Inspection on 10/02/09 for Springwood House

This inspection was carried out on 10th February 2009.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Springwood House 18/10/06

Springwood House 27/01/06

Springwood House 05/08/05

Springwood House 25/01/05

Springwood House 25/06/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springwood House Duffield Bank Duffield Derbyshire DE56 4BG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Janet Morrow     Date: 1 0 0 2 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Springwood House Duffield Bank Duffield Derbyshire DE56 4BG (01332)840757 F/P01332840757 springwood_house@hotmail.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Mr Phil Clemens,Mrs Karen Clemens care home 29 Number of places (if applicable): Under 65 Over 65 29 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Springwood House care home is set on a hillside on the outskirts of Duffield. The home provides personal and social care for 29 people aged 65 years and over. All bedrooms are used as single rooms, with the option of providing shared rooms if required. All rooms with the exception of six have ensuite facilities. The home is on three floors with two shaft lifts in place to ensure access to all areas. The lounge and dining areas are on the ground floor. Residents have access to a large attractive garden, which is well set out. Care Homes for Older People Page 4 of 28 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This inspection visit was unannounced and took place over one day for a total of 6.5 hours. Care records and staff records were examined. A partial tour of the building was undertaken. Nine of twenty-one people currently accommodated, one relative, three members of staff, the deputy manager and the manager were spoken with. The Commission for Social Care Inspection received three surveys from people living in the home and two from relatives prior to the visit. Written information in the form of an annual quality assurance assessment had been Care Homes for Older People Page 5 of 28 received prior to the visit and informed the inspection process. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. Care Homes for Older People Page 7 of 28 The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 28 Details of our 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) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 28 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There was sufficient admission information available, which established that the home could meet peoples needs. Evidence: The written information supplied by the home stated that The Management meet with the new resident and their relatives prior to a resident deciding on their choice of care Home to answer any of their questions. Two of the three surveys received from people living in the home stated that they received enough information before deciding to move into Springwood House. One survey did not have a response regarding information. A relatives survey commented that the initial assessment was sensitive and thorough and the needs identified have been met. Care Homes for Older People Page 10 of 28 Evidence: Two peoples care records were examined and both had information about individual needs available. Neither person had any information from external professionals as they had not been admitted via the assessment and care management process. However, the deputy manager had information in another file that showed reviews of care were undertaken with external professionals, where relevant. Assessments for risk of pressure sores and nutritional assessments were also available. However, there was no documentation available to show that risk of falls had been assessed. Care Homes for Older People Page 11 of 28 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Health and personal care needs were met and the care of people living in the home was planned and given in a way that respected individuality. Evidence: Two peoples care files were examined and both had a care plan in place that contained useful information. This was combined with the assessment document and although it covered all areas of need including social needs, the information was limited and not specific. For example, one persons plan stated under continence needs that the person requires pads but had no other information and another had identified under mobility needs that the person had had a fall but did not state if they used a walking aid or what staff needed to do to prevent falls. There was an individual record in each persons bedroom. This detailed what personal care the person needed, whether they required a walking aid, glasses, dentures and continence aids and then their description and location. The deputy manager stated Care Homes for Older People Page 12 of 28 Evidence: senior carers and management regularly checked this documentation and amended when appropriate to ensure residents received the exact care they needed. Risk assessments for nutrition and pressure sores were completed monthly on each person and weight was recorded monthly. The files showed that access to health professionals such as district nurses, chiropodists and opticians was available. Recent changes to local health services were identified on the written assessment provided by the home as a barrier to improvement. This was discussed with the deputy manager and she was able to show how she had tried to address these changes. She also stated that she had approached a private company for training in visual and hearing awareness and that the same company also provided on-site visits for visual, hearing and dental issues. All people spoken with stated that their privacy and dignity was respected and warm relationships were observed during the inspection visit. Staff were observed to knock on bedroom doors before entering. Two of the three surveys received from people living at the home responded that they usually received the care and support they needed and one survey responded that they always did. One survey commented that the staff here are always available and helpful. One person spoken with described the staff as very willing and another said they were more than satisfied with the help they received. One of the two relatives surveys received responded that needs were usually met and the other responded that they always were. The written information supplied by the home stated that our residents are asked whether they would like us to take custody of and administer their medicines. Those that wish to retain custody themselves are sensitively assessed then the procedures they must follow are explained to them. Three medication administration record (MAR) charts were examined for accuracy of recording. This showed that the records were signed accurately with no gaps on the charts. However, they did not have a signature when the medicine was received into the home. Two medication administration record (MAR) charts were then examined in more detail and both were completed accurately and corresponded with the dispensing system (blister pack). Both had all the medication in stock that was required. Two people were not signing handwritten charts consistently to ensure these were accurate. One person had not signed their