Care Home: Springfields

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What the care home does well Springfields provides a very relaxing and homely environment. Residents are encouraged to feel comfortable in voicing their opinions and to influence life at the home. The premises are decorated high standard and comfortably furnished. The general standard of cleaning is very good and safe practices to minimise the risk of infection are in place. The gardens are immaculately tended and provide residents with visual enjoyment as well as providing opportunities for their mobilisation, which are actively encouraged by staff. Standards of maintenance and repair are strictly adhered to, ensuring the premises are safe. There is a strong emphasis on customer care that extends to residents` families. The Proprietor is very involved in the daily life at the home. Social events are planned throughout the year to which friends and families are invited.Standards of personal and healthcare are good with very good access to GP and district nurse support. What has improved since the last inspection? The quality assurance programme has been developed to include full consultation with residents, relatives, GPs and district nurses. A suggestion box has been provided for residents and their relatives enabling them to put forward anonymously their views and influence life at the home. A new brochure of the home has been produced for prospective residents` and their representatives` information. A new assisted bath & shower have been installed. Social activities have further developed in consultation with residents to provide more variety that includes a weekly-seated exercise session. Care planning has been developed to provide more detailed guidance for staff and is regularly reviewed. Individual activities are now recorded in each resident`s care records Some improvements have been made in storage, administration and recording of medication. Staff training has improved with food hygiene, infection control, and tissue viability, NVQ 2, medication and health and safety training provided. Staff hand-washing facilities have been provided in all areas where personal care is provided. CARE HOMES FOR OLDER PEOPLE Springfields Easthorpe Road Copford Green Colchester Essex CO6 1DH Lead Inspector Diana Green Unannounced Inspection 4th July 2008 13:30 X10015.doc Version 1.40 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 Springfields DS0000017935.V367953.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 Older People. 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. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfields Address Easthorpe Road Copford Green Colchester Essex CO6 1DH 01206 212261 01206 213238 springfieldsmail@btconnect.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) Springfields Residential Homes Limited Mrs Patricia Ann Green Care Home 16 Category(ies) of Mental Disorder, excluding learning disability or registration, with number dementia - over 65 years of age (1), Old age, of places not falling within any other category (16) Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. Persons of either sex, aged 65 years and over, who require care by reason of old age only (not to exceed 16 persons) One service user aged 65 years and over with a mental disorder whose name was made known to the Commission on 14/03/06 The total number of service users accommodated in the home must not exceed 16 persons 31st May 2007 Date of last inspection Brief Description of the Service: Springfields is a residential home providing personal care and support for up to 16 older people. The home is located in the village of Copford, close to Marks Tey where there are shops, a train station and access to the A12. Springfields is a three-storey building, previously a house. It has 16 single en-suite rooms. On the ground floor are communal rooms two lounges and a dining area. There is a passenger lift to reach the upper floors. The home has extensive, landscaped gardens to the rear of the property and ample visitor parking at the front of the house. This home does not accommodate wheelchair users. Adjacent to the residential home is a nursing home managed and owned by the same company. Laundry and catering facilities are shared between the two establishments. The fees range from £409.00-£577.00 weekly. Additional costs apply for chiropody, toiletries, sundries, hairdressing and newspapers. This information was provided to the CSCI on 4th July 2008. Springfields DS0000017935.V367953.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 3 star. This means the people who use this service experience excellent quality outcomes. This report has been written following an unannounced key inspection undertaken on 4/07/08. The report has been written using accumulated evidence gathered prior to and during the site visit, including the homes (AQAA) Annual Quality Self Assessment and surveys distributed to residents, relatives, staff, and health and social care professionals. The inspection process included: discussions with the deputy manager, three residents, care staff, the proprietor, a tour of the premises including a sample of residents’ rooms, bathrooms and communal areas; an inspection of a sample of policies and records (including any records of notifications or complaints sent to the CSCI since the last inspection). Twenty-six standards were inspected (three were commended) and one requirement and four recommendations were made. The deputy manager, staff and proprietor were welcoming and helpful throughout the inspection. What the service does well: Springfields provides a very relaxing and homely environment. Residents are encouraged to feel comfortable in voicing their opinions and to influence life at the home. The premises are decorated high standard and comfortably furnished. The general standard of cleaning is very good and safe practices to minimise the risk of infection are in place. The gardens are immaculately tended and provide residents with visual enjoyment as well as providing opportunities for their mobilisation, which are actively encouraged by staff. Standards of maintenance and repair are strictly adhered to, ensuring the premises are safe. There is a strong emphasis on customer care that extends to residents’ families. The Proprietor is very involved in the daily life at the home. Social events are planned throughout the year to which friends and families are invited. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 6 Standards of personal and healthcare are good with very good access to GP and district nurse support. What has improved since the last inspection? What they could do better: The statement of purpose needs to be reviewed to provide more detail of the care provided at the home including end of life care. A list of staff signatures & initials needs to be maintained to enable identification of care staff who are authorised to give medication and to enable any issues that may arise to be easily followed up. The Controlled Drugs (CD) register must be used for recording all CD drugs. Stimulating social activities could be further developed to invite speakers and more outings could be provided to enhance residents lives. Staff would benefit from further training on care issues (for example dementia awareness/confusion in older people). Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 7 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. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 8 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 9 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good based upon sampled inspected standards 1, 3 & 6. People planning to move to Springfields can expect to be well informed and to have their needs assessed prior to moving in to the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home had a statement of purpose and service user guide that were combined documents. These had not been reviewed for some time and a recommendation is therefore made to this effect. However a new brochure of the home had been produced since the previous inspection and was available for visitors’ information. A copy of the statement of purpose/service user guide was observed on display in the entrance hall of the home for visitor’s information and also in several residents’ rooms. From discussion with the deputy manager and information received in the AQAA it was evident that Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 10 prospective residents and/or their relatives would be invited to the home prior to making a decision and copies would be made available to them. All residents and their relatives stated in completed surveys that they always received enough information. One resident told us: ’Springfields comes highly recommended and I have yet to find fault’. Three care records were viewed and all included a full assessment of care needs. All had a pre-admission assessment of care needs recorded that had been undertaken prior to admission. Evidence that the resident and/or their representative had been involved in the assessment was present on all files viewed. This home does not provide intermediate care. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 11 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good based upon sampled inspected standards 7, 8, 9 and 10. The health and personal care needs of residents are appropriately met through robust care planning and monitoring of practice that ensures residents’ privacy and dignity is respected. This judgement has been made using available evidence including a visit to this service. EVIDENCE: Three care plans were reviewed during the site visit. All included a resident’s profile that contained good detail of the residents’ state of well being on admission together with family information. Since the previous inspection care plans had been produced using a computer. Residents’ care needs (for example personal care, oral care, foot care, sight and hearing, diet etc.) were recorded in detail. Risk assessments were undertaken and recorded for falls, and risks associated with each individual resident. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 12 All risk assessments and care plans had been reviewed monthly on all three sampled records. Daily records were detailed and showed good monitoring of needs and appropriate action taken as relevant. Care plans had improved since the previous key inspection to include more detailed guidance for care staff on how to meet the resident’s needs. When asked do you receive the care and support you need four of the six residents who responded to surveys told us: ‘always’ and two said ‘usually’. All six said that care staff listened to them and acted on what they said. The records provided evidence of good monitoring of health care needs with prompt referral to GPs and health care professionals and appropriate follow up action being taken. The home was supported by a local GP who visited the home weekly. The records confirmed that a doctor saw residents regularly and they were enabled access to district nurses as relevant. The records viewed detailed regular treatment from a chiropodist and annual eye tests. One health professional when asked ‘what do you feel the service does well’ told us in a completed a survey: ‘provides dedicated resident holistic care. The staff are very sincere and conscientious’ and we received the following comments from relatives:’ provides a very