Care Home: Springfield Lodge

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What the care home does well A good standard of care is provided for the people who live at the home. People said they enjoyed living there, and that the staff were kind and helpful. Comments received were very positive about the care. People said, `I enjoy living here, the care is good and the staff are friendly and helpful`. and `I like living here and will never leave. The staff and residents are very nice`. All of the people said that the food was good. Comments included, `I find Springfield Lodge is nice, the food is fine with plenty of choice and the staff are very helpful`. The environment was in the main nicely decorated and well maintained. Staff were motivated and enthusiastic about their work. What has improved since the last inspection? This is the first inspection since Ascot Care North East purchased the home. What the care home could do better: Assessments should include how people would like to be looked after at night. This is to make sure that the home can meet all of the assessed needs. Care plans should be available to tell staff how people would like to be looked after at night. This is to make sure that people receive care appropriate to their individual need. Hand written entries and changes to the medication administration records should be signed by two people.This is to minimise the risk of errors and to make sure that people receive their prescribed medication. The complaints procedure needs to be updated to include the contact details of the local authority and the primary care trust. This is so that people know of the other agencies who can help them should they wish to make a complaint. Key inspection report Care homes for older people Name: Address: Springfield Lodge Springfield Lodge North Street West Rainton Co Durham DH4 6NU     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Susan Lowther     Date: 0 8 1 2 2 0 0 9 This is a review of 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. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 25 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. 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 Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Springfield Lodge Springfield Lodge North Street West Rainton Co Durham DH4 6NU 01915842805 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Ascot Care North East Limited Name of registered manager (if applicable) Type of registration: Number of places registered: care home 37 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is:37 The registered person may provide the following caregory of service only: Care Home with Nursing - Code N To service users of the folloing gender : Either Whose primary care needs on admission to the home are within the following caregory: Old Age, not falling within any other category - Code OP Physical disability - Code PD Dementia Code DE Date of last inspection Brief description of the care home Springfield Lodge is a care home registered to provide care (including 24 hour nursing care) for older people, people with a physical disability and up to five people with dementia. Care Homes for Older People Page 4 of 25 Over 65 5 37 37 0 0 0 Brief description of the care home The building was converted for use as a care home in 1989. It is situated in the centre of West Rainton and is within easy reach of the shops and local amenities. Accommodation is provided on the ground floor. There are 35 single bedrooms and one double room, some with en-suite facilities. There are adequate additional toilet and assisted bathrooms. There is one lounge dining room which is combined with some lounge space. There are two smaller lounges located within the home. The home is surrounded by well-maintained gardens and has some car parking space available for visitors. Care Homes for Older People Page 5 of 25 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: two star good 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 2 star. This means the people who use this service experience good quality outcomes. This unannounced inspection of this home took place on the 8th December 2009. Records were examined and a tour of the building took place. Time was spent talking to staff, the people who live in the home and their relatives. The manager supplied some written information to the CQC before the inspection. The inspection focused on key standard outcomes for people who live in the home. 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 Care Homes for Older People Page 6 of 25 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. The fees charged at the time of the inspection were between 390 pounds and 614 pounds per week. This does not include the cost of hairdressing, chiropody personal toiletries and newspapers. Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. Sufficient information is available for people to decide whether they would like to live in the home. Assessment procedures are in place to ensure that the home can meet all of the needs of the people who go to live there. Evidence: People are only admitted after a full assessment of need is carried out by an appropriately trained person. This is usually the manager. This is to make sure that the home can meet the care needs of the people who go to live there. The family of one person who had recently gone to live in the home confirmed that they had looked around the home and had been supplied with all of the information they needed to make a decision about whether or not their relative would like to live there. The statement of purpose and service user guide were seen to contain all of the appropriate information. People spoken with confirmed that they have a contract and understand the service that they can expect to receive. Care Homes for Older People Page 10 of 25 Evidence: The assessments of three people recently admitted to the home were found to be comprehensive in most areas. However these could be expanded further to include social interests and more information about how the person would like to be looked after at night. The home does not admit people for intermediate care therefore assessment of standard 6 is not required. Care Homes for Older People Page 11 of 25 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. Good systems are in place to ensure that health care needs of service users are met. Service users can be confident that their privacy and dignity is protected and that they are treated with respect. Evidence: The manager said that all of the people who live in the home have care plans so that staff know how to look after people on an individual basis. Three were examined during the inspection. These were in the main comprehensive and contained individual plans of care. This is to make sure that staff meet all of the needs of the people who live in the home. However plans should be available to tell staff how people would like to be looked after at night. People spoken to during the inspection said that they are happy with the care received and the level of information given. Records examined showed that people receive visits from other healthcare professionals. These include district nurses, doctors, and care managers. Medication is administered by qualified nurses. The home has a comprehensive Care Homes for Older People Page 12 of 25 Evidence: medication policy. Records of all medicines received, administered and those leaving the home are maintained. However hand written entries and changes to the medication administration records should be signed by two people to minimise the risk of errors and to make sure that people receive their prescribed medication. People spoken with said that staff always treat them with dignity and respect. Staff confirmed that they have recently received training in this area. Staff have also been trained with regard to dealing with death and dying. On the day of the inspection the family of one person visited the home to thank staff for the care they had given to them and their family member, who had recently died. Care Homes for Older People Page 13 of 25 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 activities are varied and provide recreation for some of the people living in