Care Home: Springfields

Similar services:

• The Shelley
• Springfield House
• Sutton Lodge Nursing Home
• St Helier`s Residential Hotel
• St Joseph`s
• Ridgemount
• Wingham Court
• Old Hastings House

What the care home does well The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The pre admission process ensures that only residents whose needs can be met at the home are admitted.Residents` needs are being met with the information provided in the care plans on the assessed needs of individuals. Staff practice reflects a good understanding of residents` personal and healthcare needs, which ensure that needs are met. Residents` privacy and dignity are respected. Residents` lifestyle within the home is generally their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents are provided with varied nutritional meals and are provided with choice to ensure their preferences are catered for. Residents feel comfortable to complain, reassuring them that they are being listened to and that action will be taken, if necessary. Residents are safeguarded by the procedures in place and the training of staff in Safeguarding Adults. Residents` needs are being met with the skill mix of staff on duty. Recruitment procedures in place ensure that residents are safeguarded. Staff and residents benefit from a well managed home. The health, safety and welfare of residents and staff are promoted and protected so far as is reasonably practicable. Residents spoken with were happy residing at the home and some comments received were `In all the times, things are going well`, `the matron is excellent`, `homely, lovely atmosphere`, `glad to be here` and `food is excellent and plenty of it`. What has improved since the last inspection? Work has been done to ensure compliance with the outstanding requirements made at the last inspection. Any recommendations made at the last inspection have been addressed. A developed quality assurance and quality monitoring system enables the Registered Manager and registered provider to monitor their service and ensure that the home is run in the best interest of service users. Work has been undertaken and is continuing to improve standards within the home, ensuring residents live in a comfortable and suitable environment. This includes undertaking work within the kitchen area to ensure compliance with environmental health. For those residents who wish their room doors be kept open, action has been taken to ensure that residents are safeguarded and safety be promoted in the event of a fire. The registered providers, or designated person, are now undertaking monthly Regulation 26 visits and a report of these visits are provided to the Registered Manager. These monthly visits assist the providers in monitoring their service and ensuring it is meetings it aims and objectives. Three of the requirements made at the last inspection were outstanding. The home has now complied with these and must ensure that these continue to be maintained, ensuring good outcomes for residents are sustained and built on. What the care home could do better: Risk assessments for the use of bed rails need detailed information, be specific to the individual and provide guidance if the use of bed rail covers are required or not. Information received identified that action was taken immediately to address the minor shortfalls noted in medication procedures. The home has implemented a new audit book and must ensure that robust medication procedures are followed at all times. Any shortfalls noted of which no requirement or recommendation has been made have been highlighted throughout the content of the report. CARE HOMES FOR OLDER PEOPLE Springfields 11 Langdale Road Hove East Sussex BN3 4HQ Lead Inspector Jennie Williams Unannounced Inspection 15th August 2008 11:10 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 DS0000014059.V369312.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 DS0000014059.V369312.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Springfields Address 11 Langdale Road Hove East Sussex BN3 4HQ 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) 01273-735784 01273 738260 panita.vig@vigcare.com Mr Joginder Singh Vig Mrs Beant Kaur Vig Mrs Colleen Hutton Care Home 32 Category(ies) of Old age, not falling within any other category registration, with number (32) of places Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. The maximum number of service users to be accommodated at any one time is thirty two (32). Service users should be aged sixty five (65) and over on admission. That the home is registered to admit three service users aged over sixty-five years on admission, with a dementia-type illness. Only older people who have been assessed as requiring nursing/residential care are to be accommodated. 19th September 2006 Date of last inspection Brief Description of the Service: Springfields is a care home providing nursing and personal care for up to thirty-two (32) older people. The registered providers own several care homes throughout the South of England, predominantly older people services. The home is situated in a quiet residential area in Hove, within close walking distance of the sea front. There are nearby local amenities and access to public transport. There is no parking available at the home, however there is restricted paid parking available in adjacent streets. Residents’ accommodation is provided over two floors in a large property that has been converted from three houses. A passenger shaft lift enables residents to access all parts of the home. There are eighteen single rooms with six being provided with en suite facilities. There are seven rooms for shared occupancy, of which three have en suite facilities. There are a number of communal toilet and bathing facilities located throughout the home. There is a lounge/dining area on the ground floor, and a small sitting area in the foyer of the home. There is a pleasant garden at the rear of the building that is accessible to residents. Current fees charged are between £490 to £650. There are additional fees for hairdressing, chiropody, personal toiletries, newspapers/magazines etc. A full list of what is not included in the fees can be found in the Service Users Guide. This information was provided to the CSCI on the 15 August 2008. Springfields DS0000014059.V369312.