caring, thoughtful and comprehensive service’; ’kind, reliable staff’. From the positive comments received from relatives it was evident that residents’ care needs were monitored and they were kept informed: When asked ‘do you feel the care home meets the needs of your relative? All five relatives who completed surveys told us: ’always’ and when asked ‘are you kept up to date with important issues affecting your friend/relative (for example if they have been admitted to hospital or had an accident)? Five relatives told us: ’always’. Medication was supplied in individual containers from the local supplying pharmacist. Senior care staff administered all medication and all had received medication training (confirmed from the records) since the previous key inspection. There was no list of staff signatures and initials available for staff to identify who was authorised to give medication. The deputy manager was advised to ensure a record was made and kept updated to enable any issues that may arise to be easily followed up. Medication was stored in a locked trolley secured to the wall in the office on the ground floor of the home. Supplies were also kept in a locked cupboard on the first floor of the home that also contained a Controlled Drugs (CD) cupboard. However although stored appropriately in the CD cupboard, the CD register was not being used to record receipt, administration and disposal and Temazepam. Regular room temperature monitoring was undertaken and recorded. The temperature taken at the site visit was 24.5° Centigrade and there was evidence from the records that temperatures had occasionally reached between 25-27° Centigrade, which exceed the recommended safe maximum temperatures of 25° Centigrade. Action had been taken to reduce the temperature using ice packs but consideration should still need to be given to finding alternative storage or purchase of an air conditioning unit. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 13 The medication supplies and medicine administration records were viewed for a three residents. All had a photograph of the resident and a medication profile recorded with the potential side effects of each medication. All medication was available as prescribed and well recorded. However medication administration records (MAR) sheets had been transcribed by senior staff and did not mirror the instructions detailed on the medication labels and prescription that would ensure they were given as prescribed. Staff were observed to knock before entering residents’ rooms and to sensitive in their manner when addressing them. Residents spoken with said that staff respected their privacy and were polite, friendly and always knocked before entering. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 14 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good based upon sampled inspected standards 12, 13, 14 and 15. People living at Springfields can expect to mantain contact with their family and friends and to have a lifestyle that satisfies their cultural expectations. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The home’s daily activities were organised by care staff and occasional outings were arranged as residents had chosen. Some events (for example strawberry garden party) to which families were invited were organised between the residential and nursing home with full support of all staff. One resident told us: ‘the strawberry tea was very good. I was very impressed by it’. From discussion with the care staff and the records viewed it was evident that residents’ life history and interests were discussed with them on admission to the home. The AQAA stated that residents had daily delivery of newspapers and a mobile library regularly visited the home and residents were encouraged Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 15 to become involved in mental stimulation such as group quizzes and crosswords. This was confirmed through discussion with a resident who also told us that they enjoyed the musical movement (seated exercise) session. When asked ‘Are there activities arranged by the home that you can take part in?’ Five of the residents who completed surveys told us ‘usually’ and one said ‘sometimes’. The home’s statement of purpose included the policy on visiting and residents said that their friends and relatives could visit at any time, and they could meet with them in private in their rooms. The AQAA stated that the home ‘gains involvement from relatives in the client’s care and well-being’ and they ‘ensure relatives are encouraged and warmly welcomed in into the home’. When asked ‘Does the care home or agency help your relative to keep in touch with you?’ all of the five relatives who completed surveys stated ‘always’. Residents were observed to have some choice about their daily life in the home, especially in regard to where they spent their day, ate their meals etc. Many of the rooms seen were well personalised, showing that people could bring their own possessions into the home with them. Information on advocacy services was included in the statement of purpose and available in the home. A resident told us ’ it’s ok here. You can please yourself what you do’. When asked ‘does the care service help people to live the life they choose?’ three of the five relatives who completed surveys told us: ‘always’ and two said ‘usually’. Residents were just leaving the dining room having enjoyed a lunch of home cooked fish and chips with peas with alternatives offered comprising fish in sauce or cottage pie followed by a desert. All food is cooked on site in the kitchen located in the adjacent nursing home and served from the residential home’s domestic type kitchen. Residents spoken with said they usually enjoyed the food at the home. The records viewed confirmed that nutritional intake was closely monitored and action taken to provide supplements as needed. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 16 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent based upon sampled inspected standards 16 & 18. People living at Springfields can expect to have their complaints listened to and acted upon and to be protected from abuse by robust policies, procedures, staff training and practices. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The arrangement for management of complaints was discussed with the deputy manager. The home had a complaints procedure that included the timescales within which complainants can expect a response. The procedure was included in the statement of purpose and displayed in the entrance of the home. No complaints had been received since the previous inspection. The manager also worked closely with care staff providing personal care and operated an open door policy and was therefore very accessible to residents and their relatives. The Proprietor was also very visible in the home taking part in various social events organised on residents’ behalf. When asked ‘has the care service responded appropriately if you or the person using the service has raised concerns about their care? Three out of four relatives who completed surveys stated ‘always’ and one said this has never been a problem. All of the six residents who completed surveys told us they knew how to make a complaint and they knew who to speak to if they were unhappy. A suggestion Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 17 box had recently been installed at the home at residents request. Suggestions, (for example providing wine with Sunday lunch rather than sherry) had quickly been actioned. The home had comprehensive policy and procedures for safeguarding vulnerable adults that were kept under review and local Essex procedures were available for staff guidance. The records confirmed that all staff had received updated training in safeguarding adults since the previous key inspection. We were informed that there had been no incidents or allegations of abuse made. From previous knowledge of the home and manager it was evident that any incidents or allegations would be referred in line with safeguarding procedures as required. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is excellent based upon sampled inspected standards 19, 22 and 26. People living at Springfields can expect to live in a clean, well-decorated, comfortable furnished and well-maintained environment that has safe standards of infection control in place. This judgement has been made using available evidence including a visit to this service. EVIDENCE: A partial inspection of the premises was made that included communal areas, two bathrooms, a number of residents’ rooms and the kitchen. The home was in a good state of maintenance and decorated and furnished to a high standard in accordance with the client group. The gardens were immaculately tended and laid to lawn with roses, shrubs and various plants. Seating was provided for residents on a patio and there were paths throughout the garden area that Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 19 enabled wheelchair access. Records provided evidence that the building complied with the requirements of the local fire and environmental health department. The home had a passenger lift and two stair lifts to enable access throughout the premises. There were grab rails and aids in bathrooms, toilets and communal rooms to meet the needs of residents. Assisted baths and toilets were provided. Since the previous key inspection a new assisted bath and shower had been installed. Call systems were provided throughout all individual and communal rooms. The home is not fully accessible to wheelchairs and care is not provided for wheelchair users. All equipment was serviced as per manufacturers recommendations and confirmed from the records inspected. There were policies and procedures for infection control available for staff guidance and the records viewed confirmed that all staff received training during induction and at regular updated sessions. The home was cleaned to a high standard throughout. The laundry room was not inspected on this occasion. However all linen and personal laundry seen was well laundered. From previous knowledge of the home it was evident that systems were in place to minimise the risk of infection via the use of red bags for any laundry soiled by body fluids, placed directly in the washing machines and washing machines had the capacity to carry out sluice wash cycles. All of the six residents told us in completed surveys that the home was always fresh and clean. One told us:’ it is always fresh and smells lovely’. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good based upon sampled inspected standards 27, 28, 29 and 30. People living at Springfields can expect to have their needs met by skilled and caring staff that have been robustly recruited. This judgement has been made using available evidence including a visit to this service. EVIDENCE: There were sixteen residents at the home. Staffing levels comprised the deputy manager and two care staff. The registered manager was on leave. Laundry, gardening and maintenance staff were shared between the adjacent nursing home. There was evidence from the staff rota that staffing levels were well maintained and from observation these seemed to meet residents’ needs. Information received in the AQAA stated that ten of the eighteen care staff employed at the home had qualifications to NVQ level 2 or above. This is 60 of care staff employed and exceeds the 50 needed to meet the standard. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 21 The recruitment files of two recently employed staff were inspected. Both had evidence that the required checks had been obtained (two satisfactory references, CRB/POVA checks) and evidence of identification and photographs obtained before the individuals commenced employment at the home. Both had received a statement of terms and conditions of employment. There was evidence from the files viewed that both staff recently employed had received induction to Skills for Care Standards and undertaken training in fire safety and manual handling. The home had an established training programme. The training records were viewed and confirmed that since the previous key inspection staff had received updated training on first aid, safeguarding adults, infection control, fire safety, food hygiene, medication training, moving and handling and tissue viability. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 22 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Quality in this outcome area is good based upon sampled inspected standards 31, 33, 35, 36, 37 and 38. Springfields is well managed and run in the best interests of residents. The health and safety of residents and staff is safeguarded by the policies, procedures and practices at the home. This judgement has been made using available evidence including a visit to this service. EVIDENCE: The registered manager has managed the home for a number of years and holds the RMA (Registered Manager’s Award). She has several years experience in care. From former knowledge and an inspection of the records it was evident that she was skilled and competent and had undertaken recent Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 23 updated training relevant to a manager of a care home for older people. Staff who completed a survey told us: ‘our manager is always available to listen to any problems we may have or to discuss any issues’ whilst another response stated that ‘meeting with the manager is not frequent’. The home’s quality assurance programme had been developed since the previous key inspection. Regular resident’s meetings were held and a suggestion box had been provided to enable residents and their relatives to put forward suggestions. We were shown the responses to residents, GP and district nurse survey and family surveys that had been undertaken. Comments received from the family surveys included: ’we think my xxx is having excellent care and xxx is happy’ and ‘it is a great relief to know that our xxx is receiving such wonderful care and in the most lovely surroundings.’ The deputy manager informed us that residents’ personal monies were not managed by the home. All residents had a relative/advocate to manage their finances on their behalf and all transactions were invoiced directly to them. Residents were discouraged from keeping valuables in the home. From discussion with the deputy manager and the staff records viewed it was evident that staff supervision was provided to Skills for Care standards and provided every two months to meet the standard. Records held on behalf of residents were kept up to date and stored safely in secure facilities in the office in accordance with the Data Protection Act 1998. Records viewed at this inspection included the statement of purpose, the service user guide, medication records, care plans, staff files, activities records, and fire safety records, maintenance records and accidents records. The home had health and safety policies and procedures that were regularly reviewed. The training records viewed confirmed that two recently appointed staff had attended health and safety training since appointment. Evidence of a sample of records viewed showed that there were systems in place to ensure the servicing of equipment and utilities and there was evidence of appropriate weekly and monthly internal checks being carried out (e.g. checks on fire equipment fire alarms and emergency lighting etc.). All accidents, injuries and incidents were well-recorded and appropriate action taken. Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 4 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 4 17 X 18 3 4 X x 3 X X X 3 STAFFING Standard No Score 27 3 28 4 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 X 3 x 3 3 3 3 Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 25 Are there any outstanding requirements from the last inspection? NO STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. Standard OP9 Regulation 13(2) Requirement To ensure the safe administration of medicines: 1. All CD drugs must be recorded in the CD register on receipt, administration and disposal. 2. A list of signatures and initials of care staff authorised to give medication must be maintained. Timescale for action 31/07/08 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. Refer to Standard OP1 OP9 OP12 OP30 Good Practice Recommendations The statement of purpose should be reviewed to describe the service provided in the home. The storage of medicines should be reviewed to ensure the temperatures remain within maximum recommended levels (25°Centigrade). Social activities should be further developed to include more stimulating activities (for example speakers) and more outings. Staff training should be provided in dementia awareness/confusion in older people. DS0000017935.V367953.R01.S.doc Version 5.2 Page 26 Springfields Springfields DS0000017935.V367953.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Eastern Region Commission for Social Care Inspection Eastern Regional Contact Team CPC1, Capital Park Fulbourn Cambridge, CB21 5XE 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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