agreement for the staff to keep their medicines. Care Homes for Older People Page 13 of 28 Evidence: The stock of controlled drugs was examined. This was in a secure cupboard and the written record corresponded with the amount of medicines in stock. The home did not have a copy of the up to date Royal Pharmaceutical Society Guidelines on handling medicines in social care. Care Homes for Older People Page 14 of 28 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Activities, meals and contact with the community were all well managed, which ensured that people living in the home had a good quality of life and control over their lives. Evidence: The written information provided by the home gave comprehensive detail of what activities had taken place and of plans for the following year. For example, it commented that special occasions would be made of Wimbledon and the Grand National and that greater use would be made of the gardens. It also stated that The home has good ties with the community. The home supports the community through fund raising, advertising and taking on work experience students from the local secondary school. The community supports the Home by providing entertainment and information to the home and our residents. There were no specific activities seen occurring during the day of the inspection visit but people spoken with were observed pursuing their own interests such as reading and spending time in their rooms. Care Homes for Older People Page 15 of 28 Evidence: Regular activities included an art class and manicures. The three surveys from people living at the home had different opinions of the activities provided; one responded that there were usually activities, one responded that there sometimes were and one commented that there were frequent activities and also stated that they were well supplied with books by the lending library. One relatives survey commented that the Christmas Fayre, bonfire night and Christmas reception were really enjoyable for their informality. Another commented that greater attention to social activities would improve the home. The serving of the lunchtime meal was observed and was nutritious and wholesome. All people spoken with stated that they had enjoyed their meal. One person described the food as excellent and another as very good. An internal survey conducted by the home had received comments on the meals and one person had said thoroughly enjoyed every meal, the portions are just right. Although there was no choice for the main meal, individual tastes were catered for and one person received an alternative meal. One of the three surveys received from people living in the home responded that they always enjoyed the meals and two responded that they usually did. Another commented that lunch is excellent, varied and tasty. Tea also good. One relatives survey received commented that more alternatives and a menu up each day would be an improvement. The deputy manager advised that there was a menu up each day in the Main Lounge. The dining room was bright and cheerful and the tables were well laid with condiments. The manager was aware of how to contact advocacy services if required, although no one in the home currently had an advocate. Visitors were observed to visit when they wished. One relative spoken with stated that they were made to feel welcome and confirmed that they could visit at any time. Both relatives surveys responded that they were always kept up to date with important information. Care Homes for Older People Page 16 of 28 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Systems were in place to ensure that complaints and safeguarding issues were responded to appropriately, which ensured that people living in the home were safe and their concerns handled objectively. Evidence: The written information provided by the home stated that there had been no complaints received during the last twelve months. The complaints record was seen and showed that there had been no recent complaints. The procedure for making a complaint was clear and stated that the home would provide a response within twentyeight days. All three surveys received from people living in the home responded that they knew how to make a complaint and one commented, have had no reason for complaint. Both relatives surveys received also responded that they knew how to complain and one commented that the owners and manager were approachable and very keen to please. The home had its own procedure for safeguarding adults that was clear about the need to refer to the appropriate agency. However, it did not have the Derby and Derbyshire Local Authority Social Services safeguarding procedures or information on how to refer to the Protection of Vulnerable Adults (POVA) list. Care Homes for Older People Page 17 of 28 Evidence: Safeguarding training was provided via an external agency and certificates showed that this had occurred in 2007 - 2008. However, one member of staff was yet to undertake the formal training, although they were aware it was required. Staff spoken with were aware of their responsibilities in reporting potential abuse. Care Homes for Older People Page 18 of 28 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well maintained, well decorated and had well tended grounds, which provided comfortable and appealing accommodation for people living there to enjoy. Evidence: The written information supplied by the home said Our Home has a reputation for being very clean, tidy and well maintained. We pride ourselves on the fact that our home always smells fresh and clean plus it is well ventilated as well as being warm enough for our residents. Springwood House was clean, tidy and well maintained at the time of this inspection. People living in the home and their relatives commented favourably on the comfortable accommodation and pleasant gardens. One person spoken with said the views from the dining room were lovely. Fittings and furnishing were of good quality and there was an ongoing programme of maintenance. Two bedrooms were viewed and these were personalised and had the furniture required. Both people spoken with said they were pleased with their rooms. Two of the three surveys received from people living in the home responded that the home was always fresh and clean and one responded that it usually was. One person Care Homes for Older People Page 19 of 28 Evidence: commented that my room is hoovered regularly and bed made daily and linen changed regularly. Plenty of cushions and pillows. One relatives survey commented that Springwood House is remarkably clean and devoid of smell, giving the impression of a small country house hotel. The laundry was viewed and there were three washing machines, one with a sanitising/sluicing facility. People spoken with were pleased with the laundry service and clothing was well maintained. Staff spoken with confirmed that they had undertaken infection control training. They were knowledgeable on how to prevent the spread of infection and confirmed that there was always a plentiful supply of protective equipment, such as gloves and aprons. Care Homes for Older People Page 20 of 28 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples safety was not fully ensured due to omissions in recruitment procedures