Inspection on 07/12/06 for Springhill Resource Centre

This inspection was carried out on 7th December 2006.

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 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

Springhill Resource Centre 05/03/09

Springhill Resource Centre 21/03/06

Springhill Resource Centre 13/10/05

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 Resource Centre Springhill Resource Centre Broad Lane Rochdale Lancs OL16 4PP Lead Inspector Sue Donovan Unannounced Inspection 12th December 2006 09:30 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 Springhill Resource Centre DS0000062995.V306096.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 Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springhill Resource Centre Address Springhill Resource Centre Broad Lane Rochdale Lancs OL16 4PP 01706 659922 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) Rochdale MBC Miss Elizabeth Colley Care Home 21 Category(ies) of Dementia (5), Dementia - over 65 years of age registration, with number (21), Old age, not falling within any other of places category (21) Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Within the maximum registered number (21), there can be up to :21 Older People (OP) 21 Adults with Dementia, over 65 years (DE(E)) 05 Adults with Dementia (DE) The service should, at all times, employ a suitably qualified and experienced Manager who is registered with the Commission for Social Care Inspection The registered Person must ensure that all staff working in the home have dementia awareness and dementia care training, which equips them to meet the needs of the service users accommodated, as defined in the individual plan of care. The service should at all times employ suitably qualified and experienced members of staff, in sufficient numbers, to meet the assessed needs of the service users with dementia. The Registered Person may accommodate up to 5 service users in the category of DE aged over 55 years of age. 2. 3. 4. 5. Date of last inspection 21st March 2006 Brief Description of the Service: Springhill Resource Centre is registered to provide care for up to 21 older people, some or all of whom may have dementia. The service is working towards providing care ultimately for 21 people with dementia on a short-term basis for assessment. At the moment the service is in a transitional stage, and continues to offer permanent care to residents who resided at Springhill (before its refurbishment) and Birch View Older Persons homes (which has closed). The home is single storey and all bedrooms are single, with a small number having en-suite facilities. Springhill is spacious and provides 3 lounge/dining areas. Sufficient bathrooms and toilets are provided. An internal patio area is available to residents to access in good weather. The home is located close to the centre of Rochdale, and is easily accessible by bus route. Parking is available to the front of the home. A day-care unit is attached to the home however, this has not yet opened. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The home was not told the inspection was to take place. The site visit to the service took place over seven hours from 8.40am to 3.40pm. The report was written after looking at the information sent to the commission for social care inspection (CSCI) including comment cards (two from doctors and nine from relatives) and after talking to some of the residents of Springhill Resource Centre, their relatives, two team leaders and staff and looking around the home. During the inspection, assessment, care and medicine records were looked at to make sure resident’s needs were being met. The inspector looked around the building at the lounge and dining room areas to check if they were clean and well decorated. The inspector joined residents for lunch and looked at how the meal was served, looked at how residents money was looked after and checked records to see how the home and the equipment was kept safe. What the service does well: The home is very welcoming. Residents live in clean and comfortable surroundings, a relative said, “everything was wonderful and clean at Springhill.”. The home specialises in caring for people who have dementia and supports them in the way they need supporting. A copy of the service user guide was kept in each resident’s room. No complaints had been received by the CSCI since the last inspection and residents and relatives confirmed that they knew how to make a complaint. Resident’s needs are assessed well and this helps them get the right service when they leave Springhill. Springhill is good at working with other agencies like doctors and community nurses and following their advice. Staff are well trained to care for residents and they organise things for people to do during the day. The meals were very good and this was confirmed by everybody the inspector spoke to say so. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 6 Residents said, “staff are excellent they excel themselves,” and “ its brilliant here.” Relatives said, “the care is brilliant, can’t fault it at all,” and “ I am very happy with the dedication of the staff team.” What has improved since the last inspection? 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 Resource Centre DS0000062995.V306096.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 Springhill Resource Centre DS0000062995.V306096.