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. It should be noted that following recent CSCI consultation, it was identified that service users prefer to be called people who use services. It was confirmed that the home uses the term residents. For the purpose of this report, people who use the service will be referred to as residents. This unannounced site visit took place over eight and a half hours on the 15th August 2008. Evidence obtained at this site visit, previous information regarding this service and information that the CSCI have received since the last inspection forms this key inspection report. This report includes information from an Annual Service Review (ASR) that was undertaken on 27 December 2007. Six residents were spoken with throughout the site visit. The pre admission assessment and care plan was viewed for a recent admission. Specific areas of care were viewed in a further five care plans. The Registered Manager and eight staff were spoken with throughout the site visit, including care staff, activities person and the cook. Four staff files were inspected, along with training records. A tour of the environment was undertaken and some individual rooms were viewed. Medication procedures were inspected. The quality assurance system was discussed, some recent results viewed and complaint records were viewed/discussed. An Annual Quality Assurance Assessment (AQAA) was received from the home prior to the site visit. This was to obtain information about the establishment to assist CSCI in the inspection process. The AQAA also provided the Commission with numerical information. There were thirty residents residing at the home on the day of the site visit. What the service does well: The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The pre admission process ensures that only residents whose needs can be met at the home are admitted. Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 6 Residents’ needs are being met with the information provided in the care plans on the assessed needs of individuals. Staff practice reflects a good understanding of residents’ personal and healthcare needs, which ensure that needs are met. Residents’ privacy and dignity are respected. Residents’ lifestyle within the home is generally their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents are provided with varied nutritional meals and are provided with choice to ensure their preferences are catered for. Residents feel comfortable to complain, reassuring them that they are being listened to and that action will be taken, if necessary. Residents are safeguarded by the procedures in place and the training of staff in Safeguarding Adults. Residents’ needs are being met with the skill mix of staff on duty. Recruitment procedures in place ensure that residents are safeguarded. Staff and residents benefit from a well managed home. The health, safety and welfare of residents and staff are promoted and protected so far as is reasonably practicable. Residents spoken with were happy residing at the home and some comments received were ‘In all the times, things are going well’, ‘the matron is excellent’, ‘homely, lovely atmosphere’, ‘glad to be here’ and ‘food is excellent and plenty of it’. What has improved since the last inspection? Work has been done to ensure compliance with the outstanding requirements made at the last inspection. Any recommendations made at the last inspection have been addressed. A developed quality assurance and quality monitoring system enables the Registered Manager and registered provider to monitor their service and ensure that the home is run in the best interest of service users. Work has been undertaken and is continuing to improve standards within the home, ensuring residents live in a comfortable and suitable environment. This includes undertaking work within the kitchen area to ensure compliance with environmental health. For those residents who wish their room doors be kept open, action has been taken to ensure that residents are safeguarded and safety be promoted in the event of a fire. The registered providers, or designated person, are now undertaking monthly Regulation 26 visits and a report of these visits are provided to the Registered Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 7 Manager. These monthly visits assist the providers in monitoring their service and ensuring it is meetings it aims and objectives. Three of the requirements made at the last inspection were outstanding. The home has now complied with these and must ensure that these continue to be maintained, ensuring good outcomes for residents are sustained and built on. 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. Springfields DS0000014059.V369312.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 DS0000014059.V369312.