Care Home: Springfield Care Home

What the care home does well Due to the nature of the service users` disabilities, communication between service users and the Inspector was not always possible. However service users appeared happy and comfortable in their surroundings. The inspector observed a good interaction between service users and staff. People who spoke to the inspector said they were satisfied with the care that their relatives receive. One person said ` staff know my husband well and how to care for him` another commented on the `excellent care`. People said they were always made to feel welcome are listened to and things are acted upon. What has improved since the last inspection? The home continues to offer a good service. Some service users bedrooms have been decorated. CARE HOMES FOR OLDER PEOPLE Springfield Care Home Wylam Avenue Darlington Durham DL1 2YN Lead Inspector Jane Bassett Key Unannounced Inspection 26th August 2008 09:00 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address Wylam Avenue Darlington Durham DL1 2YN 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) 01325 468048 01325 354415 springfield.darlington@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd Manager post vacant Care Home 48 Category(ies) of Dementia (3), Dementia - over 65 years of age registration, with number (48) of places Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 18th October 2006 Brief Description of the Service: Springfield Care Home is a well established home, built in 1987 and situated in the Springfield area of Darlington. Accommodation is on two floors with lift access the upper floor. All bedrooms are single occupancy, personalised and equipped to meet the needs of the individual service user. There are a number of separate communal lounges and dining rooms available on both the ground and the first floor together with sitting areas. The inspector was informed the fees are £382 per week. This information was correct at the time of the visit. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This inspection was a key inspection. As a key inspection, all of the key standards were looked at or discussed. This was to check that the home meets the standards that the Commission for Social Care Inspection say are the most important for the people who use services, and that it does what the Care Standards regulations say it must. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations - but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. During the inspection the inspector carried out an unannounced visit to the home. The inspection visit lasted seven hours. During this time the inspector looked at a range of documentation including, service user and staff files. The inspector spoke to two service users, two relatives, three staff members and the manager. Two service user representatives returned questionnaires to CSCI. The manager of the home completed an Annual Quality Assurance Assessment (AQAA). At the time of the inspection the home was providing services to 40 service users. What the service does well: Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. However service users appeared happy and comfortable in their surroundings. The inspector observed a good interaction between service users and staff. People who spoke to the inspector said they were satisfied with the care that their relatives receive. One person said ‘ staff know my husband well and how to care for him’ another commented on the ‘excellent care’. People said they were always made to feel welcome are listened to and things are acted upon. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 3 & 6 were looked at. People who use the service experience good quality outcomes in this area. Prospective service users needs are assessed prior to admission to the home. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the inspection visit the files of four service users were examined. All were found to contain information gathered prior to that person’s admission to the home. During discussion with the manager and senior care staff they were able to describe the process that is followed to obtain information about a prospective service users needs including, an assessment from the care manager if that person is funded by a local authority. Information contained in surveys returned to CSCI confirmed people are given sufficient information prior to admission to the home. The home does not offer intermediate care. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 7, 8, 9, & 10 were looked at. People who use the service experience good quality outcomes in this area. People have access to health care services both within the home and the local community. Health needs are monitored and appropriate action and intervention taken. The home has a policy and procedure regarding the safe handling of medication. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the visit the inspector examined four service user files. These were seen to be well organised. Each file contained records of assessments and reviews including dependency assessment, moving and handling, falls risk, nutrition, well being profile, risk of pressure damage and Cornell scale. Files were seen to contain plans of care in relation to physical health care needs. These contained good information regarding the care needed, the persons abilities and what staff assistance was required. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 10 All files seen contained information that indicated service users have access to GP’s and other health professionals as needed. Staff who spoke to the inspector were able to demonstrate a good knowledge of individuals needs and how these are met. Staff spoke of promoting individual’s privacy, dignity and independence. Relatives who spent time with the inspector and those who returned surveys confirmed they were happy with how the care is given. They said they were notified of any changes. One person said ‘ staff know my husband well and how to care for him’ another commented on the ‘excellent care’. Due to the nature of the service users’ disabilities, communication between service users and the Inspector was not always possible. However service users appeared happy and comfortable in their surroundings. The inspector observed a good interaction between staff and service users. A sample audit of medication found no major concerns regarding the ordering, storage, administration, and disposal of medications. During the inspection the inspector observed some controlled medication awaiting return to the pharmacy was not being stored correctly. The manager acted upon this immediately. The home offers care to a number of people on a respite basis. The medications for one person was seen to be in a container supplied by the family and not in individual labelled containers supplied by the dispensing pharmacist. The inspector was told staff who administer medication have all completed safe handling of medication training. The home has recently commenced annual competency assessments in relation to the safe handling of medication. A sample audit of Medication Administration Records (MAR) examined were seen to be completed with no gaps in entries. However hand written entries of details of medication and method of administration did not contain the signature of the person making the entry or the signature of a second person confirming the accuracy of detail. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 11 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 12, 13, 14, & 15 were looked at. People who use the service experience good quality outcomes in this area. The food at the home is of a good quality, well presented and meets the dietary needs of the people who use the service. Activities are encouraged, however are limited by the service users frailties and disabilities. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the visit the inspector looked at the files of four service users and the records kept by the activities coordinators. The inspector observed good records of the activities each service user had participated in. Files seen did not contain any evidence of information obtained in relation to service users social, leisure and family history. The home employs two activities coordinators who provide activities each day. Service users, relatives and staff who spoke to the inspector told her there was a range of group and one to one activities, which take place. These included dominoes, bingo, trips, and regular entertainment. One service user spoke of having a ‘really good time’ dancing at recent event. The inspector was told there are regular visits from a local church. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 12 Staff who spent time with the inspector spoke of getting to know peoples likes and dislikes and offering people choice in their daily lives. Service users relatives confirmed they could visit at any time and were always made to feel welcome. The home has a set four week menu, the inspector was told that this can be altered to meet the needs of the service users. Staff and relatives who spent time with the inspector told her the variety and choice was good, and all diets are catered for. Service users and relatives who spoke to the inspector said they were ‘happy with meals’, one person commented on the ‘excellent food’. Comments in surveys returned to CSCI confirmed the meals were ‘good’ and ‘enjoyable’. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 13 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 16 & 18 were looked at. People who use the service experience good quality outcomes in this area. People who use the service are able to express their concerns and have access to a complaints procedure, are protected from abuse and have their rights protected. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The home has a policy and procedure in relation to the handling of complaints. Response in surveys returned by service users to CSCI and those who spoke to the inspector indicated people are aware of how to raise any concerns should they have any. All people who responded said they were satisfied with the care they receive. Records seen during the inspection indicated the home has received one complaint since last inspection. Staff who spoke to the inspector were able to demonstrate through response to questions the action they would take if they became aware of a concern. All demonstrated a commitment to protecting service users from abuse. The home has a policy in relation to prevention of abuse. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 14 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 19 & 26 were looked at. People who use the service experience adequate quality outcomes in this area. The home provides a generally clean and comfortable environment, however further refurbishment would enhance the comfort and safety of service users. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: During the visit the inspector walked around the building. It was seen that the home provides a generally clean, odour free & homely environment. Some of the bedrooms have recently been redecorated. The inspector was informed that a number of bedroom carpets are to be replaced. The inspector observed a number of areas where the environment would benefit from further refurbishment. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 15 The décor, curtains and bedding in a number of bedrooms was seen to be old and faded. In one room the wallpaper was peeling away from the wall. Some carpets were found to be stained. It was not possible to close a number of bedroom doors as the internal mechanism to door handles and / or doorframe catches were missing. Toilets and showers would also benefit from refurbishment. Paintwork was seen to be marked, some tilling and flooring was seen to be missing. Tiling on the dining room wall has in the past been painted, this was marked and flaking. The kitchen door was seen to be damaged. A ceiling tile in the ground floor corridor was seen to be damaged and stained. Wallpaper on the first floor corridor and paintwork to all corridors was seen to be damaged. The carpets to first floor lounges were found to be stained. The access to one first floor lounge was restricted by a bolt fitted to the door. The first floor has two sluice facilities, on the day of inspection one was out of order, the inspector was told this had been the case for some time. The flooring, sink and walls were badly stained and appeared unhygienic in the other sluice. During the time the inspector walked around the building it was noted a number of bedroom doors were wedged open with items of furniture. These were removed at the time of inspection. One person who spoke to the inspector said the home was ‘always clean, but was a bit tired and in need of refurbishment. Comments in surveys returned to CSCI indicated the home is usually clean and odour free. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 27, 28, 29, & 30 were looked at. People who use the service experience good quality outcomes in this area. People are satisfied with the care they receive. The home has a recruitment procedure that promotes the safety and wellbeing of service users. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: On the day of the inspection the home was accommodating 40 service users and provides day care for one or two people per day. The inspector was informed that there were usually 6 care staff (2 senior care and 4 care staff) during the day and four care staff, including seniors overnight. Service users relatives who spoke to the inspector and responses in surveys returned to CSCI indicated there were sufficient staff on duty to meet the current physical care needs of the service users. Service users and visitors who spoke to the inspector told her they were satisfied with the care they receive. One person stated ‘the staff are wonderful’ another stated ‘staff listen and act’. Staff who spoke to the inspector told her there were usually sufficient staff to meet service users physical needs, however the increasingly complex needs of some of the service users are reducing the time staff can spend one to one with people. Staff also said service users needs are always given priority over paperwork so this can sometimes not be completed as quickly as it should be. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 17 The inspector examined the files for one staff member who was recently recruited. This was found to contain evidence of two written references and CRB (Criminal Record Bureau) check obtained prior to employment. The files for this staff member and two other files seen by the inspector contained evidence that staff have received training in relation to Moving & handling, Infection control, first aid, safe handling of medication and /or medication awareness, dementia care and prevention of abuse. Staff who spoke to the inspector confirmed this, one senior care assistant also spoke of completing palliative care training. Information in the AQAA returned to CSCI indicated 12 of the 26 care staff had successfully completed NVQ at level 2 or above and a further 3 were doing the training. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Outcomes for standards 31, 33, 35, 36, & 38 were looked at. People who use the service experience good quality outcomes in this area. The management and administration of the home is based on openness and respect, has quality assurance systems that should promote the safety and well being of service users. We have made this judgement using a range of evidence including a visit to this service. EVIDENCE: The registered manager has recently transferred to another home within the same company, and a new manger has recently been appointed. It is expected that an application to be registered is to be submitted to CSCI in the near future. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 19 Staff who spoke to the inspector told her communication remains good. There have been recent meetings for both staff and service users / relatives. The inspector saw evidence of regular Regulation 26 visits and reports. Staff told the inspector they had regular formal supervision and annual appraisals. Staff files contained documentation recording these. Information received from service users representatives indicated that they were kept informed and any issues are acted upon. Accidents were seen to be recorded and information stored in individual files. The home operates a joint account for service users’ personal monies in line with the policy of Four Seasons Health Care. Records seen on the day of inspection indicated transactions are recorded and signed receipts are kept. The account is audited on a regular basis by financial staff employed by Four Seasons Health Care. Information contained in the AQAA returned to CSCI indicated the home has a range of policies and procedures that should promote the safety and well being of service users. These were reviewed in 2006. Other information indicates the home and equipment are maintained as required. Other records seen indicate fire alarms are tested on a weekly basis. Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 X 3 X X 3 Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard OP9 Regulation 13 Requirement Staff must ensure that all medication administered is from a clearly labelled container supplied by the dispensing pharmacist. Controlled medication must be stored appropriately at all times. Action must be taken to refurbish the sluice room that is badly stained and unhygienic. The registered person should ensure there are sufficient door guards to allow service users the choice of leaving their bedroom doors open. Staff must ensure that doors are not wedged open with items of furniture and equipment. Timescale for action 01/10/08 2 3 4 OP9 OP19 OP38 13 23 13 01/10/08 31/01/09 31/10/08 Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 22 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP9 Good Practice Recommendations Hand written entries on MAR charts should include the signature of the person making the entry and the signature of a second person confirming the accuracy of details to promote the safety and wellbeing of service users. A social assessment should be carried out for each service user to ensure activities provided matches expectations and preferences in relation to social, cultural, and recreational interests and needs. A programme of refurbishment and redecoration would improve the environment and the comfort of the service users. 2 OP12 3 OP19 Springfield Care Home DS0000000753.V370458.R01.S.doc Version 5.2 Page 23 Commission for Social Care Inspection North Eastern Region St Nicholas Building St Nicholas Street Newcastle Upon Tyne NE1 1NB 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 Springfield Care Home DS0000000753.V370458.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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