Care Home: Springcroft

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What the care home does well The atmosphere at the home was relaxed with communication between staff, residents and visitors being positive, open and friendly. There is a detailed and informative Statement of Purpose and Service Users Guide that gives prospective residents the information required to enable them to make an informed choice about where they live. Some residents were able to confirm that they were visited by the manager Mrs Samy, prior to admission to the home. There is an open house policy, which welcomes visitors at all reasonable times. There are processes in place for dealing with complaints ensuring that people living in the home and their relatives feel their concerns are listened to. The activities meet the residents expectations at this time and residents are involved in making choices in respect of their preferred lifestyle. All residents relatives visitors and visiting professionals contacted as part of the inspection process confirmed a satisfaction with the home and its services one resident saying, `I am very well cared for, the staff are nice`, `Its a lovely home and has good food. The quality and choice of meals remain good and all residents spoken with were complimentary about the food. The training for staff is very comprehensive and covers a wide variety of resident related conditions, which give the staff an understanding of the residents needs. There is a robust recruitment process in place that protects the residents. What has improved since the last inspection? The home was deemed excellent at the last key inspection, with no requirements or recommendations made. The AQAA stated that the home continue to monitor the service they provide and continue to improve their service to meet the residents expectations and preferences. What the care home could do better: There were no requirements made at this inspection. Some recommendations in respect of developing the care plans were made and these were acknowledged and will be attended to. Two areas of maintenance shortfalls were attended to immediately. Key inspection report Care homes for older people Name: Address: Springcroft 58 Springfield Road St Leonards On Sea East Sussex TN38 0TZ     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Deborah Calveley     Date: 0 5 1 1 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 26 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 26 Information about the care home Name of care home: Address: Springcroft 58 Springfield Road St Leonards On Sea East Sussex TN38 0TZ 01424-431856 01424202354 teelaga@yahoo.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mr T Samy care home 12 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users to be accommodated is 12 The registered person may provide the following category of service: Care home with nursing (N) to service users of the following gender: Either whose primary care needs on admission to the home are within the following category; Old age, not falling within any other category (OP) Date of last inspection Brief description of the care home Springcroft Nursing Home is a detached property in a residential road in St Leonardson- Sea. It is registered to provide nursing care for 12 service users. The home is on three floors. There is a shaft lift and in addition to this there are two stair lifts provided. Fire escape staircases evacuate to the rear garden. Service users have use of a lounge and conservatory for communal activities. There is level access to the home through the front garden. A gate at the side of the property gives security to a rear, neatly tended, walled garden providing a pleasant area for service users. The home offers nursing care in a relaxed, but professional environment. Charges for extra services such as hairdressing and chiropody are variable, depending on the Care Homes for Older People Page 4 of 26 Over 65 12 0 Brief description of the care home service provided and information on these are provided by the home. Care Homes for Older People Page 5 of 26 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: three star excellent 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: The reader should be aware that the Care Standards Act 2000 and Care Homes Regulation Act 2001 often use the term service user to describe those living in care home settings. For the purpose of this report those living at Springcroft will be referred to as residents. This was a key inspection that included an unannounced visit to the home and follow up contact with residents, representatives and visiting health and social care professionals. This unannounced inspection was carried out over 4.5 hours on the 05 November 2009. There were twelve residents living in the home on the day, of which four were case tracked and spoken with. During the tour of the premises four other residents were also spoken with. Care Homes for Older People Page 6 of 26 The purpose of the inspection was to inspect the key standards against the information received from the completed Annual Quality Assurance Assessment (AQAA). As part of the inspection process a range of documentation was viewed which included: the Service Users Guide, Statement of Purpose, care plan, medication records and recruitment files. Two carers, one registered nurse, the cook and the registered manager Mrs Samy were spoken with. Telephone contact was made with health and social care professionals following the visit. The information received verbally has been incorporated into this report. Along with the information received from resident surveys staff surveys and the competently completed AQAA. Care Homes for Older People Page 7 of 26 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 Care Homes for Older People Page 8 of 26 following this report, you can contact them using the details on page 4. 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 9 of 26 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 10 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides prospective residents and relatives with a good level of information about the home, its facilities, services and the costs involved. The admission procedures allow for the needs of prospective residents to be assessed by a competent person before admission and they are assured in writing that the home can meet their needs. Evidence: There is a comprehensive and informative Statement of Purpose and Service Users Guide in place that are written in plain English and in a user friendly format. These documents gives prospective residents and their representatives the information they need to make an informed choice about where to live. It was confirmed whilst talking to visitors that the contract arrangements were clear and understood. There is a copy of the terms and conditions of residency included in the homes information documents. Care Homes for Older People Page 11 of 26 Evidence: A review of the care documentation