springhill Care Home is a large detached house, which has been extended to provide purpose built accommodation on two levels. It is situated in a residential area, on a hillside overlooking the small town of Oswaldtwistle. It is on a bus route and close to all local amenities. The home offers personal care, nursing care, palliative care and care to older people with dementia. The home also has a contract with the local Primary Care Trust to provide orthopaedic intermediate care for 6 people. The home is registered to provide care to a maximum of 75 residents. Accommodation is provided in mostly en-suite bedrooms. Communal rooms include 5 lounge areas and 2 dining areas. A passenger lift facilitates access to all areas of the home. The grounds are spacious with ample parking for Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 5 visitors and staff. The seating areas are easily accessible to residents. The current fees charged at Springhill House Nursing Home are from £325 to £523.50 per week. Additional charges are payable for hairdressing and newspapers. A statement of purpose and service user guide was available to prospective residents and their relatives on request. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. A key unannounced inspection, which included a visit to the home, was conducted at Springhill House Nursing Home on the 5th and 9th March 2007. No additional visits have been made since the last inspection. Two comment cards were received from the relatives of residents expressing their overall satisfaction with the care provided. The three residents who completed a survey stated they always received the care and support they needed. Six comment cards were received from general practitioners and one from a social worker. All stated they were satisfied with the care provided to residents at the home. At the time of this inspection 66 residents were living at the home. A tour of the premises took place and staff files and care records were inspected. Members of staff on duty, residents and visitors were spoken to. Discussions also took place with the manager regarding issues raised during the inspection. What the service does well: What has improved since the last inspection? Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 7 Since the last inspection care planning has improved. Care plans are reviewed monthly and up dated when the needs of the resident change. During the inspection nurses were observed to be following correct procedures when giving out medication. New employees are not allowed to start working at the home until two written references and a POVA/CRB check has been obtained. 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. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 8 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 Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 9 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 and 6 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Admission procedures were thorough. A pre-admission assessment was completed for each resident prior to admission. Intermediate care was well organised and provided in a dedicated area of the home. EVIDENCE: The individual records of six residents were inspected. Each contained a detailed pre-admission assessment. A senior member of staff visited prospective residents, except those referred for intermediate care, in hospital or their own home prior to admission. These assessments provided important information for the care plans. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 10 The home has a contract with the Primary care trust to provide intermediate orthopaedic care for up to six residents. The intermediate care co-ordinator employed by the trust was responsible for arranging admissions to this unit. A dedicated area of the home was used for this service. Residents admitted for intermediate care usually stayed at the home from two to six weeks. Meetings involving the physiotherapist, occupational therapist, intermediate care co-ordinator, social worker, nursing and care staff at the home was held weekly to discuss progress and further treatment. Designated members of staff were responsible for caring for these residents. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 11 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 and 10. Quality in this outcome area is good This judgement has been made using available evidence including a visit to this service. Care plans contained detailed information relating to all aspects of care. Medication was well managed. Privacy and dignity was promoted for all residents. EVIDENCE: The individual care plans of six residents were inspected. These care plans identified the personal and healthcare needs of each resident and explained how these needs were met. Appropriate risk assessments had been carried out. Information about how identified risks were managed was also included in the care plans. The care plan for a resident on the Lynwood suite gave clear guidance to staff about how to deal with any behaviour problems. Care plans also included ‘fact sheets’ about promoting independence and eating and drinking. These reminded members of staff about the principles of good practice to help them maintain a high standard of care. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 12 A written report about the care given to individual residents was completed during each shift. Care plans were reviewed monthly and up dated when the needs of the resident changed. Residents and their relatives were encouraged to read and sign the care plans and discuss any issues with a senior member of staff. Residents were registered with a GP and had access to other healthcare professionals. Registered nurses were responsible for administering medication. Records relating to the management of medication were seen to be up to date. Medication was stored correctly in a clinical room. The temperature of this room was checked and recorded daily. Controlled drugs were stored securely and a stock check was satisfactory. Personal care was carried out in private. Members of staff were observed attending to residents in a friendly and professional manner. Four members of staff explained in detail how they promoted privacy and dignity for all residents. One resident said, “The staff are very kind.” Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 13 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 and 15. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. An excellent range of leisure activities suitable for all residents were organised Visitors were welcomed into the home at any reasonable time. The daily routine met the needs and preferences of residents. Menus offered variety and choice. EVIDENCE: Social activities were advertised in the home. These included arts and crafts, sewing, knitting, jigsaws, painting, dominoes, skittles, exercise and creative dance. Pictures painted by residents were displayed in the entrance hall. Residents were also encouraged to pursue their own interest and hobbies. Members of staff ensured residents who were interested had access to football results. Leisure activities for residents on the Lynwood suite were often done in small groups. These included crosswords, dominoes and craft activities. An outside entertainer visited the home every month. Residents were encouraged to make decisions about their lifestyle and daily routine. One resident said she chose when to get up and when to go to bed. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 14 Residents were encouraged to personalise their rooms with photographs, ornaments etc. Visitors were welcomed into the home at any reasonable time. Visiting at lunchtime was discouraged to ensure residents had sufficient time to eat a full meal. Local clergy regularly visited the home. The meal served at lunchtime on the second day of the inspection was wholesome and appetising. Puréed meals were served with each item liquidised separately. A member of staff sat at each dining table with the residents to encourage and assist residents with feeding. The mealtime was unhurried allowing residents time to chat and enjoy their meal. The menus were varied and offered choice. Alternatives to the menu were readily available on request. All the residents asked said the meals were good. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 15 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): Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Complaints were taken seriously and investigated. Appropriate policies and procedures were in place to ensure the protection of residents at the home. EVIDENCE: A copy of the complaints procedure was displayed in the home and included in the service user guide. Two complaints have been made to the commission since the last inspection. Policies and procedures relating to the safeguarding of vulnerable adults were in place. This issue was discussed with four members of staff. They were aware of the procedure and said they would report any concerns immediately. Springhill House Nursing Home DS0000022487.V327458.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 and 26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home was clean and comfortable and provided a homely environment for the residents. Laundry facilities were appropriate for the size of the home. EVIDENCE: At the time of the inspection the home was clean, tidy and well maintained. The decoration and furnishings were of a high standard. However, the lounge on the Lynwood suite was dimly lit making it difficult for residents to read or look at a magazine if they wished. There was also an unpleasant odour in the entrance to the Lynwood Suite and especially in the lounge. This issue was discussed with the manager and a new carpet has been ordered. One resident said, “My room’s cleaned regularly.” The grounds and gardens were well kept and accessible to all residents. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 17 Laundry facilities were appropriate for the size of the home. An infection control policy was in place. One resident said, “I leave my dirty clothes out and they’re washed.” Springhill House Nursing Home DS0000022487.V327458.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 and 30. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Staffing levels were appropriate to meet the assessed needs of the residents. Recruitment procedures were thorough. Training for all members of staff was given a high priority. Eighty-five percent of care assistants had NVQ qualifications at level 2 or 3 in care. EVIDENCE: Examination of the duty rota confirmed that a sufficient number of staff were on duty for all shifts to meet the assessed needs of the residents. Members of staff asked said they were never short staffed and always had time to take their breaks. The files of six members of staff appointed since the last inspection were examined. These files indicated that all the required pre-employment checks to ensure protection of the residents had been completed prior to appointment. It was evident from discussion with members of staff and the manager that training was actively encouraged. This included health and safety, moving and handling, fire safety, first aid, abuse, dementia care, nutrition, prevention of pressure sores, continence management, care of the dying, record keeping and eye care. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 19 The manager was responsible for the induction training for all new employees. This training met the ‘Skills for Care’ standards and included additional training to support the home’s policies and procedures. During the three months induction period staff were required to attend at least four training sessions. Thirty-five care assistants (85 ) have NVQ qualifications, eleven at level 3 and twenty-four at level 2. In addition to this a further seven members of staff were working towards NVQ level 2 or 3. Springhill House Nursing Home DS0000022487.V327458.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 and 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home has an experienced and competent manager. Residents and their relatives were consulted about the quality of the care and services provided at the home. Appropriate procedures to safeguard the health, safety and welfare of residents were in place. EVIDENCE: The registered manager is an experienced nurse. She has recently obtained a certificate in education. This will support the training and education of staff that is considered by the management to be important in maintaining and improving standards at the home. The manager also attends relevant study days and conferences, uses the Internet and reads care journals to ensure her Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 21 knowledge of caring for older people including those with dementia remains up to date. One member of staff said the manager was perfect. The home has achieved the nationally accredited ISO 9001/2000 and Investors in People. The resident’s survey form has recently been changed to ensure the questions relate to the outcomes included in the National Minimum Standards. These questionnaires are distributed to residents annually. Relatives also receive a questionnaire annually. Large print copies of these questionnaires are available on request. The annual surveys are evaluated to enable any appropriate action to be taken. Residents on the intermediate care unit are asked to complete a questionnaire before discharge. A recent suggestion placed in the box in the hall requested the provision of a parking space for people who were disabled. The manager said action was being taken to create such a space. Residents and relatives meetings are held every six months. At these meetings any aspect of the care and services provided are discussed. Minutes of these meetings were available. Records of financial transactions involving resident’s money were seen to be well maintained and up to date. Policies and procedures for safe working practices were in place. Fire alarms were tested weekly and emergency lighting every three months. Fire drills were held every six months and staff attendance records were kept. The manager was advised to have more frequent fire drills to ensure all members of staff regularly received this training. Records of the routine servicing of equipment were seen. The kitchen was clean and tidy. Records maintained by the cook included fridge, freezer and food temperatures. Springhill House Nursing Home DS0000022487.V327458.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 X X 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 4 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 4 28 4 29 3 30 4 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 X 3 X 3 X X 2 Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 23 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. OP26 Standard Regulation 16(2)(k) Requirement To ensure residents are living in comfortable and homely environment the odour problem in the Lynwood Suite and especially in the lounge must be addressed. Timescale of 31/03/06 not met. Lighting must be improved on the Lynwood suite to enable residents to read if they wish to do so. Timescale for action 27/04/07 2 OP26 23(2)(p) 27/04/07 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 OP38 Good Practice Recommendations Fire drills should be held at more frequent intervals to ensure all members of staff regularly receive this training. Springhill House Nursing Home DS0000022487.V327458.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection North Lancashire Area Office 2nd Floor, Unit 1, Tustin Court Port Way Preston PR2 2YQ 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 Springhill House Nursing Home DS0000022487.V327458.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!