Care Home: Springfield Care Home

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What the care home does well People’s needs are fully assessed before they move in so that they can be assured their needs can be met there. There were opportunities for visits and to have a free trial stay before deciding to move in. We found that personal and health care is planned. People told us they were “well looked after” by staff at the home. Staff showed respect when they were helping with personal care and one comment was “They’re always friendly and kind here”. A range of appropriate meals are provided to meet individual needs and preferences. People told us: “they always give me a good meal here” and “we always get a choice”. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.2 All areas of the home are kept clean and are well maintained. People told us they like the way it is decorated. What has improved since the last inspection? We found that care plans are more detailed and person centred. Staff have improved in following procedures for the safe handling and recording of medication. A new minibus is now available. Activities are planned by the new activities co-ordinator. Staff have received the training they needed including Safeguarding Adults, Moving and Handling, Food hygiene, Fire safety and Infection control training. Decorating and maintenance of the home has taken place and work is ongoing to provide further shared living spaces. What the care home could do better: For people who are looked after in bed or stay in their rooms, they should keep brief records on a chart to show that regular care and attention is given. All other daily records must be well maintained and monitored by the manager to make sure staff have clear information about any changes in needs. They should always make sure they have full information about the medication prescribed for people so that all medication is given safely. Initial records of complaints should include the date the complaint was received. Key inspection report CARE HOMES FOR OLDER PEOPLE Springfield Care Home Lawton Drive Bulwell Nottingham NG6 8BL Lead Inspector Meryl Bailey Key Unannounced Inspection 3rd December 2009 10:00 DS0000002305.V378666.R01.S.do c Version 5.3 Page 1 This report is a review of the 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. 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. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.2 Page 2 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 Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Care Home Address Lawton Drive Bulwell Nottingham NG6 8BL 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) 0115 927 9111 0115 979 4759 ckpatel1@tiscali.co.uk Annesley (Oldercare) Limited Care Home 40 Category(ies) of Dementia (40), Old age, not falling within any registration, with number other category (40) of places Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. The registered person may provide the following category of service only: Care Home with Nursing - Code N To service users of the following gender: Either Whose primary care needs on admission to the home are: Old age, not falling within any other category - Code OP Dementia - Code DE The maximum number of service users who can be accommodated is: 40. 26th November 2008 2. Date of last inspection Brief Description of the Service: Springfield is registered to provide personal care and accommodation for 40 older people, including those with a diagnosis of dementia. The home is owned by Annesley (Oldercare) Limited. The home is in Bulwell, which is approximately 4 miles to the north of Nottingham city centre. The home consists of a three-storey building with the lower ground floor being used to accommodate the dining room and conservatory, kitchen and laundry. All but four of the bedrooms are single. All bedrooms have en-suite facilities that consist of a toilet and wash hand basin. There is a passenger lift. The gardens are easily accessible from the conservatory and consist of lawned areas. There is a car park to the front of the building. The fees for this service are currently £329-£550 per week. Written information about the home, in the form of a service user guide, and a copy of the latest inspection report are available from the home. Springfield Care Home DS0000002305.V378666.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 that the people who use this service experience good quality outcomes. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people who live at the home and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice. In planning our visit we reviewed all of the information we have received about the home since we last visited and we considered this in planning the visit and deciding what areas to look at. We used the Annual Quality Assurance Assessment (AQAA) which we received from the director of Annesley (Oldercare) Limited and the acting manager. This detailed what they felt the home was doing well, what had improved since the last inspection and plans for improving the service in the next twelve months. The main method of inspection we use when we visit is called case tracking which involves us choosing people who live at the home and looking at the quality of the care they receive by speaking to them, observation, reading their records and asking staff about their needs. We observed staff working with people in the lounge and dining room and also spoke to a visiting relative to form an opinion about the quality of the service being provided. We read various documents and records as part of this visit and looked around the premises. What the service does well: People’s needs are fully assessed before they move in so that they can be assured their needs can be met there. There were opportunities for visits and to have a free trial stay before deciding to move in. We found that personal and health care is planned. People told us they were “well looked after” by staff at the home. Staff showed respect when they were helping with personal care and one comment was “They’re always friendly and kind here”. A range of appropriate meals are provided to meet individual needs and preferences. People told us: “they always give me a good meal here” and “we always get a choice”. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.2 Page 6 All areas of the home are kept clean and are well maintained. People told us they like the way it is decorated. What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details 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. Springfield Care Home DS0000002305.V378666.