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): 1, 3, 4, 5 & 6 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. The home has information available for prospective residents/representatives on the facilities and services provided to make an informed decision if their needs can be met at the home. The pre admission process ensures that only residents whose needs can be met at the home are admitted. EVIDENCE: The home has a Statement of Purpose and Service Users Guide that is available at the home and provides prospective residents/representatives with information about the services and facilities provided at the home. The AQAA identifies that these documents are available in other languages or large print on request. The AQAA identifies that their plans for improvement in the next 12 months is to update the information given to prospective residents. The contact details for the CSCI needs to be updated in the complaints section in Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 10 the Statement of Purpose. This information has been updated in the Service Users Guide. The Registered Manager confirmed that the pre admission assessment form has been amended to include additional prompts, such as ensuring a Statement of Purpose and Service Users Guide is provided to the individual/representative. Assessments are undertaken on all prospective residents to ensure that their needs can be met with the services and facilities provided at the home. Additional information is obtained from social services and other health professional wherever possible. There was a pre admission assessment observed to be in place for a newly admitted resident. The home takes emergency admissions, however the Registered Manager confirmed that they ensure an assessment is still undertaken by the home prior to admission. Prospective residents/representatives are encouraged to visit the home prior to admission. Of the residents that were asked, all confirmed that they or a representative visited the home prior to moving in. A resident confirmed that they were provided with a choice if they wished to share a room or not. The AQAA identifies that in the last 12 months they have improved the admission process by introducing as many members of staff possible when a prospective resident/representative visits the home. Staff spoken with confirmed that they felt all residents were appropriately placed at the home with all needs being met. They stated that appropriate action is taken if someone’s needs can no longer be met at the home. There is no dedicated accommodation to provide intermediate care, however respite is available if there is a spare place available. Springfields DS0000014059.V369312.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): 7, 8, 9 & 10 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are being met with the information provided in the care plans on the assessed needs of individuals. Staff practice reflects a good understanding of residents’ personal and healthcare needs, which ensure that needs are met. Recording and administering medicines could be more robust to further safeguard residents and staff. Residents’ privacy and dignity are respected. EVIDENCE: Care plans were not viewed in detail as a Quality Review Nurse from the local purchasing authority had recently undertaken an audit of the home, of which the home was happy to share with the Inspector. These reports advise the home on areas for improvement and provide them with an action plan and timescales within which to comply. The Quality Review Nurse monitors the home to ensure action plans are complied with. There were also no concerns Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 12 noted with the care plans at the last inspection and the Registered Manager confirmed that there has been no changes made to the format used. The AQAA identifies that care plans continue to be person centred. The Inspector viewed specific areas of care within five care plans. There was clear guidance in place for staff on how to meet these specific needs. Staff spoken with confirmed that they find the care plans user friendly and easy to understand. Of the residents that were asked, confirmed that the staff discuss their care with them when needed. One identified that they would not want to be involved in their care planning. Residents/representative sign their initial care plan. It was discussed with the Registered Manager that evidence be provided when an individual/representative has been involved in the review of the care plan. There is a key worker system in place. A resident was able to confirm who their key worker was. Malnutrition Universal Screening Tools were in use for monitoring individuals nutritional needs. These were based on scoring outcomes, however no information was provided in the care plan to identify what the scoring meant. This information was located in another folder. It is recommended that the guidance to be used with this assessment tool be attached to the assessment form. It was confirmed that staff have an understanding of what the different scoring means. On viewing daily notes, it was observed that some staff were writing ‘all due care given as per care plan’. Daily records are a good source of evidence to show that care is being provided, as detailed in the care plan, however the term All care given is not helpful or adequate, especially if care plans do not reflect accurately all needs. Daily records when well written, help ensure a consistent approach and good quality of care for residents. It is in the homes interests to be able to show what they have done, along with providing the evidence on which to base the monthly review and to record that they are following the assessment of needs. A resident confirmed that staff encourage them to be as independent as possible. The care staff team is predominantly female. A male resident spoken with confirmed that this was not an issue for them and did not mind receiving personal care from females. There was evidence that advice is sought from specialist health professionals when the needs arise eg. Dietician and Tissue Viability Nurse. A resident commented that they had visited a dentist recently and another confirmed that the home is ‘quick to access a GP’ and they have eye checks and dental treatment as needed. The home has access to pressure relieving equipment when required. A visiting health professional spoken with confirmed that there is always a staff member available when they visit and staff are knowledgeable and know the residents needs. Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 13 The Registered Manager confirmed that there are risk assessments in place for the use of bed rails. Consent for the use of these are signed by the individual or representative. These documents read as being general, not specific to the individual and do not provide clear information. These risk assessments need to be more detailed, specific to the individual and identify if bed rail covers require to be in place. It was confirmed that there are policies and procedures in place for all aspects of dealing with medicines. The content of these were not read. Photos were observed to be on Medication Administration Records (MAR) charts to assist with staff identifying individuals. On viewing MAR charts and corresponding blister packs, it was identified that some medicines were being signed for but not administered. The Registered Manager confirmed to the Inspector in writing, immediately following the site visit, why the errors had occurred and what action has been undertaken to address the shortfalls. Examples are; a new audit book has been implemented and medicines will be audited every two weeks and refresher medication training is being arranged for all nurses. The information provided evidences that the Registered Manager has been proactive in promptly addressing any shortfalls. No requirement has been made around medication, however this will continue to be monitored throughout the inspection process. It was confirmed that records are maintained of all medicines received into the home and all that are returned. It was confirmed that unused medicines are disposed of through a licensed company. Residents are provided with an opportunity to self medicate if they wish and it has been risked assessed that they are capable to do so. Records viewed identified that accurate records are being maintained of controlled drugs. Residents spoken with confirmed that staff respect their privacy and dignity. One resident confirmed that staff always ensure a screen was put up in the shared room when staff are assisting them with personal care. Some staff were heard throughout the site visit calling residents by the term ‘darling’. It was discussed with the Registered Manager that she ensures residents are happy with this terminology, as some may perceive it as derogatory. She confirmed that no resident has commented on this to date. The appointed manager confirmed that advanced care plans for the end of life care are implemented. The AQAA identifies that all staff have had training in bereavement and pain. It was observed throughout the site visit that staff at the home are sensitive and caring towards individuals and their relatives when their general health deteriorates. Springfields DS0000014059.V369312.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): 12, 13, 14 & 15 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ lifestyle within the home is generally their own choice and residents are provided with sufficient stimulation to fulfil their interests and needs. Residents are provided with varied nutritional meals and are provided with choice to ensure their preferences are catered for. EVIDENCE: Residents spoken with confirmed that generally their routines of daily life are to their own choice and preference. Residents were observed to move freely throughout the day. Some residents identified that they have set days for bathing. They confirmed that they were satisfied with this routine and one confirmed that they would be able to have an additional bath/shower on other days should they wish to. There is an activities person employed at the home who works fifteen hours per week at the service. Residents spoken with confirmed that there are enough suitable activities provided at the home, should they choose to be involved. One resident confirmed they prefer to remain in their room and this Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 15 preference is respected. There are notices within the home advising what activities have been planned. External entertainers are arranged to visit the home on the days the activities person does not work. Records are maintained of activities provided. It was confirmed that outings are arranged on a monthly basis. A mini bus van is hired to take residents out into the community. Nine residents recently went out on a bus trip. The activities co-ordinator confirmed that they ensure that residents who remain in their room, either by choice or due to health needs, are regularly visited. Residents are also supported on a one to one basis to visit local shopping facilities if they wish. Some residents have been involved in assisting school children in making a short documentary about the history of transport. A spiritual need assessment is undertaken and it was confirmed that representatives from churches will visit individuals. Visitors are encouraged and welcomed to visit the home. There are no visiting restrictions at the home. A resident confirmed that there were no restrictions on people wishing to visit them. It was observed throughout the site visit that residents were provided with choices. Examples are: offered alternative food for supper, one resident returned to the home from being out was asked if they would like to go to their room or to the communal lounge room. The cook confirmed that they did have three weekly rolling menus in use, however after consultation with residents, menus are now devised on a week by week basis with the involvement of residents wherever possible. It was confirmed that there are no budget restrictions imposed in relation