Care Home: Springfield Court Nursing Home

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What the care home does well The needs of people were thoroughly assessed before they moved into the home, to ensure that the staff team could provide the care and support required. The plans of care were being followed in day-to-day practice so that people`s health, personal and social care needs were being met. Those living at the home were treated with respect, their privacy and dignity being maintained at all times. Good nutritional, pressure and incontinence care was provided, which involved a range of external professionals, ensuring that people living at the home received appropriate health care. The daily routines within the home were flexible and people living there were offered a variety of choices throughout the day. Visitors were made very welcome to the home and residents were able to access an independent person to act on their behalf, if they so wished. Activities were provided in accordance with the needs of people living at Springfield Court and religious needs were appropriately met. The management of meal times was good. The menu provided a choice of nutritious food and people were allowed to eat at their own pace, so that the dining experience was enjoyable for them. Special diets were provided, as was required, and the meals served looked appetizing to aid in nutrition. Complaints were well managed and people living at the home were adequately safeguarded from abusive situations. The recruitment procedures were robust so that people living at the home were protected and staff were provided with a wide range of training to ensure that they were able to look after the people in their care. The home was tastefully furnished and decorated to a high standard throughout and the environment was warm, comfortable and homely, providing very pleasant surroundings for people to live in. The control of infection was good, so that those living at the home were protected against infectious diseases. The home was well managed and a transparent and open approach was evident so that people felt comfortable to approach the management team to discuss any issues they may have. The health, welfare and safety of those living at Springfield Court was promoted by all systems and equipment being serviced as required and by the policies and procedures of the home. One relative wrote in her letter to us, `we could not fault the attention our relative received from the nursing staff who remained alert to his needs to the very end. We were kept well informed of any changes in his condition or medication and we found it very easy to consult with the nursing staff at any time. We always found all the staff approachable and understanding and they were especially so after our relative`s death`. Other relatives provided us with positive comments, including, `I am very happy with Springfield Court. I feel at ease that I know my relative is safe in a well run, clean and warm home` and `we dreaded the time our parents would need a nursing home. Ourfather was particularly negative about this. However, in his visits to our mother and when moving to Springfield court himself he was very positive. Both the staff and physical environment allowed him to end his life content and in peace`. What has improved since the last inspection? Although the physical environment is always of a good standard, further improvements had been made in order to provide yet more pleasant surroundings for those living at Springfield Court. A very tastefully decorated and furnished conservatory had been erected to the rear of the home, which incorporated a library, a computer room and an aquarium. The kitchen had been completely refitted since the last inspection to ensure a good standard of cleanliness so that people`s hygiene needs were being met. The home had achieved 58% of care staff successfully completing a recognized qualification in care, so that a good ratio of care staff were adequately trained to ensure that people living at the home were looked after properly. The recruitment practices had improved so that all prospective staff were appropriately checked before starting work at the home so that people living there were adequately protected. Training for staff had improved, which was in depth and covered a wide range of topics, including induction programmes and recognized qualifications in care. The management of medications was better and the nurse responsible for medication practices within the home had worked hard to improve these standards to ensure that people living there were adequately protected from drug errors or misuse. What the care home could do better: The care planning process could have been better so that the care being provided was recorded on the plans of care, which could have been more person centered with less vague terminology being used, so that staff were given clear, specific guidance as to how people`s needs were to be appropriately met. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springfield Court Nursing Home Springfield Court Springfield Road Aughton Ormskirk Lancashire L39 6ST     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Vivienne Morris     Date: 0 3 1 2 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. 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 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 Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 30 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). 