Care Home: Springbank

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What the care home does well Support is provided in a home that is well decorated and maintained, and which provides service users with a homely relaxed atmosphere. Staff are well supported by the management team to enable service users to lead as fulfilling and rewarding lives to the best of their individual abilities. Staff are provided with a good level of training to enable them to carry out their roles safely and effectively. What has improved since the last inspection? There is now a business plan in place for the service that was available and open to inspection. The home is now maintaining a log for the recording of any complaints received. The home was found to be in a good state of repair internally. What the care home could do better: The home continues to provide a good standard of care in all of the quality outcome areas; as a result no requirements were set following this inspection. CARE HOME ADULTS 18-65 Springbank Heath Road Tendring Clacton on Sea Essex CO16 0BX Lead Inspector Neal Cranmer Unannounced Inspection 29th November 2007 09:30 Springbank DS0000069781.V355931.R01.S.doc Version 5.2 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 Springbank DS0000069781.V355931.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 Adults 18-65. 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. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springbank Address Heath Road Tendring Clacton on Sea Essex CO16 0BX 01255 870237 01255 870098 springbank@schealthcare.co.uk 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) Active OPCO Limited Mrs Elaine Feeney Care Home 34 Category(ies) of Dementia (9), Dementia - over 65 years of age registration, with number (9), Learning disability (34), Physical disability of places (34) Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. Persons of either sex, under the age of 65 years, who require care by reason of a learning disability who may also have a physical disability (not to exceed 34 persons) Persons of either sex, under the age of 65 years, who require care by reason of dementia who may have learning and physical disabilities, to be accommodated in Phoebe House (not to exceed 9 persons) Persons of either sex, aged 65 years and over, who require care by reason of dementia who may have learning and physical disabilities, to be accommodated in Phoebe House (not to exceed 9 persons) The total number of service users accommodated must not exceed 34 persons 20th December 2006 Date of last inspection Brief Description of the Service: Springbank caters for service users with learning and physical disabilities, the majority of whom have medium to high levels of need. The home is a detached property set in the village of Tendring. Accommodation consists of mainly single bedrooms, although there are some double rooms. Many of the rooms have en-suite facilities. There is adequate parking to the front of the building, with the rear having extensive pleasant gardens. The home is situated approximately nine miles from the towns of Clacton and Colchester, and the many amenities that both of these towns have to offer. Fee’s for residing at the home are £998.62 per week, with additional charges being made for 1.1 hours, hairdressing and outings. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This report follows an unannounced key inspection of the home, which took place over one day in November 2007, lasting approximately 6.00 hours. During the course of the inspection the registered manager, their deputy and three members of the care team were spoken with. The needs of the service users are complex, and it was therefore not possible to obtain any verbal feedback. However, observation of service users indicated that they were comfortable and relaxed in their environment. During the course of the inspection a tour of the premises was undertaken, including service users rooms, bathing and toileting facilities, as well as communal and garden areas. In addition to the above a range documentary records were sampled, including the home’s Annual Quality Self Assessment Audit (AQAA). The information included in the annual quality assurance form (AQAA) which had been submitted to the Commission for Social Care Inspection, was also used in compiling the inspection report. This form gives homes the opportunity of recording what they do well, what they could do better, and what has improved in the previous twelve months as well as future plans for improving the service. What the service does well: What has improved since the last inspection? There is now a business plan in place for the service that was available and open to inspection. The home is now maintaining a log for the recording of any complaints received. The home was found to be in a good state of repair internally. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 6 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. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2. Quality in this outcome area is excellent. This judgement has been made using available evidence including a visit to this service. Service users can be assured that a comprehensive assessment of their needs will be undertaken by a representative of the home, prior to a service being offered. EVIDENCE: The home has had one new admission since the last inspection, the assessment was sampled and covered the following areas of need: Emotional well being, Spirituality, Eating and drinking, Personal hygiene, Mobility and dexterity, Sleeping and waking, Activities and leisure, Vision and hearing, Health care, Medication, Mental health and capacity to consent and sexuality. Pre- admission assessments are carried out by the registered manager, and are used as the basis for formulating the service user’s initial plan of care. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that their assessed needs will be reflected within their individual plans of care, and they will be supported to make decisions and take risks, with assistance as required. EVIDENCE: All service users care plans are generated from the home’s comprehensive peradmission assessment, and those sampled were based upon the activities of daily living. Guidance to staff was clear and unambiguous. One of the care plans sampled related to the administration of covert medication and had been set up and agreed through a multidisciplinary approach, including consultant and a specialist nurse who deals with epilepsy. The guidance provided was clear and clearly explained that in the first instance medication should be administered using a non covert approach, and that administering in a covert way should only be used as a last resort. Due to the nature of this care plan it was being kept under regular review. Discussion with staff indicated that they were involved in the development and review of care plans. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 10 None of the service users residing in the home are able to manage their own financial affairs, although all have their own bank accounts. The home does access advocates on behalf of the service users, however at the time of the inspection no advocates were providing input into the home. Risk assessments are undertaken in respect of all service users, which identified the nature of the risk, the likelihood of the identified risk presenting, as well as the risk level, and any management strategies in place to help reduce and minimise the identified risks. Risk assessments were in place in respect of epilepsy, community access, and dealing with false accusations and supporting people with mobility. The risk assessments were designed to keep service users as safe as possible, without impeding their independence. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that they will be supported to take part in activities that are of their choosing, and that they will be supported to maintain links with people that are important to them. Service users can be assured that they will be provided with a varied and nutritious diet. EVIDENCE: The home employs an activities co-ordinator five days a week, discussion with them indicated that they provide sessions on card making, drawing, pampering, art and craft, music sessions, flower arranging and gardening. The activities co-ordinator informed the inspector that an activities board is placed on the wall in each of the homes unit’s, which informs service users, and staff of the activities going on in the home at any given time. In addition to these in-house activities evidence was seen of service users also accessing the community to take part in the following activities: Shopping, trips to the theatre, meals out, swimming, visits to the local pub and visits to the local rural centre. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 12 Two service users have some voluntary occupation, with another attending Adult Education College, where they attend classes on cookery and every day living skills. The home has an open door policy on the receiving of visitors, and a quiet lounge area is available for use if required. Discussion with a relative visiting the home indicated that they were always made welcome, and provided with drinks and a meal when visiting their relative, they also spoke of the home picking them up from and dropping them back of at the railway station at the end of their visit. Staff were seen and heard during the course of the inspection interacting with service users, and not exclusively with one another, the interactions seen and heard were appropriate and respectful, and the service users seemed genuinely at ease and relaxed in the company of the care staff. Meals are provided three times daily, at least one of which was provided as a hot meal. Meals are provided flexibly to facilitate service users daytime activities, and service users occupied during the day are provided with packed lunches. The home employs two cooks, who between them cover seven days a week. Discussion with one of the two cooks indicated that the kitchen is well equipped, with all of the necessary equipment they need to carry out their roles. Menus were seen to be on display in the dinning room, and were available in picture form, the menus seen were four weekly rotational and were varied and nutritious. Each of the units is equipped with its own small kitchen area where breakfasts and small snacks can be prepared, the main meals of the day are prepared in the home’s main kitchen. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 21. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in a way that ensures their physical and emotional needs are met in a way that is appropriate to their needs. Service users can further expect to be protected by the home’s policies and procedures for dealing with medicines. EVIDENCE: Discussion with staff and observation of practice indicated that service users are supported in a way that respects their privacy and dignity. Staff interactions with service users were respectful and polite and staff spoken with described ways in which they worked with service users to ensure their privacy was upheld at all times. All service users are registered with a General Practitioner, and healthcare records sampled were good, and indicated input from a range of healthcare professionals including: District nurses, occupational therapists, Physiotherapists and epilepsy nurse specialists. Each service user has an O.K health check record which included the following information: Body measurements, Body mass index, Medication, How pain or distress is communicated, Circulation and breathing, Epilepsy, Digestion and elimination, Oral hygiene, sexuality, mental healthcare needs. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 14 None of the service users are able to self medicate and medication is dispensed via a combination of a Measured Dosage System (MDS) and directly named containers, and is only dispensed by staff who have received the appropriate training. Training is provided both in-house as well as by trained pharmacists. The home does not maintain any controlled medicines, although invasive medicines are held and administered, staff administering these medicines do so only following completion of the necessary training. Medications are dispensed directly from medicine cabinets situated in service users rooms, and these are kept locked at all times. Medication no longer in use or out of date is returned to the pharmacy in a medication returns book. Medication audits are carried out monthly by the registered manager, in addition to these audits, periodic unannounced audits are carried out by visiting pharmacists. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can be assured that the home has in place robust policies and procedures for responding to complaints and for ensuring that they are protected from harm and or abuse. EVIDENCE: The home has in place corporate policies for dealing with complaints and, Since the last inspection of the service four complaints and have been received. The home maintains a complaints log for the recording of complaints, which detailed the nature of the complaint received, the date reported, to whom and the outcome. The home’s adult protection policies and procedures are also corporately developed and are comprehensive and robust, and included the forms of abuse that may occur, and how these may present. Guidance to staff was clear about how they should respond in the event of an allegation. There have been two adult protection referrals since the last inspection. All staff with the exception of new recruits have received training in adult protection. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported in an environment that is homely, comfortable, well maintained and safe, and which is kept free from any unpleasant odours. EVIDENCE: A tour of the premises was undertaken, which found them to be safe, comfortable and generally well maintained, and fit for its stated purpose. The home is divided into three smaller units, each of which was accessible to the service users, with hallways wide enough to facilitate movement by service users who required the use of a wheelchair. Furnishings and fittings were domestic in nature and were of a good quality. Since the last inspection of the home new radiator covers have been fitted. An on-going programme of refurbishment is underway, which is to include the fitting of new carpets, bathrooms and shower rooms. The home’s laundry facility is situated away from areas where food preparation is undertaken, and was equipped with a sluicing facility. The washing machines Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 17 and dryers were industrial in style and were equipped with disinfection programmes, designed to reduce the risk of infection. On the day of the inspection the home was found to be clean and tidy and free of any unpleasant odours. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34 and 35. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect to be supported by a team of staff who are competent, appropriately qualified and well trained. They can further expect to be protected by the home’s recruitment practice. EVIDENCE: The home employs thirty care staff, of who seventeen hold National Vocational Qualifications (NVQ) at level 2, a further eight are qualified to level 2, with a one being qualified to level 4. Four staff files were sampled in respect of the home’s recruitment practice, all contained the necessary documentary evidence including: Application form, Written references, Criminal Records Bureau Checks (CRBs), evidence of induction, supervision and training. The staff files sampled indicated that a good range of training was being provided to staff across the team, this included cooks, domestics, maintenance staff, night care staff and day staff. The training evidenced included: Fire safety, Food hygiene, Health and safety, Appointed persons first aid, Infection control, Medication administration, epilepsy awareness, moving and handling, Adult protection, and assessment and care planning. Discussion with staff indicated that access to staff training was good. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39, 42 and 43. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users can expect that they will benefit from having their needs met in a home that is well run and managed, and in which their views will be sought. Service users can further expect that the home’s working practices will protect and promote their health and welfare. EVIDENCE: The registered manager has significant previous experience of working in the care sector, and holds a National Voluntary Qualification level 4 in Care, as well as a diploma in Health and Social Care. The registered manager is only responsible for the one establishment, and undertakes periodic training to enable them to remain current and up to date in terms of their practice. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 20 The home reviews the quality of its service provision by sending out periodically comment cards to relatives, a sample of responses received included: ‘With the resources you have you do an excellent job’ I am very pleased with the care my relative receives’ My relative is well looked after’. In addition to the comment cards sent out, a number of audits are undertaken by the home, these included: audits on Medication, Pressure areas, Accidents, Staff files, Recruitment and vacancies, and complaints. Team meetings are held every six to eight weekly, and minutes of these meeting are taken and circulated. Visits by the registered provider are undertaking monthly in line with Regulation 26 of the Care Homes Regulations, and copies of these visits are sent to the home, as part of these visits service users are consulted with about their views of the home. The home’s safe working practices were sampled through the viewing of a range of safety certificates, all of which were found to be in order. The home has in place a business plan for the service, which included details of the homes staffing structure, staff training and capital costs. Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 4 3 X 4 X 5 X INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 X LIFESTYLES Standard No Score 11 X 12 3 13 3 14 X 15 3 16 3 17 4 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 3 3 Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 22 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. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection Colchester Local Office 1st Floor, Fairfax House Causton Road Colchester Essex CO1 1RJ 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 Springbank DS0000069781.V355931.R01.S.doc Version 5.2 Page 24 - 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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