to purchasing food. The cook has been working at the home for a number of years and demonstrated that she was very pro active in her role. She regularly monitors residents weights and takes appropriate action, following discussion with the Registered Manager. Eg. If someone’s weight has decreased she will ensure the calories intake is increased. Fresh fruit is readily available for residents. The cook restricts the number of people entering the kitchen to assist in promoting good infection control. There are two small dining tables provided for those wishing to eat at tables. These would not accommodate all residents at the one time. Residents currently eat in the lounge room off individual tray tables or in their rooms if they prefer. Residents were complimentary about the food provided at the home and comments ranged from ‘good’, ‘excellent and have choice’, ‘there is always an alternative’, ‘plenty of it’ and ‘can have a cooked breakfast’. Springfields DS0000014059.V369312.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): 16 & 18 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents feel comfortable to complain, reassuring them that they are being listened to and that action will be taken, if necessary. Residents are safeguarded by the procedures in place and the training of staff in Safeguarding Adults. EVIDENCE: The home has a complaints procedure that is on display within the home. The majority of residents spoken with confirmed that they would feel comfortable making a complaint and would know who to speak to. Of the residents that expressed any concerns to the Inspector, this was fed back to the Registered Manager, with the individuals permission, for her to address with the individuals. A central log of complaints is maintained and copies of any correspondence are kept. The AQAA identifies that there has been four complaints in the last 12 months, of which one was upheld. Records viewed identified that the home takes any concern seriously and records the action they have taken to resolve the issue. Staff spoken with confirmed that they are familiar with the procedures to take in the event of a resident raising any concerns with them. No concerns or complaints have been raised with the CSCI since the last inspection. Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 17 The AQAA and the ASR undertaken on 27 December 2007 identified that there have been three Safeguarding Adults referrals make to the Safeguarding Adults team. The ASR identifies that two of these referrals were investigated and subsequently closed, the third was deemed not to require investigation. The ASR identifies that on each occasion the home demonstrated that they responded to these allegations appropriately and reviewed systems of work where required. Since this time, the home has made on referral to the Safeguarding Adults team. This was investigated by the home and was substantiated. Action was taken to resolve this. The alert was not related to care practices or staff within the home. The AQAA identifies that Safeguarding Adults is at the forefront of their delivery of care. It identifies that staff receive training in Safeguarding Adults and staff spoken with at the site visit confirmed that they have received this training, which included whistle blowing. It was observed that there is information located at the entrance of the home regarding abuse and providing people with contact numbers should they wish to report any abusive practices. The AQAA identifies that staff have been made aware of the Mental Capacity Act and demonstrates that advocate services will be accessed whenever required. Trained nurses have undertaken training on the Mental Capacity Act and cascades this information to the carers. Springfields DS0000014059.V369312.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): 19 & 26 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Work has been done and continues to be undertaken to improve standards within the home, ensuring residents live in a comfortable and suitable environment. EVIDENCE: The home is located in a residential area within Hove. The Statement of Purpose identifies that there are 18 rooms for single occupancy, of which six have en suite facilities. Seven rooms are for shared occupancy, of which three are provided with en suite facilities. There are communal toilets and bathrooms located throughout the home for residents to use. Two of the baths are assisted and there is a wheel in shower available. Residents spoken with were happy with their individual rooms and the general environment. For a Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 19 resident who resides in a shared room, they confirmed that staff discuss any new admissions with them. The ASR stated that the AQAA received identified that a number of environmental improvements have been made since the last key inspection. These include the provision of automatic fire door closure devices to all doors, redecoration and refurbishment of bedrooms and work being done to the kitchen area as required by the Environmental Health Officer. A plan of maintenance has been developed for the coming year. On discussion with the Registered Manager, it was confirmed that this redecoration and refurbishment programme is continuing. The outside of the home was being painted on the day of the site visit. Comments received from residents were ‘ I am happy with my room’, ‘my call bell is answered quickly’ and ‘my bed is comfortable and I have a new mattress’. Staff spoke positively about the renovations being done at the service. Staff accommodation is provided on the top floor of the service. There is no separate entrance for staff to access their own accommodation. It was confirmed that using the main entrance of the home does not impact or disturb residents when used at night. The home was clean and free from offensive odours on the day of the site visit. A visiting health professional spoken with confirmed that the home was always clean and fresh when they visited. There is liquid soap, paper towels and alcohol gel provided throughout the home. Alcohol gel is also provided at the entrance of the home for visitors to use when entering and leaving the service. These practices put in place assist in promoting infection control. The AQAA identifies that 100 of staff have received training on the prevention of infection and management of infection control. There are two sluice machines at the home and the service has a contract with a company for disposal of clinical wastes. Staff spoken with confirmed that protective clothing ie gloves and aprons are readily available throughout the home for use. Springfields DS0000014059.V369312.