and training . Evidence: The written information supplied by the home stated We always ensure we have the right levels of staffing to look after our residents needs. There were sufficient staff on duty on the day of the inspection, that included two carers and a senior member of staff on the morning and afternoon shift. There was one waking night staff and the owners were available as sleep-in staff. There was also a cook and general assistant on duty each day. Two of the three surveys received from people living in the home responded that there were always staff available when needed and one responded that there usually were. A core group of long term staff were still employed, which ensured consistency of care. However, the deputy manager highlighted that there had been some changes of staff and one relative commented on a survey that staff turnover is not insignificant. Recruitment procedures were not as thorough as indicated in the written information supplied by the home, which stated that our staff files are up-to-date and include all Care Homes for Older People Page 21 of 28 Evidence: the necessary information and we ensure each member of staff has a CRB check, two written references and two forms of identity (one of which is photographic). Examination of two staff files showed that the Criminal Record Bureau (CRB) check in place had not been completed by Springwood House but had transferred from a previous employer. Current CRB checks owned by the individuals were accepted by the home. Neither file had evidence of a Protection of Vulnerable Adults (POVA) First check. One file did not have any identity information except a photograph. These issues have been raised at two previous inspections in 2006 and compliance with the Care Homes Regulations 2001 will now be monitored. A training matrix supplied by the home shortly after the inspection visit showed that seven out of fourteen care staff had achieved a National Vocational Qualification (NVQ) to level 2 or above and the deputy manager stated that a further five have been enrolled and are commencing their NVQs in April 2009. This meant that the home was meeting the target of having 50 of care staff qualified to NVQ Level 2. The written information supplied by the home stated that We offer more courses for staff now which include numeracy and literacy, computer courses and team leading. We also provide cleaning NVQ as well as Health and Social Care NVQ. Training information was available on a range of subjects in video format and staff spoken with confirmed that mandatory health and safety training took place. However, one member of staff had not undertaken any recent moving and handling training and two had not done any first aid in the last twelve months. The deputy manager stated that they were in the process of registering with an external college for training and that dates for additional courses were not yet known. Medication training was planned. Care Homes for Older People Page 22 of 28 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home was well managed and run in peoples best interests. Evidence: The manager was a registered nurse and had extensive knowledge and skills to manage the home, having worked as the registered manager and joint owner at Springwood House since 1995. However, the deputy manager was undertaking a large proportion of the managerial responsibilities and was in the process of completing an application to become the registered manager of Springwood House. Quality assurance systems were mostly informal and often took the form of obtaining verbal feedback. However, an internal survey had been circulated in 2008 and the responses to this were seen; feedback was mostly positive and most areas had been rated as excellent or good. Thank you cards received also praised the home with one stating that it was a wonderful caring home. The deputy manager had gone to considerable efforts to provide comprehensive information on the annual quality Care Homes for Older People Page 23 of 28 Evidence: assurance assessment required by the Commission and this had clearly demonstrated where the home wanted to improve. One survey from a person living in the home stated that they were very happy with the care and a relatives survey received commented that the owners are friendly and well organised and another said the willingness to please cannot be faulted. Two peoples financial records were examined. These were accurate with the money stored corresponding with the written record. Two people signed the record to ensure its accuracy. Cash was stored securely. The written information provided by the home stated that no-one in the home acted as appointee for anyone. Staff spoken with confirmed that they undertook mandatory health and safety training in fire safety, infection control, first aid, moving and handling and food hygiene and this was also stated in the written information provided by the home. However, one member of staff had not undertaken any recent moving and handling training and two had not done any first aid in the last twelve months. The written information provided by the home stated that maintenance checks were undertaken regularly and that all necessary checks had been undertaken in 2008. This was confirmed by a random sample of the certificates for gas safety and the fire detection equipment. Care Homes for Older People Page 24 of 28 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 29 19 The recruitment information for staff must include everything detailed in Schedule 2 of the Care Homes Regulations 2000, including a Protection of Vulnerable Adults (POVA) First check, identity information and a Criminal Record Bureau (CRB) check undertaken by the home. This is to ensure that legal requirements are met and that people are cared for by staff who have been checked and deemed suitable to work with vulnerable people. 01/04/2009 2 38 13 All staff must have up to date mandatory training, particularly in first aid and moving and handling. This is to ensure that staff are competent and that peoples health and safety is addressed. 01/06/2009 Care Homes for Older People Page 26 of 28 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 2 3 3 7 9 Risk assessments for falls should be completed on admission for all people moving into the home. Care plans should contain specific detail on what assistance is needed with personal care. The medication administration record (MAR) chart should be signed when medicine is received and checked into the home. Hand written medication adminstration record (MAR) charts should be signed by two people to ensure accuracy. The home should obtain a copy of the Royal Pharmaceutical Society guidelines on handling medicines in care homes. Further consideration of more varied activities to suit individual needs should occur. The home should consider offering a choice for the lunch time meal. The home should obtain a copy of the Derby and Derbyshire Local Authority safeguarding adults procedures and the guidance on how to refer to the Protection of Vulnerable Adults list. The home should arrange training courses related to care. 4 5 6 7 8 9 9 12 15 18 9 30 Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 28 of 28 - 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!