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 CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 30 Information about the care home Name of care home: Address: Springfield Court Nursing Home Springfield Road Springfield Court Aughton Ormskirk Lancashire L39 6ST 01695424344 01695424674 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Springfield Court Limited Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 53 Number of places (if applicable): Under 65 Over 65 53 old age, not falling within any other category Additional conditions: 0 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 The maximum number of service users who can be accommodated is: 53 Date of last inspection Brief description of the care home At the time of our visit to this service the acting manager was responsible for the day to - day operation of the home. Springfield Court is a purpose built care home for older people requiring personal and nursing care. Care Homes for Older People Page 4 of 30 Brief description of the care home The home has fifty-one permanent places and two dedicated respite beds. The home is privately owned by Springfield Court Limited. Most rooms are single with an en-suite facility. Five companion rooms are available for service users who wish to share. Three of these have en-suite facilities. Accommodation is all at ground floor level and ramps are provided to enable access for wheelchair users. There is a large lounge and two conservatories, both of which provide a suitable venue for activities. The home is set in its own gardens that include a lawn, an enclosed courtyard area with seating and a summerhouse. At the time of this visit to the service the information given to the commission showed that the fees for care at the home ranged from 546 pounds to 625 pounds per week, with added expenses for private chiropody, private physiotherapy, escorts for hospital appointments and installation of a telephone line. Care Homes for Older People Page 5 of 30 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 3 star. This means that the people who use this service experience excellent quality outcomes. The site visit to Springfield Court Nursing Home formed part of the inspection process and was conducted over one day in December 2008. It was unannounced, which means that the managers, staff and people living at the home did not know it was going to take place. During the course of the site visit, discussions took place with those living at the home, as well as relatives and staff. Relevant records and documents were examined and a tour of the premises took place, when a random selection of private accommodation Care Homes for Older People Page 6 of 30 was viewed and all communal areas were seen. Comment cards were received from fourteen people who were living at the home and five staff members and their feedback is reflected throughout this report. We also received a letter from someone whose relative had lived at the home and who wanted us to use the information provided towards the inspection process. Therefore, extracts from the letter are included in this report. Every year the provider completes a selfassessment (AQAA), which gives information to the Commission about how the home is meeting outcomes for the people using the service and how the quality of service provided is monitored. We also ask for some numerical information to be given to us on this form. We observed the activity within the home and tracked the care of three people during the site visit, not to the exclusion of other residents. The total key inspection process focused on the outcomes for people living at the home and involved gathering information about the service from a variety of different sources over a period of time. The time spent observing what life was like at Springfield Court found staff to be patient, spending quality time talking with residents and taking time to ask people questions in relation to their preferred routines rather than making decisions on behalf of the people living at the home. What the care home does well: The needs of people were thoroughly assessed before they moved into the home, to ensure that the staff team could provide the care and support required. The plans of care were being followed in day-to-day practice so that peoples health, personal and social care needs were being met. Those living at the home were treated with respect, their privacy and dignity being maintained at all times. Good nutritional, pressure and incontinence care was provided, which involved a range of external professionals, ensuring that people living at the home received appropriate health care. The daily routines within the home were flexible and people living there were offered a variety of choices throughout the day. Visitors were made very welcome to the home and residents were able to access an independent person to act on their behalf, if they so wished. Activities were provided in accordance with the needs of people living at Springfield Court and religious needs were appropriately met. The management of meal times was good. The menu provided a choice of nutritious food and people were allowed to eat at their own pace, so that the dining experience was enjoyable for them. Special diets were provided, as was required, and the meals served looked appetizing to aid in nutrition. Complaints were well managed and people living at the home were adequately safeguarded from abusive situations. The recruitment procedures were robust so that people living at the home were protected and staff were provided with a wide range of training to ensure that they were able to look after the people in their care. The home was tastefully furnished and decorated to a high standard throughout and the environment was warm, comfortable and homely, providing very pleasant surroundings for people to live in. The control of infection was good, so that those living at the home were protected against infectious diseases. The home was well managed and a transparent and open approach was evident so that people felt comfortable to approach the management team to discuss any issues they may have. The health, welfare and safety of those living at Springfield Court was promoted by all systems and equipment being serviced as required and by the policies and procedures of the home. One relative wrote in her letter to us, we could not fault the attention our relative received from the nursing staff who remained alert to his needs to the very end. We were kept well informed of any changes in his condition or medication and we found it very easy to consult with the nursing staff at any time. We always found all the staff approachable and understanding and they were especially so after our relatives death. Other relatives provided us with positive comments, including, I am very happy with Springfield Court. I feel at ease that I know my relative is safe in a well run, clean and warm home and we dreaded the time our parents would need a nursing home. Our Care Homes for Older People Page 8 of 30 father was particularly negative about this. However, in his visits to our mother and when moving to Springfield court himself he was very positive. Both the staff and physical environment allowed him to end his life content and in peace. 