the home. Family and friends can visit the home at any time and are made to feel welcome. The meals are of a good standard. Menus are varied and service users are given a choice. Evidence: Most of the people said that activities are suitable. The activities organiser spends time with people on an individual basis to find out what activities they would like to do. People would benefit from having their social needs assessed formally and care records kept to demonstrate that activities are tailored to individual need wherever possible. Relatives said that they could visit at any time and that they are always made welcome. People confirmed that they have contact with the local community. recently people have attended two nativity plays and a pantomime. On the evening of the inspection a musical group were to visit the home to provide entertainment. People said that they have a choice about how they like to spend their day. They can also choose what time to get up and go to bed and when they would like to have a Care Homes for Older People Page 14 of 25 Evidence: shower or bath. The lunch looked nice. Staff who were helping people were doing this in a discreet and dignified manner. Evidence was seen in care plans to confirm that nutritional needs are assessed and other professionals consulted if required. Care Homes for Older People Page 15 of 25 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. People can be confident that their concerns and complaints are dealt with appropriately and that safeguards are in place to protect them from abuse. Evidence: Information about complaints, how and who to make them to, is made available to the people who live in the home and their families through information displayed in the entrance to the home and in the Service Users Guide. However this needs to be updated to include the contact details of the local authority and the primary care trust. This is so that people know of the other agencies who can help them should they wish to make a complaint. There have been two complaints recorded since the current provider was registered. These were investigated by the home. The manager said that where appropriate advocacy services would be accessed for people. She also confirmed that people who wished to and were able would be taken to vote. Postal voting will also be arranged for people unable to visit a polling station. The home had a comprehensive adult protection procedure. This gives staff the support they need to make a referral should this be required. The staff spoken to during the inspection were asked about abuse and what they would do if they saw or heard anything inappropriate. All said that they would tell someone, for example the manager, or make a referral themselves if this was more appropriate. Training is provided for all staff in adult protection. Care Homes for Older People Page 16 of 25 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 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. It is decorated and furnished to a good standard and provides a homely environment for the people who live there. Evidence: The home has a large combined dining and sitting area in addition to two smaller areas. There are 35 single rooms and 1 double room, which can be used for married couples. 11 of the rooms have en suite facilities. During a tour of the building we saw that many of the rooms are decorated to the persons own taste and there was evidence to confirm that people can take in some personal items when they go to live there. This includes pieces of furniture as well as photographs and ornaments. The provider is in the process of decorating and providing new furniture to many areas of the home. Those completed are to of a good standard and both staff and the people who live in the home confirmed that they are pleased with the progress being made. There was a range of equipment seen around the home to support people with bathing and mobility. There are adequate toilet and bathing facilities located throughout the building. We found the building to be clean, tidy and free from offensive odours. Care Homes for Older People Page 17 of 25 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 are appropriately recruited, trained and in sufficient numbers to meet the needs of the people who live in the home. Evidence: From the rota supplied at the inspection there was sufficient care staff on duty to meet the assessed care needs of the people who were using the service. People said that staff were usually around and answered the call bells quickly. There is a commitment at the home to having a trained workforce with 50 of the staff having an NVQ at level 2 or above. The home had staff files in place, which provided evidence that the appointment of a new staff member is made through proper recruitment processes. This includes the vetting of staff through the use of references, POVA first checks and Criminal Record Bureau (CRB) checks. As well as mandatory training, recent training has also taken place in adult protection and dementia awareness. Staff said that they are also supported with regard to personal training needs. Staff comments in this area were positive. Comments included There is always plenty of training going on and you can ask for additional training if you want to. Care Homes for Older People Page 18 of 25 Evidence: Care Homes for Older People Page 19 of 25 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 good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People can be assured that the home is well managed and they are given the opportunity to comment on how the home is run. Policies and procedures are in place to safeguard their health, safety and wellbeing. Evidence: The manager is qualified and competent to run the home. She is a qualified nurse and holds an appropriate management qualification. There was an open and friendly culture between the management team and staff working at the home. People living at the home and visitors who were spoken to during the inspection confirmed that the manager is approachable and that they would go to her if they had any concerns. Staff also confirmed this to be the case. Regular meetings are held and there are a number of systems in place to consult with people living at the home. Relatives and the people who live in the home can approach the staff at any time. Care Homes for Older People Page 20 of 25 Evidence: Personal finances are kept in the home for people who request this. Signatures are obtained and receipts are kept to ensure peoples financial interests are safeguarded. There was evidence in staff files to show that supervision was taking place and that the staff were being appraised. Staff confirmed that supervision takes place on a regular basis and that they are well supported. The manager confirmed that all equipment in the home is regularly checked. The maintenance certificates that were seen at this inspection were found to be in order. Health and Safety checks are carried out regularly to safeguard people living and working at the home. Care Homes for Older People Page 21 of 25 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 22 of 25 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 16 22 The complaints procedure 31/12/2009 needs to be updated to include the contact details of the local authority and the primary care trust. This is so that people know of the other agencies who can help them should they wish to make a complaint. 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 3 Assessments should include how people would like to be looked after at night. This is to make sure that the home can meet all of the assessed needs. 2 7 Care plans should be available to tell staff how people would like to be looked after at night. This is to make sure that people receive care appropriate to their individual need. 3 9 Hand written entries and changes to the medication Page 23 of 25 Care Homes for Older People 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 administration records should be signed by two people. This is to minimise the risk of errors and to make sure that people receive their prescribed medication. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. 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