confirmed that pre-admission assessments are completed by a competent person. The latest admissions to the home were identified and the records relating to the admission procedures followed were reviewed. This confirmed that pre-admission assessments are completed and provide a satisfactory assessment of prospective residents care needs. Prospective residents are seen either in their home or hospital before admission and the input from relatives and other professionals is used whenever possible. It was confirmed that the home confirms in writing that having regard to the assessment that the home can meet the assessed needs of the prospective resident. Mrs Samy was knowledgeable regarding the people who live in the home and stated that staff receive training in order to meet the residents differing needs. Trial visits to the home can be arranged. It was confirmed that residents are invited to a trial period to ensure suitability of the home. This is clearly stated in the Statement of Purpose and in the statement of terms and conditions. Intermediate care is not provided at Springcroft Care Home. Care Homes for Older People Page 12 of 26 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. Care plans provide a good framework for the delivery of care which give clear guidance to care staff on all the care needs of all the residents. The home was found to be meeting residents health and general needs with accessed additional specialist support when needed. Medication practices in the home promote and protect the health needs of residents and on the whole the privacy and dignity of residents are promoted. Evidence: The care documentation pertaining to four residents was reviewed in depth as part of the inspection process. The format of the care plans used in the home is comprehensive and detailed and one resident spoken with confirmed that they had been involved in planning their care. The residents were found in the main to have care plans specific to their needs and evidence regular review since the last key inspection. Risk assessments for health needs are included in the care planning format used by the home. The risk Care Homes for Older People Page 13 of 26 Evidence: assessments were found to be completed and followed through with an appropriate plan of action when identified as required. The homes documentation in respect of their health needs ensure that residents receive the care and support they need to protect and promote their health. Areas that need developing were discussed in full and include communication. The shortfalls were acknowledged and will be undertaken. Residents are registered with a GP from local surgeries and all residents have access to health professionals. The health needs of residents are adequately met with evidence of good multi disciplinary working taking place on a required basis. Residents spoken with were satisfied with the care provided at the home one saying that the home, Oh its lovely I receive good care I am comfortable. There are policies and procedures in place for staff to refer to regarding the safe administration, storage, disposal and recording of medication. The medication administration charts were in the main competently completed. Some minor shortfalls were discussed and will be addressed. This includes residents photographs for identification purposes. The systems for recording and checking controlled drugs were found to be thorough. The residents health needs are promoted and protected by the homes medication practices. The residents spoken with confirmed that they were treated with dignity and respect and that their right to privacy was respected. During the site visit residents were addressed by their preferred term and dressed appropriately in well-laundered clothing and their personnal care was as the residents wished. Care Homes for Older People Page 14 of 26 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. Social activities and meals continue to be creative and provide daily variation and interest for people living in the home. Residents are able to make a range of choices about their lives as well as maintaining links with friends and relatives. Evidence: The home does not have an activity programme, but ensure the residents follow their interests and hobbies. It was confirmed that residents are taken out for trips and Mrs Samy has also taken residents to a local sea resort for a short holiday. The care plans evidenced a range of individual activities undertaken daily. The home also support residents in accessing a therapy of their choice such as massage. Residents are supported and facilitated to maintain their independence for as long as they are able. There are no restrictions on visiting times as long as consideration is shown to all the residents. Many of the residents have individualised their bedroom with items from home and residents confirmed that they can bring in their own bits and pieces. Care Homes for Older People Page 15 of 26 Evidence: It was observed during the inspection that the routines at the home are flexible, residents spoken with confirmed that they were consulted about all aspects of their lives. The home has an advocacy policy in place and the information regarding this is available to all residents. The mid day meal was observed and was seen to be organised and well managed. The staff were observed ensuring that those residents needing assistance were given time and able to have the assistance that they needed in an unrushed manner. Meals are served in either the residents own room or the lounge/dining area with breakfast being served in the residents own room. The menu of the day is displayed in the communal areas of the home, the residents are also asked verbally on the day and they can ask for something different if they wish. Records are kept of the meal and of the quantity eaten by the care staff. There is a four weekly rotating menu that demonstrated a nutritious and well balanced diet. The meal seen was attractively presented and the soft/pureed option was also attractively presented. There was evidence of fresh fruit and vegetables in the home and all the staff have undertaken the food hygiene course. The kitchen was clean with records as required by the Environmental Health Agency in place. Care Homes for Older People Page 16 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents feel able to make a complaint with the knowledge that this will be addressed in a fair and open manner. Staff receive training to protect residents from abuse. Evidence: The complaints procedure is displayed in the main hallway and included in the service user guide. Residents spoken with said that they were aware of the complaints procedure but had not needed to make a complaint. Any minor concerns are recorded in a grumbles book and are dealt with immediately. The residents felt that the staff in the home were approachable and open. The home has received no complaints in the previous twelve months and records are kept about