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 9 of 30 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 30 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples needs are thoroughly assessed before they are admitted to the home to ensure that the staff team can deliver the appropriate care. Evidence: The care of three people living at Springfield Court was tracked during this site visit to the service. We looked at the care records of all three people, which showed that the needs of each person had been thoroughly assessed by the home before they were admitted, so that the managers were confident that the staff team could fully meet each persons individual needs. The information recorded gave a clear picture of peoples personal, health and social histories, so that staff were able to discuss with them things that were important to them. We received comment cards from fourteen people who use the service and thirteen of these people said that they received enough information about Springfield Court Care Homes for Older People Page 11 of 30 Evidence: before they moved in so that they could decide if it was the right place for them to live. One person wrote, I visited the home without an appointment. Written information was also given to me, and a relative wrote on behalf of someone living at the home, we were given useful brochures and the staff were very helpful on two unannounced visits we made to the home. One person told us that they were not given the information before they moved in to the home because they were admitted under emergency circumstances. When asked what the service does well, the registered manager told us, all prospective residents/relatives are invited to view the home at any time. No appointments are needed. A comprehensive service users guide and information pack is provided to include a coloured brochure showing the environment. A full preadmission assessment is completed by a senior clinical nurse to ensure that we can meet the needs of the resident. The admission procedure was undertaken in accordance with the admission policy available at the home and those responsible for undertaking the pre-admission assessments were fully aware of how to gather the relevant information about people before they moved into the home. Care Homes for Older People Page 12 of 30 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Medications are very well managed and the health care needs of people living at the home are fully met with their privacy and dignity respected at all times. However, the care planning process could be better by use of more person centered records. Evidence: The care of three people living at Springfield Court was tracked during our site visit to the service. Assessed needs were not always recorded within the plans of care and clear guidance was not consistently provided for staff as to how assessed needs were to be fully met. The care plans were supported by a risk management framework, so that any potential risks to the health or personal care of people living at the home were identified. However, written strategies had not always been implemented to minimize these risk factors. The plans of care had been reviewed each month or more regularly, if needed and changes in care needs were reflected well, so that staff were made aware of the current needs of people in their care. However, a lot of vague and unspecific Care Homes for Older People Page 13 of 30 Evidence: terminology was used within the care plans, which did not demonstrate person centered planning and did not give staff precise directions about how to meet the needs of people in their care. Care records showed that a wide range of external professionals were involved in the care of people living at the home to ensure that their health care needs were being consistently met. People spoken to told us that all their care needs were being met and that their privacy and dignity was consistently maintained. One person living at the home said, the staff are very caring and considerate and another commented, you just have to ask and it is done for you. When asked what the home does well the registered manager wrote on the selfassessment, we continually respect the value of privacy, dignity, choice, rights, independence and fulfillment for residents. Care plans are constantly updated and evaluated to ensure that any changes to the health and personal care needs are respected at all times. Care staff assist with personal care respectfully, encouraging self care where appropriate. Full risk assessments are completed to include possibility/choice for self medication ensuring policies are adhered to. Privacy and dignity is respected at all times e.g. staff knocking on doors and closing curtains. Comment cards were received from five members of staff. All felt that, in general, they always have the right support, experience and knowledge to meet the differing needs of people who use the service. One person wrote on the comment card, the home provides support from numerous agencies to meet the needs of residents. When asked what the service does well, one member of staff wrote on the comment card, Springfield Court provides a secure and safe place for families to leave their loved ones, in the knowledge that they will be looked after. All fourteen people who use the service and who submitted comment cards said that they always receive the care and support that they need, including medical care. A relative of one of these people