Care Home: Springwater Lodge Care Home

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What the care home does well People have their needs assessed before they move into the home to make sure they can be met. People receive care and support in a way which promotes their privacy and dignity. During the visit people were seen taking part in various activities and comments made included `What a lovely song` and `I watch television in my room, I like to watch the football`. People are able to take part in community based activities, including visiting local churches and schools. One person said on return from a trip to a local pub, `I enjoyed a nice pint`. There are various visits to the home from friends and family and people are encouraged to be as independent as possible. People can raise any concerns or complaints about the home and staff know how to ensure people are safeguarded. People in the home said they would tell staff if they were not happy about anything and that they feel perfectly safe in the home. The building is well maintained and appropriately decorated, including the dementia unit, which is designed to stimulate people`s minds and memories. One person said, "I like to look at the plants and sit on the bench". Everywhere is kept clean and tidy and staff know how to prevent the spread of infection. Some staff have a professional qualification and other staff are working towards one. Staff receive regular training to enable then to meet people`s needs. Only staff who have been through the recruitment checks designed to ensure they are suitable to care for people are employed in the home. The home is managed in the best interests of people who live there. People can comment on how the home is run in residents` meetings and in surveys carried out. Comments made in the last survey included, `Treat all residents with respect and a lot of love - brilliant` What has improved since the last inspection? Improvements have been made to the storage arrangements for medication, and the recording of when it is administered. One person commented `I get the doctor come out to see me when I am not feeling well` and another said, `I have just had some tablets, I had some at breakfast and will have some more at tea time`. What the care home could do better: Care plan should show people`s needs and how these are to be met, and the support they need must be provided when needed. People`s dignity needs to be respected at all times, including when they are being moved with a hoist. People need to be able to have more say and choice over what they have to eat at mealtimes. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Springwater Lodge Care Home 10 Smithy View Calverton Nottingham NG14 6FA     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Stephen Benson     Date: 1 7 0 3 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 28 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 28 Information about the care home Name of care home: Address: Springwater Lodge Care Home 10 Smithy View Calverton Nottingham NG14 6FA 01159655527 01159655310 springwaterlodge@highfield-care.com www.southerncrosshealthcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Southern Cross Care Homes No 2 Ltd care home 50 Type of registration: Number of places registered: 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: No one falling within category DE to be admitted into Springwater Lodge Care Home when there are 14 persons of category DE already accommodated in the home No one falling within category OP to be admitted into Springwater Lodge Care Home when there are 50 persons of category OP already accommodated in the home No one falling within category PD to be admitted into Springwater Lodge Care Home when there are 6 persons of category PD already accommodated in the home The maximum number of persons accommodated within Springwater Lodge Care Home is 50 The minimum age of people falling within the category DE shall be 55 years. 12 0 6 Over 65 0 50 0 Care Homes for Older People Page 4 of 28 Date of last inspection Brief description of the care home Springwater Lodge is a detached, two storeys and purpose built care home in the village of Calverton, established in 1990. It is set back from the main road, within 500 yards of local amenities. It offers personal care for people over the age of 65 years and can cater for a broad range of needs. The home is registered for fifty beds six of which may be used for people with physical disabilities. The living accommodation comprises of 41 single and one double room all with ensuite facilities spread over two floors, as well as bathing and toilet facilities and a lounge and dining room. A passenger lift provides access to the first floor. There is a visitors lounge, which is also utilised by service users as a quiet/reading room. The homes registration includes the category of dementia, and provides a separate unit for people with dementia. St Wilfords Walk is a separate unit of the home for people with the primary need of dementia. It is pleasant and clean with doors of peoples bedrooms colour coded to ensure people are able to find their bedroom. The manager said on 17/03/09 that the fees range from £355 - £525 depending upon the services provided. This does not include chiropodist, hairdressing, newspapers and personal allowance. This information together with last inspection report is available to located in the foyer of the home or upon request. Care Homes for Older People Page 5 of 28 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 focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for people accommodated and their views on the service provided. This process considers the providers capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provision that need further development. This was our first visit to the home since 1st April 2008. This inspection involved one inspector; it was unannounced and took place in the daytime, including lunchtime. Prior to the visit an analysis of the home was undertaken from information gathered over the last year including that from the Annual Quality Assurance Assessment they completed. Care Homes for Older People Page 6 of 28 The main method of inspection used is called case tracking which involves looking at the quality of the care received by a number of people living at the home. We also use evidence from our observations; we speak with them about their experience of living at the home; we look at records and talk with staff about their understanding of the peoples needs who they support. The premises were not inspected in detail but various areas of the home were visited as part of the inspection. What the care home does well: What has improved since the last inspection? What they could do better: Care plan should show peoples needs and how these are to be met, and the support they need must be provided when needed. Peoples dignity needs to be respected at all times, including when they are being moved with a hoist. People need to be able to have more say and choice over what they have to eat at mealtimes. Care Homes for Older People Page 8 of 28 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.