concerns received and the actions taken to address these. All staff are aware of their responsibilities regarding the protection of those in their care and have all received the appropriate training. Mrs Samy was aware of the reporting protocols under the adult protection system and the procedures involved. No adult protection issues have taken place in the home. All the care plans viewed evidenced a Deprivation of Liberty assessment in place and staff have received appropriate training. Care Homes for Older People Page 17 of 26 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Springcroft provides a comfortable clean and safe environment for those living in the home and visiting. Residents are enabled and encouraged to personalise their room and rooms are homely and reflect the residents personalities and interests. Evidence: Springcroft is well maintained and safe and meets its stated purpose and the aims and objectives of the home. The gardens are accessible and pleasant for residents and visitors to the home. The home have a choice of various communal areas which are attractive and allow for different uses ensuring residents have choice where they spend their time. The home has specialised equipment available throughout the home to promote health and encourage independence. In relation to fire safety, all records are current and in place to protect the safety of those living and visiting the home. All of the staff team attend regular fire safety training. It was confirmed that all staff receive training in infection control and that the policies Care Homes for Older People Page 18 of 26 Evidence: and procedures are updated regularly. They are easily accessible to staff thus protecting those living and visiting the home from risk of cross infection. Good practice in respect of infection control measures by staff was observed during the inspection visit and there were gloves and aprons freely available in the home. Sluice areas were found to be clean and safe with appropriate systems in place for soiled linen and waste. Care Homes for Older People Page 19 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment procedures are in place to protect residents and staff training ensures they are aware of their roles and are able to provide the support and care the residents need. Evidence: The staffing rota evidenced that there were appropriate numbers of trained and competent staff on duty over a 24 hour period to care for the residents. It was confirmed by the manager that there is flexibility of the staffing levels and they are adjusted according to the changing needs of the residents. The staff turnover is low. Staff employed by the home provide cover for sickness and holidays therefore no agency staff are used at the present time. Residents confirmed that the home had enough staff to give the level of care they expect and need. A roster is held giving names of staff on shift. In addition to care staff, there are ancilliary staff in post. A selection of staff recruitment files were viewed and demonstrated that there is a thorough and robust recruitment process in place to protect their residents The documentation in the files supported the information supplied in the AQAA that all staff receive a thorough induction to the home, which includes shadowing senior staff on their first shifts in the home. All new staff complete a trial period to ensure that the Care Homes for Older People Page 20 of 26 Evidence: job is suitable for them. Staff spoken with said that training opportunities are being offered and that it is Mrs Samy has introduced a training matrix. This enables the management team to track the training needs. This ensures that all staff receive the training required to perform their job competently and therefore promoting the health and well being of the residents living in the home. There is an induction programme in place and has been introduced for all staff. Files seen confirmed this. The induction and foundation training is in line with the Skills for Care guidance. New staff are required to complete an initial induction programme and undertake mandatory training including fire and health and safety. This leads into foundation training in preparation of National Vocational Qualification (NVQ). Care Homes for Older People Page 21 of 26 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The overall management of this home is excellent with effective systems in place to protect and promote residents health safety and well being. Evidence: The manager and providers, Mr and Mrs Samy have owned the home for several years and both have achieved the National Vocational Qualification level 4 in management and the Registered Managers Award. Both are Level 1 Registered General Nurses and Mr Samy has nurse teaching qualifications. The management structure of the home has created an open, positive and inclusive atmosphere that benefits those living, working and visiting the home. There are systems in place to monitor the quality in the home and include the use of questionnaires. It was confirmed that these are audited reported on and responded to. There are relative meetings yearly and staff meetings which are minuted and form part of the quality assurance system. Care Homes for Older People Page 22 of 26 Evidence: Mrs Samy does manage the monies for some residents and clear records are kept of any transactions with two signatures. The systems in place safeguard the residents financial interests. Evidence was seen of regular two monthly supervision sessions and all staff spoken with confirmed that they felt it beneficial. Mrs samy confirmed and the staff training records show that all staff are kept updated on the Health and Safety policies. The manual is available to all and clearly defined with regularly updated policies and procedures and best practice guidelines that ensure the health safety and welfare of the people using the service. Staff were able to discuss the training they received and said that they were kept up to date with changes to policies in connection with fire safety and health and safety. The accident book was completed in full and strategies are put in to place for prevention of a recurrence. First aid boxes are located in the home and easily assessable when required. All staff have received the mandatory training necessary to promote and protect the safety and well being of the residents. The manager confirmed that all staff are appropriately supervised until they have received the necessary training. Good practice was observed throughout the inspection in respect of promoting the safety and well being of the residents. Care Homes for Older People Page 23 of 26 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 24 of 26 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 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 Care Homes for Older People Page 25 of 26 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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