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Inspection on 25/07/05 for Springview

Also see our care home review for Springview for more information

This inspection was carried out on 25th July 2005.

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

The inspector 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

This is a well managed home, which offers a pleasant and well-appointed living environment for service users. Service users assessed needs inform their care plans, and there are a number of systems in place to ensure that service users have an opportunity to have a say in the way the home is run. A particular feature of life in Sringview is the excellent programme of activities both inside the home and in the wider community. This makes the home a lively and stimulating place for service users to live.

What has improved since the last inspection?

There were six requirements made at the last inspection, and the inspector noted compliance with all six, resulting in improvements to the homes practice in relation to the management of pressure sores, and the recording of service users wishes with regard to the arrangements to be made after their death. The home also now monitors the reasons why staff leave in order to ascertain if there are any trends that need to be addressed.

What the care home could do better:

Although not subject to a requirement the service manager and proprietors are aware of the need to revise the care planning system currently in use in the home. The mobility of services users would be enhanced by the provision of ramps from the main lounge to the rear sitting area and the balcony.

CARE HOMES FOR OLDER PEOPLE Springview 10 Crescent Road Enfield Middlesex EN2 7BL Lead Inspector Peter Allcock Unannounced 25 July 2005 @ 09.00 am 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. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Springview Address 10 Crescent Road, Enfield, Middlesex EN2 7BL 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) 020 8367 9966 020 8306 0900 Dr Arnold Powell for Springdene Nursing & Care Homes Ltd Vacant Post PC - Care Home 58 beds Category(ies) of OP - Old age registration, with number DE(E) - Dementia - over 65 of places Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: 1. The home must not accept older people with a diagnoses of dementia who are in need of nursing care. 2. The home must have a designated staff team at all times on the second floor who are trained, competent and in sufficient numbers to care for people with a diagnoses of dementia. Date of last inspection 17 January 2005, Additional Visit 26 April 2005 Brief Description of the Service: Springview is a purpose built care home registered to provide personal care for a maximum of fifty-eight older people. There are seventeen beds located on the second floor that have been registered to provide a service to people who have a diagnosis of dementia. The home is owned and managed by an organisation called Springdene Nursing and Care Homes Limited. The company also owns and manages two other care homes in London. The aims of the home are to ensure that all service users receive the highest possible standard of physical, mental, spiritual and social care within an environment, which upholds the core values of privacy, dignity, individuality, choice, rights and fulfilment. The home is a large detached four-storey house. There are fifty-eight single bedrooms with en suite facilities. These are located on the ground, first, second and third floors. On the ground floor, there is large lounge, dining room, library and activities room. Also on this floor are the kitchen, laundry room, reception and the manager’s office. There are separate lounges on the first and second floors. Communal bathrooms are located on the first, second and third floors. There is a parking area at the front of the home for several cars and a garden at the back. The garden is partly paved and accessible to service users.The home is located in a quiet residential area of Enfield Town close to a variety of shops, restaurants and transport links. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was undertaken on an unannounced basis between 11am and 4.00pm. The inspector read the pre-inspection information sent by the home, and comment cards from twenty-two service users and two relatives, whose views are reflected in the body of this report. During the inspection, the inspector spoke to the service manager, two of the proprietors, four staff and eight ten service users, toured the building and examined records and eight care plans. The inspector was received courteously by the staff and proprietors of the home, and all were open and helpful during the conduct of this inspection. The inspector would also like to thank the service users who gave their time to tell the inspector about their experience of life in the home. The home is currently advertising for a new registered manager, and management duties are currently being undertaken by senior staff with support from the service manager and the proprietors of the home. What the service does well: What has improved since the last inspection? What they could do better: Although not subject to a requirement the service manager and proprietors are aware of the need to revise the care planning system currently in use in the home. The mobility of services users would be enhanced by the provision of ramps from the main lounge to the rear sitting area and the balcony. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 6 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. Springview G59 S10649 Springview V220820 25.07.05 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 Springview G59 S10649 Springview V220820 25.07.05 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, 3, 5 Prospective service users have the written information and the opportunity to visit the home prior to admission so that they can make an informed decision about where they choose to live. The assessment and admission procedures re-assure service users that their needs have been assessed and that the home is able to meet those needs. EVIDENCE: There is a service user guide, which along with the opportunity to visit the home prior to admission gives prospective service users the opportunity to make an informed choice about where to live. A number of service users spoken to during this inspection confirmed that they had taken the opportunity to visit the home prior to admission. All six service user plans seen during this inspection contained an assessment of the service users individual needs. Springview G59 S10649 Springview V220820 25.07.05 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, 9, 10 Service users benefit from life in a home in which they are treated with respect, their right to privacy is upheld, and staff are guided in their care needs by an appropriate care plan. Service users are re-assured that their health care needs will be met and that they are protected by the systems in place for dealing with medication. EVIDENCE: Care plans whilst adequate and inclusive of the required information are very basic. The service manager told the inspector that the home are in the process of updating the care plan format to provide more detail, and said that she would send a copy to the Commission for Social Care Inspection when this work is completed. Ten members of staff hold a current first aid certificate, and service users records indicated that medical needs are met through referral to the appropriate professional or service. All service users are registered with a GP, and where GP’s can provide the full range of services it is possible for service users to retain their existing GP on admission to the home. There are currently no service users resident in the home who have pressure ulcers. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 10 The home has systems in place for the handling of medication and only staff who have received appropriate training administer medication. The records of the administration of medication seen during this inspection were seen to be up to date. The administration of the controlled drugs used by one service user were as required and the medication was appropriately stored. Service users spoken to during this inspection told the inspector that they were happy with the arrangements for their medication. Observation of care practice in the home showed that service users are treated with respect by the staff, and that their right to privacy is upheld. All 22 of the service users comment cards returned to the inspector confirmed this. Springview G59 S10649 Springview V220820 25.07.05 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, 14, 15 Service users live in a home that provides opportunities for them to experience a lifestyle which matches their expectations and preferences, and in which the development and maintenance of relationships outside the home is supported. Service users independence and individual control over their lives is maintained by consultation systems that take seriously and act upon their views. Service users can make choices about the provision of the wholesome, and appealing diet provided in the home. EVIDENCE: On the day of this inspection, a number of service users were out on a trip to a London museum. The inspector observed a morning exercise session, and during the afternoon a number of service users were engaged in activities such as discussion, board games, knitting and meeting visitors. This made the lounge a lively and stimulating place to be. The home has a varied and comprehensive programme of activities both within the home and in the wider community, and service users are free to decide in which activities they wish to participate. Activities range from participatory activities such as exercise, art and craft, games and discussion groups to visits from entertainers. These activities are facilitated by an activities co-ordinator, Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 12 and the provision of sufficient ancillary staff to give care staff time to engage service users in activities on a one to one or group basis. Eighteen service user comment cards stated that the home provides appropriate activities, and four said that they did so sometimes. The home has an open door policy for service users friends and relatives, and both comment cards received from relatives said that they were made to feel welcome when they come to the home, and that there were no restrictions on visiting. The inspector spoke to the chair of the residents committee, who felt that the issues raised by the committee were listened to and taken seriously. Records of service user committee meetings showed that changes had been made as a result of these meetings. The inspector saw that lunch in the main dining room was attractively presented, and offered a choice of two main menus, but that individual choices were also catered for. Service users were also able to specify the size of portion that they prefer. One service user said that although they are encouraged to take lunch in the dining room, it is possible to have lunch in their own rooms if preferred. The home employs two cooks during the day, and the head cook was knowledgeable as to the individual preferences of service users in the home. There is a choice of a hot or cold dinner served in the evening. Observation of practice in the dining room showed that service users were accommodated in individual choices and changes of mind, and that those that required help or encouragement were supported in a way that preserved their dignity, and encouraged their independence. Service of food to service users was seen to be efficient to ensure that food arrived hot, but not hurried creating a relaxed atmosphere in which to eat. Springview G59 S10649 Springview V220820 25.07.05 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, 18 The systems in place give service users