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): 12&3 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Up-to date information is given to residents and their families to enable them to make a decision as to the suitability of the home. Residents who are admitted for assessment have a contract that lets them know what to expect and what they need to agree to. Residents have their needs assessed prior to admission to make sure these can be met. EVIDENCE: A statement of purpose and a service user guide is provided for all residents. The documents are placed in the bedrooms of residents so they can read them with their relatives or with staff assistance. The information includes for example, meals and mealtimes, how health needs will be met, visiting arrangements and how to complain. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 9 The information shows that the home no longer accepts long term residents and any vacancies will be used to provide short term respite and assessment care for older people with mental health needs. There was no charge for residents admitted for assessment and this was shown clearly in the contract. Long-term residents relatives confirmed they were aware of how much it cost to live at the home and said that they were informed of any changes by post. A brochure “what do I pay “ is available in the reception area, which explains the services available from Rochdale adult care services and their cost. A relative confirmed that she had seen and read the service user guide that was in her relative’s bedroom, and said, “staff always keep me up-to-date.” Three residents files were looked at. One file of a long term resident did not contain a contract but the two assessment resident’s files both had contracts that had been signed and agreed to. The contracts set out the terms and conditions and showed what residents can expect from Springhill resource centre. The contract included fees charged including the cost of hairdressing, care plan, accommodation, personal items and medication. New residents are only admitted on the basis of a full assessment being received. A care manager completes the initial assessment; assessments were also seen on files from hospitals. A discussion took place with the team leader regarding the assessment process that was undertaken when someone needed a service at the home. She said that a referral would be made by adult services (usually a care manager) and Springhill would complete an initial contact sheet then the manager or a team leader would visit the hospital or a persons home and complete the full assessment. This information had been used when writing care plans. Relatives said, “I was very anxious about X going into care but it has never been a problem. I have great peace of mind,” “the care and dedication X received at Springhill made it possible for him to return home and for that I am truly grateful” and “ the home was 100 better than I expected and I was quite happy to leave X in their care.” Springhill Resource Centre DS0000062995.V306096.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 good. This judgement has been made using available evidence including a visit to this service. The care planning system in place provides staff with the information they need to meet resident’s needs. The medication system was safe ensuring the residents received their medicines safely and correctly. EVIDENCE: Three care plans of the residents were looked at. The plans contained information about how to care for residents, how they communicated, previous interests and life history. Staff had signed to say they had read the care plans and were aware of there content. Completed care plans showed physical, mental health and personal care needs and recorded the actions to be taken to meet these needs. Night care plans Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 11 were also on files. The contract says that if possible the home expect the resident and/or there relative to help them to draw up the care plan, this was seen signed on two files. On one file some information was seen showing what the resident enjoyed, “passion for sport especially football,” “enjoys a beer and a glass of wine.” This type of detail should be included in all care plans to show for example what residents like/dislike, memorable moments, career, important relationships and special dates from the past. Daily reports were seen on each file and reviews took place on a regular basis. The written records of these meetings recorded good detail of changing care needs. Nutrition assessments were completed and resident’s food/fluid intake recorded. Care plans recorded involvement of doctors, community psychiatric nurses, falls coordinator and other health professionals. A student nurse said, “it’s lovely here, the staff genuinely care.” Three doctors completing comment cards considered the home communicated clearly with them; followed their advice; showed clear understanding of residents needs; and provided overall satisfactory care at the home. Risk assessments were in place and up-to-date. Plans were in place for those residents at risk of falling and for a resident who smoked. The activity programme at the home encouraged residents to keep active and physical exercises took place three to four times a week. It was observed that other games/activities encouraged residents to reach for items and to move around. A garden area with raised beds enabled residents to have a walk or get involved in planting in warmer weather. Medication policies and procedures were in place and included the policy for residents who wished to self-administer. The medicines room was clean and tidy, kept locked and medications were securely stored. Only trained staff administered medications and certificates confirmed the training had taken place. The drugs refrigerator temperature was satisfactory and a record of temperatures maintained. The last inspection identified some areas for improvement with regard to medication and it was seen that all of these had been implemented. Most medication was supplied in a monitored dosage system (MDS) with pre-printed medication administration records (MAR). Medication appeared to be given and signed for correctly. Some residents admitted for assessment arrive with medication that may need checking or reviewing this is done with their doctor. Good practice was seen during the medication round, medication was administered after mealtimes so residents were not disturbed whilst eating. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 12 On the day of the inspection site visit, observations showed that personal care and hygiene needs were met in a discreet and sensitive way. Staff spoke quietly to residents whilst encouraging them to move to the dining room tables and staff explained what they were doing when using a hoist to move a resident from an armchair to his wheelchair. A resident confirmed that staff respected their privacy and dignity by always knocking on doors. Feedback from residents and relatives confirmed that residents received the care and support they required, relatives comments included, “very good, all the care and support anybody could wish for,” “I am well satisfied with the level of care,” “very happy with everything,” and “care brilliant, can’t fault it at all”. Residents spoken with said, “brilliant, staff are excellent they excel themselves,” “they get everything ready for me at night so I know were everything is,” and “it has a comfortable feel, it’s like a family rather than a home.” Springhill Resource Centre DS0000062995.V306096.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 & 15. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Social activities which residents enjoyed were provided on both an individual and group basis enhancing the enjoyment and fulfilment of residents. Visiting arrangements are good, ensuring links between residents and their families are maintained. Dietary needs of service users are well catered for with a selection of food that meets service users tastes and choices. EVIDENCE: An activities coordinator works within the home two days per week on other days care staff organise activities. A programme of activities was available everyday of the week and included quizzes, craft, games and baking (although this is restricted e.g. to icing cakes). An activities board was on the wall of each lounge on which the daily activities were written. Other activities take place on a regular basis in the home, including outside entertainers, and Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 14 sometimes in the community. One resident said that he had enjoyed an outing to the canal and a meal out and would like to go out more. A Christmas programme of activities was displayed in the entrance and included entertainers, pub lunches, local community groups and a bar. The inspector joined a game of musical bingo, this was well organised, seven residents joined in with staff support. The session seemed to be enjoyed by those residents involved and included singing to some favourite old time songs and hymns. The home has an open visiting policy but visitors are asked to try to avoid mealtimes. A relative said that she comes every week at whatever time suited her. Residents can see visitors in any area or in their rooms. A visitors book showed the times people had visited. Communion is held for residents of the Roman Catholic faith each Sunday and an Anglican Christmas service has been arranged. The choices residents made each day were varied and within their capabilities. Residents were generally free to choose what time to get up, go to bed, what clothes to wear, what to eat (within the choice of the day) and whether to join in activities. Residents were seen eating breakfast a different times. Personal possessions of long stay residents were seen in their rooms. Residents admitted for assessments were less likely to bring many personal possessions in but a member of staff said that they are welcome to do so if they wished. Menus were seen to provide a nutritious and varied diet. Residents are asked what they would like to choose from the menu for their meals the day before. The cook said that if someone changes their mind they could choose something different on the day. The lunchtime meal was observed in one of the three lounges. The tables were set with table clothes and matching serviettes, with condiments and flowers. Staff served the meal of chicken and leak pie with mash and a tureen of carrots and cabbage was on the tables, semolina or prunes and custard followed this. The meal was homemade and tasty and the portion size good. Provision was made for those residents needing special diets e.g. diabetic and soft foods. Residents and relatives were very complimentary about the food saying, “Chefs excellent, food is really good,” “its very good, my favourite today,” and “good meals”. One resident said that the food could be hotter. Springhill Resource Centre DS0000062995.V306096.