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 DS0000002305.V378666.R01.S.doc Version 5.3 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 3 People using the service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People’s needs are fully assessed before they move in so that they can be assured their needs can be met there. EVIDENCE: The provider and manager told us in the Annual Quality Assurance Assessment (AQAA) that anyone considering moving into the home was given the opportunity to visit the Home, together with their relatives, friends and representatives, and take a comprehensive tour led by a senior member of staff. Additionally, they were given a comprehensive Information Pack. People were encouraged to take up a free trial period of a 2-3 days stay in the home. Alternatively, they could stay for a meal at the home. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 9 Prior to admission, the acting manager received a copy of an extended social work assessment and then she or the Deputy Manager visited the person wherever they were to assess for themselves, and obtain as much information as possible. We saw comprehensive assessments on the sample of people’s files during our visit and some people told us they visited before moving in. Others had stayed at the home for respite care and then decided to live there full time. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 10 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 and 10 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Personal and health care is planned so that staff meet people’s needs appropriately and with respect, but the absence of some daily notes does not fully guarantee that all staff have full information. Action is taken to ensure people receive their medicines as prescribed by a doctor. EVIDENCE: The three care plans we saw in detail gave some clear information about how personal and health needs were to be met. Two people had been living at the home for over a year and their care plans had been reviewed on a regular monthly basis. The third person had moved in recently and the plan did not yet need to be reviewed. There were various consent forms and signed agreements that showed that people or their representatives, were involved in the planning of care. One person stayed in bed throughout the day by choice. The acting manager told us that this person will get up when there are visiting Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 11 entertainers. There was a commmunication book prepared by a Speech and Language therapist to aid communication with this person. Care staff informed me that they visit the room at regular intervals, but there were no records of these visits or of the specific care given on those occasions. We did see that staff had previously recorded fluid intake for this person when it was needed, but we found some gaps in other daily records for other another person. We saw that most people were in the lounge and dining room. People told us they were “well looked after” by staff at the home. There were records of regular visits from district nurses, doctors and other health and social care professionals. Risks were assessed within the plans. Weight was monitored and there were assessments and plans about dietary intake and pressure areas. We found that medication was stored securely and staff had signed Medication Administration Record (MAR) sheets appropriately. However, for some medication the instructions were not made clear. Some people had tablets that were intended to be given with water, but 30 minutes before food and people must remain in an upright position for 30 minutes after taking a tablet. These instructions were not with the medication, but we found them in an old copy of the British National Formulary 2007 kept in a cupboard. The tablets were with all other medication to be given at breakfast time. The acting manager informed us that she contacted the Boots Pharmacy inspector after our visit and all this type of medication has now been separated from other medication so that it is always given before breakfast. Full instructions have been provided for staff and a new, up to date copy of the British National Formulary was ordered immediately. We observed staff speaking with people individually and with respect. One person told us “They’re always friendly and kind here”. Another told us the staff always showed respect when they were helping with personal care. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 12 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13. 14 and 15 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can choose to be involved in activities and appropriate meals are provided. EVIDENCE: In the Annual Quality Assurance Assessment (AQAA) it stated: “We have an Activities Co-ordinator who arranges activities according to the Residents’ choices and preferences for things that they like to do. Residents’ families are also encouraged to participate where possible, so that our Residents feel at ease and to continue to maintain contact with their loved ones in an interactive and meaningful way (e.g. outside trips in the Minibus, gardening activities). Activities sessions allow for those who are able to exercise their independence in an interactive way. For those who require support to participate, staff members assist in a sensitive and flexible manner.” Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 13 During the inspection visit we saw some people involved in activities such as board games, darts, and writing Christmas cards. Others were watching television. People told us about trips to Twycross Zoo and Wollaton Park. A new minibus is now available. Activities were planned by the new activities coordinator, who already knew most of the people living in the home as she had worked there as a senior care worker. There were Newsletters available that gave more information about activities. There was a regular visit from a dog and handler every three weeks and a regular bingo activity every Friday afternoon. Relatives were invited to join special events and parties and also to “Residents and Relatives meetings” with the manager. We saw that meals were taken to people wherever they wanted to eat: dining room; lounge; or bedroom. Plate guards were used to help with independent eating. Staff were sitting with people who needed more help. The menu gave at least two choices for each main meal. We saw some people eating shepherds pie and others had sausage with cabbage and peas. They were also given a choice of dessert. In the kitchen the cook had a list of everyone’s likes and dislikes and notes about specific diets. There were records of what was eaten each day. People told us: “they always give me a good meal here” and “we always get a choice”. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 14 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are assured that any complaints are taken seriously and appropriate procedures are followed to keep people safe. EVIDENCE: The complaints procedure was contained in the Service User Guide, displayed in various places around the Home and copies were available in the entrance for visitors. One person living in the home said, “I know who to tell if I’m not happy, but I am.” One relative told us that when there was something of concern she would tell the manager or provider who responded immediately. We looked at the records of five complaints dealt with during the last year. Only one was dated, though full information was available and showed that the complaints were resolved quickly. The acting manager demonstrated that she was fully aware of the local area Safeguarding Adults procedures and had made contact with the appropriate people about concerns as needed. Staff told us they had received training in Safeguarding Adults and in the Mental Capacity Act. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 15 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 26 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in premises that are fit for their purpose. EVIDENCE: We saw that murals had been painted on the corridor walls and people responded well to these and told us which their favourites were, for example: older characters from Coronation Street and images of Skegness. Staff told us that these images stimulated regular discussion. The bedrooms we saw were well furnished and some people told us they had chosen their own wallpaper. There were pictures and symbols on doors to help people locate various rooms. The hairdresser’s salon was easily identified with a picture. There various sitting areas and rooms in addition to the main lounge. In one quiet room lighting was used to create a relaxing atmosphere and there were luminous Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 16 stars on the ceiling. Plans were available to demonstrate changes that were due to start to create further communal areas. All parts of the home were clean and a regular visitor told us the home was always kept clean. The laundry contained suitable machines in working order. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 17 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28, 29 and 30 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Sufficient care staff are provided to meet peoples’ needs and people are safeguarded by the recruitment procedures and the training given to staff. EVIDENCE: The rota showed that there were always a minimum of four care staff on the premises during the day and three at night to care for the current 31 people living in the home. This included a senior care assistant. The manager was present in addition to this and there were also domestic and kitchen staff. People told us that the staff were always available to help and staff themselves told us they felt there were sufficient of them to meet people’s needs. From the sample of staff records we found that checks were carried out on new staff before they started work at the home. This included checks through the Criminal Records Bureau and at least two references for each person. There was a summary sheet at the front of each staff file to clarify all records were present. There were records of induction, food safety, moving and handling and other health and safety training on individual files. Staff told us about other courses Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 18 they had completed including training in Dementia, Diabetes, and Palliative care. Information on the Annual Quality Assurance Assessment form showed us that most staff had achieved at least level 2 of the National Vocational Qualification in Care and some staff told us that they had also gained level 3. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 19 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. This is what people staying in this care home experience: JUDGEMENT – we looked at outcomes for the following standard(s): 31, 33, 35 and 38 People using the service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is run in the interests of people living there, with action being taken to keep people safe within the environment. EVIDENCE: There has been a change of Acting Manager since the last inspection and the current one started as manager in April 2009. She has started the process to register with the Commission. The Annual Quality Assurance Assessment (AQAA) was completed jointly by Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 20 the provider and acting manager and submitted to us when we requested it. It is very comprehensive with full information on all areas of the minimum standards and demonstrates how the service is meeting the Care Home Regulations. They have identified for themselves where improvements can be made “We could make more use of local amenities and facilities for our Residents’ activities, now that we have our own minibus.” Also, questionnaires were used earlier in the year for the provider to gain views of relatives. We received copies of the last two newsletters which were used to inform people of developments. Money was looked after and held securely within the home for some people. We saw evidence of clear financial record keeping with receipts kept of each transaction. This was regularly monitored by the manager to ensure there were no mistakes and people were protected from financial abuse. Information was given in the AQAA form about the dates of servicing and testing of equipment. All dates given were during 2009. During the inspection visit, we saw hoisting equipment with labels showing the same dates of servicing. However, we looked at some portable electrical equipment around the home and found some had not been checked recently. Labels on some televisions had a test date of July 2008 and one was December 2006. Arrangements were immediately made on the day of this inspection for all portable electrical appliances to be retested the following week and we have received confirmation that this was carried out by an electrical company. There was a fire safety report completed in August 2009 and records showing that staff had been trained in fire safety and evacuation in September 2009. We also saw recorded evidence of training in the other safe working topics. Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 21 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 2 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 2 17 X 18 3 3 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 DS0000002305.V378666.R01.S.doc Version 5.3 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. 1. Refer to Standard OP7 Good Practice Recommendations For people who are looked after in bed or stay in their rooms, keep brief records on a chart to demonstrate good communication between staff and to show that regular care and attention is given. Always obtain full information about the medication prescribed for people and make this available to staff. This is to ensure all medication is given safely. Initial records of complaints should include the date the complaint was received. 2. OP9 3. OP16 Springfield Care Home DS0000002305.V378666.R01.S.doc Version 5.3 Page 23 Care Quality Commission East Midlands Region Citygate Gallowgate Newcastle Upon Tyne NE1 4PA National Enquiry Line: 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). 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. 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