and their relatives and friends confidence that complaints will be listened to, taken seriously and acted upon, and that service users are protected from abuse. EVIDENCE: The home has systems in place for complaints and the record of complaints seen during this inspection included a description of the complaint and the action taken in response to the complaint. The inspector noted that the senior staff and proprietors of the home respond to complaints quickly. Eighteen of the nineteen service user comment cards that responded to the question stated that they knew how to complain if they were unhappy about any aspect of their care in the home. The home has an adult protection procedure (including whistle blowing), which complies with the Public Disclosure Act 1998 and the DOH guidance No Secrets. All twenty-two of the service user comment cards that responded to the question said that they felt safe living in the home. Springview G59 S10649 Springview V220820 25.07.05 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, 22, 26 Service users benefit from living in a clean, pleasant and hygienic home, which provides a safe and well-maintained environment. Service users independence is generally maintained by the provision of specialist equipment in the home, but the lack of ramps to the exterior of the building place restrictions on the independent movement of service users who require a wheel chair. EVIDENCE: The inspector undertook an unaccompanied tour of the premises, and a selection of bedrooms on each floor were visited as were the communal areas, bathrooms, toilets, laundry, kitchen and grounds. The inspector noted that good standards of accommodation were provided throughout the home. The standard of cleanliness was good and good quality furnishings and decorations are provided throughout the home. Springview is a purpose built care home providing en suite bedrooms to all 58 service users on ground, first, second and third floors. There are two shaft lifts although only one travels to the third floor. The inspector noted that there is a ridge at the base of the sliding doors, which lead from the main lounge to the outside sitting area. This makes it difficult for Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 15 staff and relatives to assist services users in wheelchairs to move from one area to another. It also makes it impossible for service users to do so independently. The registered persons must install a ramp facility between the main lounge and the outside sitting area, and between the main lounge and the rear balcony. The inspector noted that the home provides a pleasant and attractive environment for service users. The home was clean and was clearly well maintained. In all the shared toilets there is soap and disposable hand towels. The inspector visited the laundry and discussed the laundry arrangements with a laundry worker. The laundry was operating in a satisfactory manner. One service users concerns about their clothes going missing described in their comment card had been addressed by the management of the home. Springview G59 S10649 Springview V220820 25.07.05 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, 30 Service users benefit from the care given by sufficient staff who are receiving the training necessary to undertake their roles and responsibilities. EVIDENCE: The home was subject to an additional visit on 25th April 2005 following concerns, which had been raised with regard to the number of staff available on the second floor. A requirement was made that there are a minimum of four staff (excluding the manager) on duty on the second floor at all times. Staff rotas seen during this inspection demonstrated that the home has provided four staff on each shift. There are currently eighteen staff registered on the NVQ level 2 and eight staff registered for the NVQ Level 3 in care. New staff complete an induction course based on the Training Organisation for Personal Social Services standards. Ancillary staff have received training in food hygiene. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 17 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) 33, 38 This is a well run home which operates in the best interests of service users and which has systems in place to protect and promote their health, safety and welfare. EVIDENCE: Regulation 26 monitoring visits have been taking place on a monthly basis as required, and a copy of the report of this visit is sent to the Commission for Social Care Inspection. The inspector was impressed by the determination expressed by two of the homes proprietors to operate a home to the highest standards, and the detailed questionnaires completed by service users as part of the homes quality monitoring procedures. Staff have received training in fire safety and moving and handling, and there is evidence in the homes records of the regular servicing of fire equipment and regular fire drills. Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 18 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score 3 x 3 x 3 x 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 3 COMPLAINTS AND PROTECTION 3 x x 2 x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 x x 3 x x x x 3 Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 19 No 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 22 Regulation 23(2)(n) Requirement The registered persons must install a ramp facility between the main lounge and the outside sitting area, and between the main lounge and the rear balcony. Timescale for action 30th October 2005 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 There are no good practice recommendations made following this inspection Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Solar House 1st Floor, 282 Chase Road Southgate London, N14 6HA 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 Springview G59 S10649 Springview V220820 25.07.05 Stage 4.doc Version 1.40 Page 21 - 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!