Care Home: Springfield Care Home

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What has improved since the last inspection? There were seven requirements following the last inspection. Six have been dealt with and one has been carried forward as a recommendation. The home has updated the Statement of Purpose and Service Users guide and this means that people have accurate and up to date information about the range of services offered. Since the last inspection the home has worked hard to improve the way people`s personal and health care needs are dealt with. The care records have improved significantly and we saw that people, or those close to them, are involved in planning how their care needs will be met. This helps to make sure that people are cared for in a way that takes account of their preferences and abilities. Improvements have been made to the way medicines are managed to make sure that they are managed safely and people get their medicines as prescribed. The home has increased staff awareness of safeguarding (adult protection) issues and this is helping to make sure that people are protected from abuse. They have nominated and trained some staff as "dignity champions". Their role is to increase awareness of people`s rights, particularly those people who may be unable to speak for themselves because of diminished capacity.Springfield Nursing HomeDS0000055013.V375286.R01.S.docVersion 5.2Page 7At the time of the last inspection the home had just employed 2 activities organisers. They have continued to develop their roles and are offering people the opportunity to take part in a range of group and individual activities. Work is continuing to improve this aspect of the service to make sure people`s individual social and cultural needs are met. The home has improved its standards of food safety and hygiene and was given a 5 star (the highest) following the recent inspection by the department of Environmental Health. What the care home could do better: The home should make sure that staffing levels are kept under review to make sure there are enough suitably trained and competent staff available at all times. This review should take account of the needs of people living in the home and the layout of the building as well as the number of people in the home. A number of people expressed concerns about the high use of agency staff. They worry that people are not getting continuity of care because agency staff are not as familiar with people`s needs. The management team are aware of this and are continuing to address it by recruiting more permanent staff. Some people said they felt there was a need for more staff training particularly around basic care. Over the past 12 months the home has provided a lot of training for staff and this should continue to make sure that all staff have the knowledge and skills they need to meet people`s needs. The home has already identified that a significant proportion of people are not happy with the standard of the meals and are working to improve this. This will include providing a more varied menu to reflect the different cultural backgrounds of people living in the home. One person said they would find it helpful if staff wore name badges. Key inspection report CARE HOMES FOR OLDER PEOPLE Springfield Nursing Home 17 Western Way Buttershaw Bradford West Yorkshire BD6 2UB Lead Inspector Mary Bentley Key Unannounced Inspection 5 & 6th May 2009 09:40 DS0000055013.V375286.R01.S.do c Version 5.2 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 Nursing Home DS0000055013.V375286.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 Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield Nursing Home Address 17 Western Way Buttershaw Bradford West Yorkshire BD6 2UB 01274 694192 01274 294197 karen.coady@anchor.org.uk keri.sherwood@anchor.org.uk Anchor Trust 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) Care Home 98 Category(ies) of Old age, not falling within any other category registration, with number (98) of places Springfield Nursing Home DS0000055013.V375286.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 within the following categories: Old age, not falling within any other category - Code OP, maximum number of places 98 The maximum number of service users who can be accommodated is: 98 6th May 2008 2. Date of last inspection Brief Description of the Service: Springfield House is a registered care home with nursing. It is situated in a residential area approximately 2 miles from Bradford city centre. Accommodation is provided for up to for 98 men and women in single, en suite rooms over three floors. Spacious lounge and dining areas are provided on each floor. There is disabled access to all floors via 2 passenger lifts. The home has a garden area at the back which people can use and car parking is available in the grounds. Information about services provided by the home is available in the home’s brochure and Service User Guide. These are kept in the reception area and can be taken by relatives or visitors, or they can be posted. In May 2009 the weekly fees ranged are from £397.15 to £650.00. These charges do not include hairdressing or chiropody and a separate list of charges for these and other services is available from the provider. Springfield Nursing Home DS0000055013.V375286.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 two stars – good service. This means the people who use this service experience good quality outcomes. 