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): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents and relatives were confident that their complaints would be listened to, taken seriously and acted upon. Appropriate systems were in place to protect residents from abuse whilst living/staying at Springhill. EVIDENCE: A complaints procedure was in place. The procedure was displayed in the entrance area of the home and was given to residents/relatives when they stayed at the home. The team managers could not find a complaints book or log to show how many complaints had been received over a period of time, what the outcome had been and timescales they were handled in. One complaint received this year was shown to the inspector and this had been responded to inline with the procedure. No formal complaints had been received by the CSCI. Feedback from relatives who retuned comment cards indicated they were aware of the procedure and knew how to complain. The home had received a number of compliments and had set a file up to record these. A procedure for responding to allegations of abuse (including whistle blowing) was available as was the Rochdale Inter-agency Protection of Vulnerable Adults Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 16 (POVA) procedure. Staff spoken to recognised the importance of reporting bad practice and had received training in this area. The pre- inspection questionnaire showed 95 of care staff are qualified to a minimum level of NVQ (National Vocational Qualification) level 2, safeguarding vulnerable adults was included in the units for this award. A flow chart showing the procedure to be followed in the event of suspected abuse was seen on the office wall. Team leaders said that staff were not employed at Springhill unless the criminal records bureau (CRB) had properly screened them and satisfactory references had been received. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 17 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. A safe, clean, pleasant, hygienic and well-maintained building was provided for resident’s comfort. EVIDENCE: Springhill is a purpose built single storey building with level access providing twenty-one single bedrooms, some with an en-suite facility. It is situated close to the centre of Rochdale and adequate parking is available at the front of the building. The home has three areas that are themed into colours, green, blue and yellow. Resident’s rooms have plaques with their names on and a design of their choice; both the colour coding and plague help with identification of their Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 18 rooms. Other signage round the home was large and colourful to assist residents retain their independence. All areas of the home were seen to be in good decorative order. The lounges were bright and clean. Leading off from each lounge was an enclosed garden area although one area was in need of work with raised beds and seating areas needing developing. Toilets are close to communal areas and each toilet and bathroom had a lock to ensure privacy. Specialist equipment is provided around the home to assist with moving and handling. A hairdressing salon was situated in the annex to the home were it is planned to open a day service. The hairdresser visits weekly and was used by many of the residents. Environmental Health and local fire service had both visited since the last inspection 10/04/06 and 18/10/06 respectively. The requirements made by the fire service had been implemented. Everyone spoken with thought the home was a safe place to live and work in. Relatives spoke positively about the cleanliness and said. “ everything was wonderful and clean at Springhill” and “always clean”. It was noted however that the amount of domestic and handyperson hours within the building at the present time was low. The manager should consider if these hours are adequate to continually provide a good standard of maintenance/ cleanliness in the future. Policies and procedures were in place for infection control and since the last inspection hand-washing facilities have been provided for staff in residents rooms. Equipment that was needed when assisting residents with personal care was provided for all staff. The laundry and storage room were sited away from the food preparation area and were seen to be clean and orderly. Sufficient and suitable equipment was provided and the laundry was attended to efficiently. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 19 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 adequate. This judgement has been made using available evidence including a visit to this service. Sufficient numbers of staff were provided to meet the needs of residents. The majority of staff were trained and competent to provide residents with the care they needed. Few maintenance hours were provided to ensure the homes high standard was maintained. EVIDENCE: Observation showed sufficient numbers of care staff were provided to meet the needs of residents on the day of the inspection. At night three staff are on duty plus one sleeping in. It was identified that the handyperson hours and domestic hours are currently low. Residents said, “my carer is brilliant,” “they’re good staff,” and a relative commented, “ I am very happy with the dedication of the staff team.” 95 of the care staff had an NVQ to a minimum of level two and team leaders to a minimum level of NVQ three. Inspection of three staff personnel files showed evidence of CRB checks on two files but on one no evidence was found and no evidence of application forms or Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 20 written references for all three staff could be found. The Rochdale Adult Services human resource department said that registered establishments should be keeping evidence that staff had had the required checks for working at the home. Inspection of the file belonging to a recently recruited member of staff showed that induction was provided. Staff said that they had been shown around the home, got to know residents, read care plans and policies and procedures, shadowed other staff for a three-week period and completed a TOPPS induction training workbook. The manager needs to ensure that the induction that staff receive covers areas documented in the ‘skills for care induction standards.’ Staff also said that they had received regular supervision during their induction period. Training records were in place for all staff. These showed training had taken place since the last inspection and staff confirmed this. Training included, communication and completing records mental health and old age dementia POVA first aid Staff said,”I enjoy working with people with dementia,” “it’s good working here,” and “it’s a good atmosphere and a good team.” Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 21 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 36 & 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The home is well managed and some quality assurance systems are in place to ensure residents and other stakeholders can voice their opinions. The home has systems in place that are properly managed so that resident’s financial interests are safeguarded. EVIDENCE: The registered manager has eighteen years experience in the residential care of older people including fifteen years management experience. The registered manager has an NVQ 4 in care, registered managers award (RMA). NVQ D32/33 assessors award and has completed a management foundation course. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 22 Some quality assurance systems were in place. The team manager explained that after each assessment placement residents/relatives were asked to complete a questionnaire. The results of these were collated six monthly. The results sheet showed very positive comments with all replies showing good or very good responses to all questions. More recently a questionnaire has been devised for other people involved with the home, this included doctors, community psychiatric nurses and social workers. The responsible individual had not conducted regular visits to the home as required by Regulation 26 of the Care Homes Regulations 2001. Residents, relatives and staff all said that the manager was approachable and would listen and address matters raised. The inspector found the team managers very friendly and helpful on the day of inspection. The system for safeguarding resident’s monies was good. Their families generally undertook the management of resident’s finances. Only personal allowances are held for any purchases made and receipts given. Money was found to correspond to the log for the three residents that were checked. A staff supervision plan was seen and discussed. The team manager said that the aim was to hold a minimum of six supervisions a year. The staff files looked at showed a frequency of approximately ten to twelve weeks. Staff spoken with did confirm that they had received supervision and they found it helpful. One member of staff said she would ask for supervision if she wanted to discuss anything. A new annual performance and development review had been started. The manager and team managers had received training this year in how to carry out the reviews and these were now being introduced within the home. Training records showed that health and safety training was provided on an ongoing basis. No health and safety hazards were noted during the inspection. Regular maintenance checks had been undertaken. A spot check showed that the last portable appliance testing was December 05 and a fire plan was in place with annual fire lecture training for staff and weekly checking of the fire system. The staff said the manager and team managers were “supportive” and “brilliant, they give you a lot of support.” Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 23 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 2 3 X X N/A 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 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 2 28 4 29 2 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 3 X 3 Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 24 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. 1. Standard OP33 Regulation Reg. 26 (1) Requirement Where the registered provider is an individual, but not in day-today charge of the home, he shall visit the care home in accordance with this regulation. Specifically the registered provider must ensure monthly visits to audit the service take place. Timescale for action 28/02/07 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. 2. 3. 4. Refer to Standard OP7 OP12 OP16 Good Practice Recommendations The registered person should consider including more information in the life history section of care plans. The registered person should consider arranging more community outings for long stay residents who want them. The registered person should keep a record of all complaints made and include details of investigation and any action taken. The registered person should ensure the large enclosed garden area is accessible to residents with suitable DS0000062995.V306096.R01.S.doc Version 5.2 Page 25 OP19 Springhill Resource Centre 5. OP29 6. OP27 facilities. The registered person should ensure that copies of documents relating to staff working in the home are kept on their personal file. See schedule two of the care homes regulations. The registered person should review the handyperson and domestic hours to make sure these are adequate within the home. Springhill Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 26 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG 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 Resource Centre DS0000062995.V306096.R01.S.doc Version 5.2 Page 27 - 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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