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): 27, 28, 29 & 30 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Residents’ needs are being met with the skill mix of staff on duty. Recruitment procedures in place ensure that residents are safeguarded. EVIDENCE: Residents spoken with were complimentary about the staff working at the home. Comments received about the staff were; ‘very understandable’, ‘wonderful’ and ‘very polite’. Staff and residents spoken with felt that there was generally always enough staff on duty. A resident commented that there was always someone around if they needed assistance. Staff commented that they enjoyed working at the home and there is good teamwork and communication between all staff members. They confirmed that the only changes they would make within the service was to have a pay rise. This is not within the CSCI’s remit. The AQAA identifies that an area they have improved in the last 12 months is to have a formal pay structure in place for care staff in accordance with training and service. The Registered Manager confirmed that staffing numbers are usually: two registered nurses and five carers in the mornings, one registered nurse and four carers in the afternoon and one registered nurse and two carers working a waking night. The Registered Manager’s hours are in addition to these, who Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 21 works full time during the week. The Registered Manager confirmed that she regularly reviews staffing levels to ensure suitable numbers are on duty to meet the needs of residents. The AQAA identifies that there is a low turn over of staff, promoting continuity of care for residents. Staff were observed to have a good professional rapport with residents. The AQAA identifies four shifts have been covered by temporary or agency staff in the last 3 months. There were no staff vacancies at the time of the site visit. The AQAA identifies that there are 17 permanent care staff working at the home of which nine have National Vocation Qualification (NVQ) level 2 or above. A further three is working towards these qualifications. The Registered Manager confirmed at the site visit, that since the AQAA was completed there is 12 care staff with NVQ level 2 or above qualifications. Four staff files were viewed. Three of these had been employed by the Registered Manager and one transferred from another service within the company. The home ensures Protection of Vulnerable Adults (POVA) first check and a full Criminal Record Bureau (CRB) check are obtained. The appointed manager confirmed that where a staff member commences work with just a POVA first check in place, this person is supervised until a full CRB check is received. References are obtained, however one file did not have two references in place. The Registered Manager confirmed that she will ensure this is chased up. A recruitment checklist is undertaken and an interview form completed. The Registered Manager confirmed that she ensures the registered nurses Personal Identification Numbers (PIN) are kept up to date and all nurses working at the home are registered with the Nursing and Midwifery Council (NMC). There was evidence in the staff files that new staff members have undertaken induction training. The appointed manager confirmed that the induction undertaken complies with the Common Induction Standards as set by the Skill for Care. A new staff member spoken with confirmed that they were supernumery for two weeks and felt the induction into the home was very thorough. Staff spoken with confirmed that they are up to date with mandatory training and are provided with enough training opportunities that are relevant to their roles. Registered nurses confirmed that they are provided with additional training relevant to their roles. Staff were being provided a training session on the day of the site visit. Records viewed identified that some recent training undertaken was: Manual Handling, Basic First Aid, Safe Swallowing, Infection Control and falls prevention. Springfields DS0000014059.V369312.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): 31, 33, 35 & 38 People who use the service experience good quality outcomes in this area. This judgement has been made using available evidence including a visit to this service. Staff and residents benefit from a well managed home. The home is generally run in the best interest of residents, however further work on monitoring the service will assist in evidencing that the home meets its aims and objectives. The health, safety and welfare of residents and staff are promoted and protected so far as is reasonably practicable. EVIDENCE: The Registered Manager has been working at the home for 12 years, of which six of these have been as the appointed manager. She confirmed she has current registration with the NMC and has completed the Registered Manager Award course. She confirmed that she keeps herself up to date with current Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 23 practices by attending training courses and reading relevant literature. She confirmed that she now receives clinical supervision as previously recommended. Staff were complimentary about the Registered Manager and find her very supportive and approachable. Comments received about the Registered Manager from residents and staff were; ‘excellent’, ‘open to new ideas’, ‘trustworthy’ and ‘absolute darling’. Residents and staff commented on the relaxed and homely atmosphere within the service. A visiting health professional confirmed that the Registered Manager is open and willing to discuss issues and will take on board any recommendations made. Staff spoken with confirmed that there are clear roles and responsibilities within the service. The Registered Manager confirmed that as part of the quality assurance and quality monitoring system within the home, surveys are provided to residents every three months to obtain their feedback on the care and services provided at the home, ensuring that it is run in a way that meets their expectations. Resident meetings are held. The Registered Manager confirmed that relative surveys are randomly sent out every month. Three recent ones received were viewed that identified positive comments. Results are analysed and shared with those involved in the service. It was confirmed that the home tries to obtain feedback from other stakeholders. Discussions were had with the Registered Manager that she should actively send out surveys to GP’s, care managers and other visiting professionals to obtain their feedback. It was confirmed that staff surveys are undertaken to obtain feedback. Regular staff meetings are also held that provides an opportunity for any issues to be discussed. The registered providers, or designated person, are now undertaking monthly Regulation 26 visits and a report of these visits are provided to the Registered Manager. These monthly visits assist the providers in monitoring their service and ensuring it is meetings it aims and objectives. Management meetings are regularly held between all Registered Managers at services owned by the same providers, where good practices and ideas are discussed and shared. Notifications are being sent to the CSCI as legally required. Some residents and staff commented to the Inspector that the lift was regularly breaking down. The home must remember to notify the CSCI if this occurs for an extended period of time. The Registered Manager confirmed that the lift was always repaired promptly. Three of the requirements made at the last inspection were outstanding. The home has now complied with these and must ensure that these continue to be maintained, ensuring good outcomes for residents and sustained and built on. Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 24 It was confirmed that there are internal quality monitoring checks that are carried out on a regular basis to ensure the health, safety and welfare of residents are promoted, such as: monitoring records, environment checks, fire alarms, call bells etc. The Registered Manager confirmed that she undertakes random checks to ensure everything is being completed. ie care plans. The AQAA received identifies that management is aware of areas that they could do better and what their plans for improvement are within the next 12 months. Numerical information missing was provided to the CSCI following the site visit. The home holds small amounts of personal allowance for residents if they wish. This money is only available when the Registered Manager is working on duty. It was confirmed that this has not been a problem to date and all residents are aware of when they are able to access money. It is recommended that a system be implemented in the event that any residents wishes to access money when the Registered Manager is off duty. Records viewed identified that accurate records are maintained of all financial transactions. Receipts are kept of any purchases and receipts are provided to those leaving any money with the service for safekeeping. Health and safety records were not viewed. It was confirmed that staff undertake fire training and fire drills. A fire officer had recently visited the home and the Registered Manager confirmed that any shortfalls identified have/are being addressed. The fire risk assessment was reviewed and the Registered Manager will be implementing a new one. The AQAA identifies that equipment in use has been tested or serviced as recommended by the manufacturer or other regulatory body and that all relevant policies and procedures are in place. It was confirmed that environmental health has recently visited the home and awarded them 4* scores on the door. It was confirmed that no shortfalls were noted. Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 25 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 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 4 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X 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 2 X 3 X X 3 Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 26 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 OP7 Regulation Requirement Timescale for action 30/09/08 13(4)(a-c) That clear, detailed, person centred risk assessments are in place for individuals, particularly for the use of bed rails, ensuring individuals and staff are safeguarded. RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection Maidstone Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT 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. Extracts may not be used or reproduced without the express permission of CSCI Springfields DS0000014059.V369312.R01.S.doc Version 5.2 Page 28 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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