wrote, Springfield Court cares very well for my relative. She is always clean and comfortable. This home cared excellently for my father during the last week of his life. They (the staff) made it possible for my mother and father to be together - BRILLIANT, and another commented, the staff have always been very thoughtful and helpful with my mothers needs. They always listen to any questions or problems and they sort them out as soon as possible. One resident said, the staff are caring and on the whole very nice and supportive. Medications were being very well managed with a clear audit trail and clear policies and procedures in place to ensure the safe handling of medications. A great improvement was evident in this area with records being well maintained. One registered nurse had been given the responsibility Care Homes for Older People Page 14 of 30 Evidence: of ensuring that medications were appropriately managed and it was evident that this system was working well and that she had worked very hard to ensure medication practices were safe. When asked if there was anything else they would like to tell us one relative wrote on the comment card on behalf of a person who uses the service, my family and I have full confidence in every aspect of the care provided by Springfield Court and another commented, only that I am very happy and well cared for. Care Homes for Older People Page 15 of 30 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The daily routines of the home are flexible and people are encouraged to maintain their leisure interests and activities whilst living there. The management of meals is good and visitors are made welcome to the home. Evidence: The home employed two activity co-ordinators, who were responsible for planning, organising and providing a wide range of entertainment both inside the home and within the local and wider communities. Records were retained of activities which people participated in so that any isolation could be easily identified. The care records for one resident showed that she wanted to continue following her religious beliefs whilst living at the home. It was established that staff supported her to do this, but there was no care plan in place in relation to her spiritual needs. The daily routines of the home were seen to be flexible and people living there were offered a variety of choices throughout the day, so that they had some control over their lives and were allowed to excercise choice. All fourteen people who submitted comment cards and who use the service said that the staff listen and act on what is said. One person wrote, they (the staff) are always ready to listen and they always Care Homes for Older People Page 16 of 30 Evidence: help me with any problems that I may have, and another commented, the male charge nurse is exceptionally good. When asked what the service does well, the registered manager wrote on the homes self assessment, we have two activities co-ordinators who arrange afternoon games/entertainment for those residents who like to join in. Regular singers/pianists entertain during the afternoons. Large social activities are held approximately six times a year where residents relatives are encouraged to join us for entertainment and a meal with their relative in a safe environment. When asked if there were suitable activities provided by the home, one person living there wrote on the comment card, they (the staff) try very hard to arrange activities and I join in when I want to. Obviously, sometimes I prefer not to take part because I dont feel like it, which is my decision and not their fault. Those who submiited comment cards indicated that there were usually activities that they could join in if they wished to do so and one person wrote, the home is nicely busy, things are happening which makes it feel like a real home and not a care home. People were seen visiting their relatives within the privacy of their private accommodation or within the communal rooms, if they preferred. One visitor said that she felt very comfortable visiting the home as she was always made to feel welcome. We saw staff interacting well with visitors, making them feel included in the daily lives of the people living at the home. A visiting policy was in place at the home and an activities programme was prominently displayed as well as notices in the reception area of forthcoming events. An external entertainer was performing on the day of our visit and we noted that a new library was being installed along with a computer room for the use of those living at the home. One resident said, we have a very full activity programme for December. There are entertainers coming this afternoon and we had another entertainer here yesterday and another commented, there is always something going on. We dont get time to be bored. Information about the use of advocacy services was freely available within the home and it was evident that those living at Springfield Court would be supported to access this service, should they wish an independent person to act on their behalf. Several residents were seen reading newspapers, books, doing crosswords and a variety of in house activities were being provided in small groups. One relative wrote on the comment card, the home provides good social activities for family and friends to take part in as well, such as variety evenings and concerts and a resident told us, there were concerts in the summer and I enjoyed a trip on the canal boat. Care Homes for Older People Page 17 of 30 Evidence: We observed lunch being served, when everything was satisfactory. The kitchen had been refitted since our last visit and it was noted that good quality fitments and equipment had been installed. The people living at the home showed on the comment cards that they usually enjoyed the meals served. One person wrote, the kitchen staff are lovely. They know that I dont like to eat lunch early and are quite willing to give it to me individualy a little later. Obviously I prefer some dishes to others, but the food is always well cooked and another told us, the food is