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. This is what we used to write this report • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. The results of any visits that we have made to the service in the last 12 months. In September 2008 we visited the home with a pharmacy inspector to look at concerns about how people’s medicines were being managed. The report from this visit is available on request. Surveys returned to us by people using the service and from other people with an interest in the service such as visiting health care professionals and staff. We received 10 surveys. Information we have about how the service has managed any complaints. What the service has told us about things that have happened in the service, these are called ‘notifications’ and are a legal requirement. Relevant information from other organisations. A site visit carried out over 2 days by one inspector. The first day of the visit was unannounced. We spent approximately 15 hours in the home and during that time we spoke to people living in the home, visitors, staff and management. We looked at various records including care records, looked at some parts of the home and observed staff as they carried out their duties. • • • • • • What the service does well: The home carried out a survey earlier this year and everyone who responded described the staff as “friendly”, “courteous”, “polite” and “helpful”. We Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 6 received similar comments from people and during the visit we saw that staff interacted with people in a kind and respectful way. People are given information about how to make a complaint. People told us the management team are available and approachable. They said they feel confident that they can discuss any concerns they might have about the service. A health care professional who visits the home said staff are good at alerting them to changes in people’s conditions before a crisis develops and said the home communicates well with people’s relatives. When employing new staff the home makes all the required checks and this protects people from possible abuse by staff that are not suitable to work with vulnerable adults. The home is clean and comfortable. People’s bedrooms are suitably equipped to meet their needs and people are encouraged to have some of their personal belongings around them. The home has wide corridors which make it easier for people to move around and there are 2 passenger lifts to the first floor. What has improved since the last inspection? There were seven requirements following the last inspection. Six have been dealt with and one has been carried forward as a recommendation. The home has updated the Statement of Purpose and Service Users guide and this means that people have accurate and up to date information about the range of services offered. Since the last inspection the home has worked hard to improve the way people’s personal and health care needs are dealt with. The care records have improved significantly and we saw that people, or those close to them, are involved in planning how their care needs will be met. This helps to make sure that people are cared for in a way that takes account of their preferences and abilities. Improvements have been made to the way medicines are managed to make sure that they are managed safely and people get their medicines as prescribed. The home has increased staff awareness of safeguarding (adult protection) issues and this is helping to make sure that people are protected from abuse. They have nominated and trained some staff as “dignity champions”. Their role is to increase awareness of people’s rights, particularly those people who may be unable to speak for themselves because of diminished capacity. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 7 At the time of the last inspection the home had just employed 2 activities organisers. They have continued to develop their roles and are offering people the opportunity to take part in a range of group and individual activities. Work is continuing to improve this aspect of the service to make sure people’s individual social and cultural needs are met. The home has improved its standards of food safety and hygiene and was given a 5 star (the highest) following the recent inspection by the department of Environmental Health. 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 Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 8 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 Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 9 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): 1, 3 and 5 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 given information about the range of services offered, they are encouraged to visit, and in most cases their needs are assessed before they move in. EVIDENCE: Four of the five people living in the home who completed surveys for us said they had been given enough information about the service before moving in. One person said they had only been given verbal information which answered their questions and had not received any written information about the home. Another person said they had been given some information about the home. However, this person is fairly independent and had expected other people in Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 10 the residential unit to be same. Having moved in they found this is not the case and other people need a lot of help. People we spoke to told us they or their families had visited the home before making a decision about moving in. The home usually carries out an assessment of people’s needs before they move. This is to make sure they will be able to meet the person’s needs. In the case of emergency admissions the home gets information about the person’s needs from other agencies such as Social Services. We saw preadmission assessments and copies of assessments done by other agencies in the care records. Since our last inspection the home has updated the Statement of Purpose and the Service User guide. Copies of the new Service User guide have been placed in all the rooms on the nursing units and are also be put in the rooms in the residential units. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 11 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, 10 & 11 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 involved in planning how their care needs will be met and this helps to make sure that care is given in a way that takes account of people’s preferences and abilities. EVIDENCE: When we inspected the home last year we identified a number of concerns about the way people’s personal and health care needs were dealt with and recorded. Since then the home has taken action to improve this by providing more training and support for staff and by more regular auditing of the care records. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 12 During this visit we looked at six people’s care records. The care plans have information about people’s personal and health care needs and how these needs are to be met. The care plans are reviewed and kept up to date. We saw evidence that people or those close to them are involved in planning and reviewing how their care needs are being met. We saw that when concerns are raised during care reviews action plan is taken to deal with these concerns. For example, a recent review identified concerns about how the person’s weight was being monitored. As a result more staff training has been put in place to make sure staff are able to measure and record people’s weights accurately. There are risk assessments in place to identify possible risks such as falls, pressure sores and malnutrition. When people are identified as being at risk plans are put in place to show how these risks will be managed. We saw that people have access to a range of NHS services such as GPs, speech and language therapists, physiotherapists and the tissue viability nurse specialist. District nurses visit the home to make sure the health care needs of people living in the residential units are met. People told us they usually get the care and support they need. One person said they felt their relative was not taken to the toilet often enough and another said “the regular carers are in the main very good but there are too many agency staff and nurses. Some of whom do not know or have information about the patients”. Most people told us they get the medical support they need. Some relatives said they felt it was sometimes necessary for them to intervene as the home did not always get the response they wanted from some GPs. At previous inspections we identified concerns about the way people’s medicines were managed. Since then the home has provided additional training for staff and during this visit we found that people’s medicines are managed safely. During the visit we saw that staff were kind and respectful in their dealings with people. In a recent survey carried out by the home all the people who responded said they are treated with dignity and respect. Information about people’s wishes with regard to end of life care is recorded. One person told us they felt reassured by the fact that they had been able to talk to staff about their end of life care because they did not want to have to back to hospital. Staff have received training on palliative care, however a health care professional who visits the home said they thought staff on the nursing unit would benefit from more training in this area. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 13 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 & 15 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People are offered the opportunity to take part in a variety of activities and the home is continuing to make improvements in this area to ensure that people’s individual social, cultural, recreational and dietary needs are met. EVIDENCE: In terms of the social life of the home there is a noticeable difference between the residential units on the first floor and the nursing units on the ground and lower ground floors. This reflects to some extent the different needs and abilities of the people living in these areas. On the residential units more people tend to use the communal areas. On the morning we visited there was a lively atmosphere in the lounges, there was music playing, some people were playing dominoes and others were chatting either amongst themselves or with staff. By contrast on the nursing units the Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 14 majority of people stay in their rooms and this part of the home is a lot quieter. The home has 2 activities organisers, one for the residential units and one for the nursing units. The activities organiser on the residential unit works until 7:00 pm some evenings to give people the opportunity to take part in activities later in the day. The home offers a range of activities including bingo, games, visiting entertainers and at Easter they had an Easter bonnet parade. There are also individual activities such as reading and manicures. They told us they are planning to organise “theme days” to celebrate different cultures and on the residential units work has started on setting up individual memory boxes for people. The feedback we got from people about activities varied. Three people said there are sometimes activities for them to take part in. One person said “there are plenty of activities if I want to take part”. Another said there are only activities within the home and if they want to go out they have to go with family or friends. A relative said the activities organiser on the nursing units is “brilliant but rushed off her feet. She organises card making, bingo, exercises and still finds time to read to bed bound patients and give them one to one attention”. People’s care records have information about their past lives, interests and hobbies and the activities organisers keep separate records of what people have taken part in. In April this year the home sent surveys to people asking about food and meal times. Of the people who replied approximately 27 said they were happy with the standard of the meals. The survey found that about 50 of the meals served were enjoyed, with most people enjoying at least one meal a day. The home has started to address this with support from the group catering advisor. They have changed the role of the hostesses employed to help in the dining rooms, giving them more responsibility for organising meal times and making sure people are given a choice of meals. During the visit we observed the lunch time meal service in 2 dining rooms. People were offered a choice of meals and were necessary were helped discreetly by staff. When people were reluctant to eat we saw that staff took the time to find them something they would eat. The way the pureed meals are presented could be improved. The home has a number of people from different cultural backgrounds and the menus choices do not reflect this diversity. One person expressed some concern about the choices of puddings available to people with diabetes. This was discussed with the management team and they are aware that these areas need to be addressed. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 15 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 & 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 know how to raise concerns and concerns/complaints are taken seriously and acted. There are appropriate procedures in place to protect people from abuse. EVIDENCE: People told us they know how to make a complaint if they need to. They also said they know who to speak to if they are not happy about something. One person said “management are available to speak to relatives and if complaints are put in writing some action is usually taken.” They said the acting manager is “always ready to listen and is always very pleasant when approached”. In a survey carried out by the home earlier this year all the relatives who responded said they felt confident about approaching staff and/or management about any concerns they might have. The home told us they have received 10 complaints in the last year and 9 of these required some action to be taken to improve the service. Some of these were complaints received by the Commission which we asked the home to deal with. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 16 The home told us they have made 16 safeguarding (adult protection) referrals and undertaken 4 safeguarding investigations in the last year. They told us staff are now more aware of safeguarding issues and feel more confident about making referrals and seeking advice from the safeguarding adults unit. The majority of staff have attended safeguarding training and this is included in induction training for new staff. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 17 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): 19, 20, 21, 24 & 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. The home is clean and well maintained and overall provides a comfortable and pleasant place for people to live. However, some people may find the constant ringing of the call bells intrusive. EVIDENCE: Accommodation for people is provided on three floors. Residential care is provided on the top floor and this is subdivided into 2 units. Nursing care is provided on the ground and lower ground floors and is subdivided into 3 units. Each unit has its own communal areas. In some areas these are combined lounge/dining rooms and in others they are separate. The lounge on the lower Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 18 ground floor has direct access to an enclosed garden. When we visited work was being done to improve this area and make it easier for people to use. The home does not have any quiet rooms therefore if people want to see their visitors in private they have to use their bedrooms. All the bedrooms are single rooms. The bedrooms are comfortable and suitably equipped to meet people’s needs, people told us they like their rooms. Most people have personal belongings such as photographs, ornaments and televisions in their rooms. The corridors are wide and this makes it easier for people to move around the home, particularly people using wheelchairs. Each unit has bath/shower rooms and communal toilets which are easily accessible to people. Some of the baths are not assisted baths and therefore are not used very much. Consideration should be given to replacing them with assisted baths or showers to give people more choice of bathing facilities. There is a hairdressing room on the ground floor. The buzzer which sounds when people ring for help is loud. It can be heard all over the building which means that because of the number of rooms it is more or less constantly ringing. As well as being intrusive this gives the impression that people are always waiting for help which in turn may lead people to think there are not enough staff. This was discussed during the visit. The home was clean when we visited and people said it is usually fresh and clean. One person said “domestic staff are very helpful”, another said “cleaners come every day to clean the room” and another said “kitchen area in lounge especially sinks needs more thorough cleaning”. Overall the home is well maintained. In one of the medicine rooms there was some electrical wiring that needed attention and the acting manager arranged for his to be dealt with immediately. Overall the systems in place to reduce the risk of cross infection are satisfactory. Staff are aware of the correct procedures to follow for example not using communal toiletries. The home has been given a 5 star (the highest) rating by Environmental Health for its standard of kitchen hygiene and food safety. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 19 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 & 30 People using the service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There are enough staff to keep people safe however staffing levels need to kept under review to make sure that there are always enough suitably qualified and competent staff available to meet people’s needs. EVIDENCE: People told us staff are usually available when they need them; some said there are occasional delays when staff are busy with other people. One person expressed concern about the staffing levels on the lower ground floor. They said this is because a lot of people on this floor need 2 staff to provide care and there are only 2 care staff allocated to work there. Another person said they felt their relative could be vulnerable if they were not willing to share in the care, they said, “The home appears to be lacking in permanent staff therefore having a negative impact on continuity of care. Personal relationships and understanding of individual needs can be lost within this process” Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 20 Some other people expressed concerns about the high use of agency staff and a number of people felt this was particularly the case at weekends. One relative said they did not think the policy of rotating permanent staff was helpful to providing continuity of care, they said “This can be confusing and unsettling to vulnerable elderly individuals especially those with some forms of dementia”. The management team are aware of people’s concerns about the use of agency staff and are continuing their efforts to recruit more permanent staff. The