Care Home: Springfield House

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What the care home does well People wishing to live at Springfield House are thoroughly assessed prior to them moving in. They are able to visit the home and meet with the staff before they make a decision about moving in. Each person has a care plan in place, which clearly sets out their needs and the level of support they require from staff. People are encouraged to take part in the drawing up of their care plan. Reviews take place on a regular basis and any changes in the person`s needs is clearly written down. People who use this service are able to make choices about their lifestyle, and are supported to develop their life skills. People using the service are protected from harm. The physical environment of the home enables people living there to live in a safe, well-maintained and comfortable environment, which encourages independence. People who live at Springfield House are supported by an experienced and well-trained team of staff in sufficient numbers and who are, themselves, well supported. The home is well managed in the interests of people who live there. What has improved since the last inspection? This is the first inspection to take place at the home. What the care home could do better: Care plans should include how individuals are supported to maintain a healthy lifestyle and record events when people choose not to act upon advice given. People`s health care requirements should be recorded to ensure monitoring and screening takes place, such as regular cholesterol checks and weight monitoring. Staff should ensure they sign for medication as it is given to avoid signature omissions which can be misleading in terms of whether a person has had their medication or not. A quality assurance system should be implemented that seeks the views of people who use this service. Arrangements should be made for those people who have not yet undertaken fire safety training to do so within the next two months (end of February 2008). CARE HOME ADULTS 18-65 Springfield House 176 Sheffield Road Penistone Sheffield S36 6HF Lead Inspector Tracey South Key Unannounced Inspection 17th December 2007 09:45 Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfield House Address 176 Sheffield Road Penistone Sheffield S36 6HF 01226 379 143 01226 379 145 sg@valeoltd.com 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) Valeo Ltd Mr Steven Garbutt Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Springfield House DS0000070640.V356727.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 only - Code PC; to service users of the following gender: Either; whose primary care needs on admission to the home are within the following categories: Learning disability - Code LD. The maximum number of service users who can be accommodated is: 4. First inspection 2. Date of last inspection Brief Description of the Service: Springfield House is a care home providing personal care and accommodation for up to four younger adults with a learning disability. The home is located near to, and in walking distance of, the centre of Penistone. It is easily accessible by car and public transport. The house was built in 1907 but has been extended and modernised to include full central heating and double-glazing throughout. All bedrooms are single. There is a large kitchen with space for dining, a good-sized lounge and a sunroom (conservatory). The home also has a large separate laundry with commercial machines to wash larger items and bedding. There is also an office on the first floor accommodation. The fees at the time of this inspection ranged from £1762.06 to £2077.73 dependent on the care package agreed with commissioners. Information about the service and inspection reports are available from the home. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is 2 star. This means the people who use this service experience good quality outcomes. This is the first inspection to take place at Springfield House. The home was registered with the Commission for Social Care Inspection in August 2007. This inspection was carried out using information about the service provided by the manager and responses to surveys sent to people using the service. The inspector made an unannounced visit to the service and spoke with people living there, staff and examined records. There were two people living at the home on the day of this visit. The inspector would like to thank all involved with this inspection for their contribution and for their welcome on this visit. What the service does well: People wishing to live at Springfield House are thoroughly assessed prior to them moving in. They are able to visit the home and meet with the staff before they make a decision about moving in. Each person has a care plan in place, which clearly sets out their needs and the level of support they require from staff. People are encouraged to take part in the drawing up of their care plan. Reviews take place on a regular basis and any changes in the person’s needs is clearly written down. People who use this service are able to make choices about their lifestyle, and are supported to develop their life skills. People using the service are protected from harm. The physical environment of the home enables people living there to live in a safe, well-maintained and comfortable environment, which encourages independence. People who live at Springfield House are supported by an experienced and well-trained team of staff in sufficient numbers and who are, themselves, well supported. The home is well managed in the interests of people who live there. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 2 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The processes for admission to the home are centred on the individual’s needs. EVIDENCE: Admissions are not made to Springfield House until a full needs assessment has been undertaken. This involves the individual and their family or representative, where appropriate. The service ensures that the referral process not only takes into consideration people’s individual needs but also acknowledges that compatibility between existing and new people as important. Documentation examined in respect of one person who had recently moved into the home showed that detailed information had been obtained prior to them moving in. This person was able to visit the home, supported by his key worker, on a number of occasions until he felt ready to move in permanently. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 and 9 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. Individuals are involved in decisions about their lives, and play an active role in planning the care and support they receive. EVIDENCE: Two people were living at the home on the day of this visit; both of their care records were examined. Individuals’ needs were detailed and it was clear, from reading the care records, the level of support they require. There were shortfalls in one person’s care plan about the need to promote a healthy lifestyle. It is important to record when support and advice is given to people about healthy lifestyles even when the individual chooses not to act upon the advice given. People have notes written daily, reflecting what they have done and achieved. The format for these makes it easy to see important information such as what Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 10 people have eaten, what they have done and if there have been any untoward incidents. The manager confirmed that reviews will take place every six months or more frequently if required. Amendments to people’s individual support requirements are made as and when changes occur. Risk assessments are an important part of the care planning process for people living at Springfield House. Staff seek to maximise people’s independence and opportunities and this has to be done in a way that minimises risks. Risk assessments contained information about possible triggers to aggressive behaviour as well as how to deal with this by using de-escalation techniques. The use of contracts with some individuals, for example around budgeting and alcohol use, also contributes to individuals developing skills and self-awareness to reach their potential. One person spoke to the inspector and said he understands why he needs to have a contract in place even though he doesn’t always agree with it. He said he understood that it was there to help protect him. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 and 17 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People are able to make choices about their lifestyle, and are supported to develop their life skills. EVIDENCE: Neither of the two people currently living at Springfield House are involved in paid or voluntary employment. Prior to one person moving into the home, staff researched a number of educational/training opportunities that the person could access. When speaking to the manager about this he explained that, although the person has been encouraged to take part in learning programmes at Barnsley College as well as the local community centre, he has declined to do so. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 12 There are a number of community based services available to people such as training programmes as mentioned above. Health and fitness opportunities are provided at the local community centre although neither of the two people living at Springfield House are currently involved in any of these. Both, however, enjoy meals out and one person regularly visits the local pub where he said he enjoys catching up with friends. People are encouraged to maintain relationships with their family and friends who are welcomed at the home. One person enjoys regular contact with his family. The manager explained that people are able to plan and go on holidays of their choice. Both people living at Springfield House are expected to go on holiday this year (2008). Where possible, people using the service are involved in the domestic routines of the home, they take responsibility for their own room, menu planning and cooking meals, making sure that they are able to enjoy the food they prefer and like. Meal times are organised to suit the specific needs of individuals and one person is able to make their own food. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 and 20 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People receive personal care that is based on their individual needs and preferences, and is managed well at the home. Improvements are required in recording people’s health care requirements to ensure monitoring and screening takes place. EVIDENCE: Care plans provide information to staff on how each person prefers to be supported. The care plans clearly state the support each individual requires, including the important things for staff to remember when caring and supporting each person. This is particularly important when supporting people with challenging behaviour, which could be triggered simply by staff not doing something in a particular order. There was very little written in people’s plans about how their health care needs will be met. This needs to be addressed to ensure that people receive the right support in terms of monitoring medical conditions such as high Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 14 cholesterol levels. Both people are registered with a local GP, one of whom visited his GP supported by staff during the day of this visit. People also receive support from other health care professionals such as psychiatrists, chiropodist and opticians. The home works to an efficient medication policy supported by procedures and practice guidance. All staff receive training in medication administration as part of their induction. Medication records were seen and sample checks of stocks in the medication cupboards tallied with the records held. A couple of signature omissions were noted although the medication had been given. Staff must take greater care when giving people their medication ensuring that they sign for it at that exact time as it can be misleading otherwise. One person who spoke with the inspector told of how he has reduced his alcohol intake, which has been problematic for him in the past. These are positive outcomes for people using the service and staff should be commended for their support for individuals in helping them to achieve these benefits for their health. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 and 23 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People’s views are listened to. People using the service are protected from harm. EVIDENCE: There is a complaints procedure which is clearly communicated to people using the service, their families and professionals. The manager said that people are supported to make and voice their concerns and complaints. One person who uses the service has made a complaint, which is currently under investigation by the organisation and the adult protection team. There are systems in place to prevent abuse of people using the service. Staff have received safeguarding training (protection of vulnerable adults) and guidance in using the company’s whistle blowing procedures as part of their induction. Staff who spoke with the inspector were very clear about what they should do if they suspected any abuse. The home has a copy of the Barnsley multi-agency adult protection policy to guide staff on who to contact in the event of abuse taking place. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 and 30 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People live in a homely, comfortable and safe environment. EVIDENCE: The home has four bedrooms in total, one single room on the downstairs accommodation and three single rooms on the first floor. There is one lounge, a sunroom (conservatory) and a kitchen/dining room, all are centrally heated. People living at the home are encouraged to use the communal rooms. However, those who prefer privacy and choose to spend time in their own rooms may do so. Smoking is not permitted within the home. A smoking area is set aside for this purpose within the garden. All rooms have privacy locks on doors and a lockable facility to secure valuables and personal items. All areas were seen to be clean and generally tidy. A damp patch on the downstairs accommodation was noted and staff explained that the wall is due Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 17 to be repainted. The laundry area was neat and tidy and staff explained how people living at the home are encouraged to undertake the laundering of their own belongings. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34,and 35 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. People are supported by experienced and well-trained staff, in sufficient numbers. EVIDENCE: Staffing levels are good, generally there is one to one staffing for most people throughout the day. Two to one staffing is also provided for one person when going out. There is one staff on duty during the night shift. The manager’s hours are supernumerary. Staff training is good. Five of the seven staff employed at the home have gained NVQ level 2/3 qualification in care. Induction training is likewise of a good standard. All new staff complete induction training within their first week of employment before starting work at the home. This induction covers a wide range of basic skills and knowledge Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 19 such as Autism awareness, challenging behaviour, abuse, reporting accidents, confidentiality and safety issues such as fire safety. The manager explained that all new staff are allocated a place on LDAF (Learning Disabilities Award Framework) accredited training, usually within the first six months of employment. Training records were examined and there was evidence that the majority of staff have received the mandatory training they need to carry out their jobs effectively. Three staff files were examined and found to contain all the necessary information showing that thorough recruitment procedures are followed in order to protect people from potentially unsuitable staff. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 20 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 and 42 People who use the service experience good quality outcomes in this area. This judgement has been made using a range of available evidence including a visit to this service. The home is well managed in the interests of people who live there. EVIDENCE: The Manager, Mr Steven Garbutt, has 15 years’ service with Valeo Ltd. During this time, he has been employed as a Senior Project Worker and a Deputy Manager. Mr Garbutt has also managed two other residential services within this organisation. He completed an NVQ level 4 qualification in 2006. Staff said the manager is approachable and supportive. The manager recognises the need to develop a quality monitoring system that seeks the views of people who not only receive a service but are involved in it, Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 21 that is, relatives and other professionals. Individual reviews take place with people using the service that involves their relative, carer and social worker. In accordance with Regulation 26 of the Care Homes Regulations 2001, it is an expectation that representatives involved with this service carry out monthly visits to the home. The purpose of the visit is to speak to the people living there, and staff, in order to form an opinion of the standard of care provided in the home. A tour of the home and examination of documents must also be undertaken. Following the visit a report on the findings must be produced, a copy of which must be made available for the purpose of inspection. There were no reports available for examination during this inspection. The manager was requested to send the latest copies of the reports as evidence that regular visits are taking place. This is particularly important as this is a new service that is developing as more people are admitted to the home. The manager and staff make sure that, so far as is reasonably practicable, the health, safety and welfare of people living at the home, and staff, is promoted, by way of appropriate written risk assessments and action to minimise risks. Weekly fire alarm tests take place. Information provided by the Manager indicates that three people have not received fire training. Arrangements must be made to ensure those staff undertake the training as soon as possible, or within the next two months. Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 x 2 3 3 x 4 x 5 x INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 X 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 X 32 3 33 X 34 3 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 2 3 x 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 2 2 x 3 X 2 X X 2 X Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? N/a 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 3 4 5 Refer to Standard YA6 YA19 YA20 YA39 YA40 Good Practice Recommendations Care plans should include how individuals are supported to maintain a healthy lifestyle and record events when the individuals choose not to act upon advice given. People’s health care requirements should be recorded to ensure monitoring and screening takes place, such as regular cholesterol checks and weight monitoring. Staff should ensure they sign for medication as it is given to avoid signature omissions which can be misleading in terms of whether a person has had their medication or not. A quality assurance system should be implemented that seeks the views of people who use this service. Arrangements should be made for those people who have not yet undertaken fire safety training to do so within the next two months (end of February 2008). Springfield House DS0000070640.V356727.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Brighouse Area Team First Floor St Pauls House 23 Park Square Leeds LS1 2ND National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. 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