like a five star hotel. The menu of the day was clearly displayed and the four weekly menu offered a variety of nutritious meals, with choices being available on each occasion. Hot and cold beverages were available with lunch and condiments were supplied as required. Specialised diets were catered for and people were able to eat in their own rooms , if they preferred to do so. Care Homes for Older People Page 18 of 30 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Complaints are well managed and people living at the home are adequately safeguarded from abusive situations. Evidence: A clear accesssible complaints procedure was available so that people were aware of how to make a complaint should they wish to do so. A system was in place at the home for recording complaints received, which showed that complaints were managed well and in accordance with the policies and procedures of the home. No complaints had been received by the Commission since the last inspection. Those spoken to said that they would know how to make a complaint, should they need to do so. Five staff members who submitted comment cards said that they would know what to do if a person living at the home, their relative, friend or advocate had any concerns about the home. All fourteen residents who submitted comment cards said that they would know who to speak to if they were not happy about something at the home and that they would know how to make a complaint, should they need to do so. One of these people commented, we were provided with details in the information pack. When asked what the service does well, the registered manager told us, Policies and Care Homes for Older People Page 19 of 30 Evidence: procedures are in place for safeguarding adults, whistle blowing and complaint handling. Complaints are minimised by excellent care provided and a good staff team. Emphasis is placed on safeguarding adults and the majority of staff have attended a relevant training course. The complaints policy is displayed in the reception area and all complaints are recorded under a new pro-forma. Staff records showed that those working at the home had received training in relation to the protection of people in their care and staff members spoken to were aware of what to do if they had concerns about someone living at the home. Care Homes for Older People Page 20 of 30 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provides a hygienic, comfortable, homely and well maintained environment for people to live in. Evidence: When asked what the service does well, the registered manager told us, Directors continually invest in the company to improve the residents facilities and surroundings. We work closely with professionals to ensure a safe well maintained environment is provided. Aids and medical equipment for residents is constantly reviewed, maintained and updated. Many different hoists and bath aids are available at the home. We strive to provide a luxurious hotel-like environment. The nurse call system has recently been renewed and the kitchen has been refitted. Infection control policies and procedures were in place and clinical waste was being disposed of correctly in order to reduce the risk of cross infection. The home was warm, clean, odour free and safe for people to live in. The premises were maintained to a very high standard and were well decorated. A lot of thought had gone into making the bedrooms homely and all those viewed were tastefully decorated and furnished. The communal areas of the home were also comfortable and furnished to a high standard. Some areas of the home had been fitted with new carpets. Care Homes for Older People Page 21 of 30 Evidence: A large conservatory had been erected to the rear of the building, which was beautifully decorated and furnished, providing a very comfortable area for people to spend time in. A library and computer room were being incorporated off the conservatory and a large aquarium had been installed in the dividing wall between the conservatory and lounge area, which provided a topic for discussion and a relaxing view point. There was an ongoing programme of redecoration to ensure that the high environmental standards were being maintained for those living at Springfield Court. One resident said, my bedroom is beautiful. I have just had a new carpet. The grounds of the home were well maintained, providing pleasant areas for people to sit during the warmer weather. All fourteen people who submitted comment cards and who live at the Springfield Court felt that the home is always fresh and clean. One person wrote, the home is well furnished and it is always fresh and clean and another commented, I am amazed that the home never smells of urine or bleach. Springfield Court is exceptionally well kept compared with other homes I have visited. Care Homes for Older People Page 22 of 30 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff working at the home have the right skills, qualifications and experience to meet the needs of the people living at Springfield Court and the recruitment practices adopted by the home consistently protect the vulnerable people living there. Evidence: At the time of our visit to the service there were 49 people living at Springfield Court. The duty rota showed which staff were on duty at any time of the day or night and the skill mix of staff was clear for each shift. The needs of people living at the home were being met by the staff team although the care planning process could have been better. Records showed that all grades of staff had received appropriate training to allow them to do their job, with 58 of care staff having achieved a recognised qualification, so that there were enough people on duty to ensure the appropriate delivery of care. All five staff members who submitted comment cards said that their employer carried out all relevant checks before they started work at the home. One of these people said, references were supplied by two people, in written format and not just tick boxes. Care Homes for Older People Page 23 of 30 Evidence: Three staff files were