management team told us that since the last inspection they have reviewed the staffing levels to take account of people’s dependency. However, this was based on guidance designed for use in residential care settings not care homes providing nursing care. Any review of staffing levels should take account of the greater dependency of people requiring nursing care and the fact that these needs can change quickly particularly when people are receiving palliative care. All the comments we received about how staff interact with people were positive. One person said “Staff are polite, kind, considerate, helpful etc when asked for help” and another said “the girls are lovely”. Since the last inspection the home has been working hard to make sure that staff get the training they need. As well as training on safe working practices such as moving and handling, fire safety and infection control training has been provided on palliative care, nutrition, tissue viability and dementia care. Staff have regular supervision where they can discus their training needs and work is ongoing to make sure that each member of staff has an agreed personal development plan. All new staff have detailed induction training which meets the national standards. Staff confirmed they received induction training and said it covered most of what they needed when they started work. There is an ongoing programme of NVQ (National Vocational Qualification) training and 62 of care staff have achieved an NVQ in care at level 2 or above. The home has its own internal assessor and verifier for NVQ training. Some people told us they felt there was a need for more staff training. One relative said “Care assistants would benefit from further training and direction from qualified members of the team as they appear to do the majority of “hands on care”. This would enable higher quality of care to be delivered” A visiting health care professional said “there are some inexperienced care staff who would benefit from further basic training, some of the senior carers Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 21 often appear to delegate tasks to junior staff without offering direction/support” We looked at the files of four newly appointed staff and they showed that two written references and a PoVA (Protection of Vulnerable Adults) First check are obtained before new staff start work. New staff then work under supervision until a full CRB (Criminal Records Bureau) check has been obtained. Care staff we spoke to confirmed that they are not allowed to work on their own until the CRB check has been completed. In the case of nursing staff the home checks the NMC (Nursing and Midwifery Council) register to confirm they are registered to practice. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 22 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, 32, 33, 35 & 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 appropriately managed. People are able to share their views and contribute to the development and improvement of the service. EVIDENCE: The acting manager has been on maternity leave and is due to return to work at the beginning of June 2009. She has started the process of applying for registration with the Commission and is undertaking the Registered Managers Award. In her absence one of the company’s area managers has been based at the home to provide general management support. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 23 The remainder of the management team is made up of a Clinical Nurse manager, a Residential manager and a Services manager who is responsible for managing the ancillary staff and dealing with personnel matters in the home. The Clinical Nurse manager was appointed following the last inspection to take charge of the nursing units which were a cause of concern at previous inspections. This has been a positive step for the home and as a result many of the concerns raised at previous inspections have been dealt with. People told us the management team are approachable and said they feel confident that they can talk to them about any concerns they might have. The home sent questionnaires to people in April this year and has prepared a summary of the responses. They are working on actions to deal with the areas where people said improvements were needed. The home has meetings for the people who live there and their representatives approximately twice a year. In a recent survey carried out by the home 70 of relatives said they were aware of these meetings. The home does not get involved in managing people’s financial affairs. They do hold some small amounts of spending money for some people. Transactions are recorded and everyone receives a monthly statement of all transactions made on their behalf. In their self-assessment the home told us that there are systems in place to make sure equipment and installations are serviced and maintained at the required intervals. The maintenance records we looked at confirmed this. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 24 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 3 x 3 x 3 N/a HEALTH AND PERSONAL CARE Standard No Score 7 3 8 2 9 3 10 3 11 2 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 2 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 2 3 3 X X 3 X 3 STAFFING Standard No Score 27 2 28 3 29 3 30 2 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 3 3 x 3 x x 3 Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 25 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 2 Refer to Standard OP19 OP27 Good Practice Recommendations Consideration should be given to how the nurse call buzzer can be changed to make it less intrusive for people living and working in the home. Staffing levels should be kept under review to make sure there are always enough suitably trained and competent staff available to meet people’s needs. Springfield Nursing Home DS0000055013.V375286.R01.S.doc Version 5.2 Page 26 Care Quality Commission Yorkshire & Humberside Region Citygate Gallogate Newcastle upon Tyne NE1 4PA National Enquiry Line: Telephone: 03000 61 61 61 Email: enquiries.yorkshireandhumberside@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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