examined which showed that all checks had been conducted as required by the care home regulations, demonstrating a robust recruitment procedure was adopted by the home to ensure that people living there were adequately safeguarded. A detailed induction period was provided for all new staff, which guided them through the policies, procedures and practices of the home so that they knew what was expected of them whilst working at Springfield Court. All five members of staff who submitted comment cards said that their induction programme covered everything they needed to know very well and that they were being given training relevant to their role, which helped them understand and meet the individual needs of residents and which kept them up to date with new ways of working. One of these people wrote, I worked alongside another member of staff on numerous shifts and I was not left alone until I was familiar with the residents, the building, the daily routine and the staff and another commented, the home provides various courses that we can attend as well as mandatory courses. All five staff felt that, in general, there were usually enough staff to meet the individual needs of all the people who use the service. One member of the staff team wrote on the comment card, usually shifts are covered. The only time we are short is in exceptional circumstances due to illness. In such circumstances we use experienced nursing agency staff. All residents needs are met by staff. Care Homes for Older People Page 24 of 30 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is very well managed by appropriately trained and competent people so that the health, welfare and safety of those living at Springfield Court is consistently maintained. Evidence: Springfield Court was found to be well managed. It was efficiently and effectively operated by well trained and competent people to ensure that a high standard of service was being consistently provided. All the requirements and recommendations from the last key inspection had been appropriately addressed and the manager of the home, supported by the provider had worked very hard to improve the overall standard of service provided for the people living at Springfield Court Nursing Home, which is commendable. One person living at the home told us, If there is anyone who doesnt like living here, Care Homes for Older People Page 25 of 30 Evidence: well there is something wrong with them dear. It is marvelous. The staff are all lovely and we are well looked after and a fellow resident added, I totally agree. There couldnt be a better care home anywhere. The practices of the home adequately protected peoples finances to reduce the possibility of financial abuse and the ethos of the home quite evidently promoted the health, welfare and safety of the people living at Springfield Court. Records showed that the home was being thoroughly monitored so that any weaknesses could be identified and rectified as was required to ensure that the people living there received an excellent overall service. Detailed audit trails had been conducted and the views of a wide range of people involved in the care of those living at the home were sought, so that any shortfalls could be rectified and any strengths could be built upon. Regular meetings were held involving a range of disciplines, including the residents and their relatives so that relevant information could be passed on and so that open discussions could take place. We were told that the provider of the home was on site on a daily basis and she made a point of speaking to the residents and informing then of any changes or events which may affect them. Residents spoken to said that the manager of the home was very approachable and that they felt comfortable talking to her. The systems and equipment within the home had been appropriately serviced to ensure that it was safe for use and accidents had been recorded well to ensure that any significant patterns could be easily identified. A fire risk assessment was in place and staff had been provided with fire training so that they would know what action to take in the event of a fire. One staff member when asked what the service does well wrote on the comment card, Springfield Court lends itself extremely well to the ongoing care of the clients and relatives in many ways. The home gives necessary support to all staff and training updates are provided. Springfield Court provides an exceptional homely environment. The clients always come first. Care Homes for Older People Page 26 of 30 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 27 of 30 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 All assessed needs of people 02/02/2009 living at the home must be included in the plan of care. This must be done so that staff are aware of peoples assessed needs and are provided with clear guidance of how these needs are to be best met. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 People living at the home or their relative should be given the opportunity to be involved in the care planning process, so that they can have some input into the care they receive. Risk assessments should be supported by clear guidance of how any identified risks are to be eliminated or minimized, so that the health, welfare and safety of people living at the home and those working there is consistently protected. The plans of care should be more person centered and vague terminology should be avoided, so that precise directions are provided for staff to allow individualized care Page 28 of 30 2 7 3 7 Care Homes for Older People to be delivered. 4 12 Care plans should be developed for those people who wish to follow their religious beliefs whilst living at the home, so that staff know how to support them in doing so. Care Homes for Older People Page 29 of 30 Helpline: 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 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) Commission for Social Care Inspection (CSCI). 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. 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