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 9 of 28 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 10 of 28 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. People coming to the home will know their needs can be met as they have been assessed. Evidence: The care file for one recently admitted person was seen, who was one of the people selected for case tracking, and this contained a pre admission assessment dated 8 days before the person was admitted. The manager said she had gone out to see the person to carry out the assessment. The person concerned was seen, but did not wish to answer any questions. The manager said that either she or the deputy manager go out to assess any prospective new person wanting to come to the home, and sometimes she will take a senior carer with her. Staff from the dementia unit said they thought it would be beneficial if they were Care Homes for Older People Page 11 of 28 Evidence: involved in all assessments for people who want to come to live there. Staff were aware of when an assessment is needed from the Local Authority and the differences between people assessed as requiring residential and nursing care. The home does not provide an intermediate service. Care Homes for Older People Page 12 of 28 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. Peoples health, personal and social needs are met by care practices in the home. Evidence: A sample of four care plans were seen. The manager said that she usually tries to audit five care plans each week, but had not done so over the last two weeks as she has been working away from the home. Care plans seen referred to promoting choice, privacy and dignity. One member of staff referred to one person who has been displaying challenging behaviour, and the actions they have taken to manage this. These were seen recorded within a care plan. There were risk assessments seen to establish if the person was at risk from their daily routines. One person was assessed at risk of falling, and was seen being hoisted from a wheelchair to an armchair, however it was noted that his care file contained a care plan that had not been updated and showed a different mobility plan. When a senior carer saw the plan was out of date she prepared a current moving and handling plan. Care Homes for Older People Page 13 of 28 Evidence: The manager said they have started writing care plans in a person centred manner and staff needed to have some time to get used to this as it is a big change for them, and sometimes they were forgetting to update care plans. Staff said that senior carers or nurses prepare care plans which are updated monthly, and that they find the care plans useful. Some of the care plans seen had been updated monthly, but some had not been for a longer period. When asked about the care they receive one person said, I am able to do things I want myself, I dont need much help and another person said, Staff will do things the way I ask them. Each care plan has an evaluation sheet where any information concerning that plan is recorded. There were annual reviews of care plans, which included the person concerned where able, and sometimes a relative. One plan stated that the relatives did not want to be involved in the care planning. There is a section in the care file to record any medical appointments, and these showed people make use of a range of services. Staff spoke of promoting peoples health and said they call on community based services as needed. Staff were observed hoisting people into armchairs and they were explaining to people what they were doing, however some people had their clothing displaced. Personal hygiene records showed that people receive regular assistance with personal care, including baths, showers and hair washes. One person said, I get the doctor come out to see me when I am not feeling well and another person said, Staff help me into the shower. Nursing staff give out medication to people receiving nursing care and senior carers give it to people who receive residential care. Part of the morning and lunchtime medication rounds were observed. Staff followed the correct procedures in administering and recording medication. Medicine Administration Records seen were fully completed and where they had been handwritten they had been signed and checked as being correct. One person said after lunch, I have just had some tablets, I had some at breakfast and will have some more at tea time. Care Homes for Older People Page 14 of 28 Evidence: One member of staff has taken on the role of dignity champion and information about this was seen on a noticeboard, including a photograph of the member of staff. One person spilled a cup of tea over her dress, when a member of staff saw this a few moments later she called for another member of staff to come to the lounge so she could take the person to her room to change her clothing. . Care Homes for Older People Page 15 of 28 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. People have opportunities to take part in activities both in and out of the home and are part of the local community. There are opportunities for people to exercise choice in their lives, but the catering arrangements dont always suit their wishes. Evidence: There is an activities coordinator employed who organises and provides activities in both units. During the visit there was an exercise class, a quiz and sing a long taking place on the dementia unit. The activities coordinator was seen talking with people on the other unit, in one case listening to a person talking about his working life down the mines. The television had been on for the morning news, but this was turned off and some music put on. which one person commented after listening to a Harry Secombe track, What a lovely song. Staff said that the activities coordinator offers plenty of activities, but it doesnt always go to plan as people want to do something different, which happens. Staff on the dementia unit described how they use the displays on the unit to help people remember and talk about things they remember from their past. Care Homes for Older People Page 16 of 28 Evidence: One person said, I dont like to join in games, I watch television in my room, I like to watch the football. One person on the dementia unit was seen watching a digital photo frame with pictures of her family and flowers being shown. The person was able to talk about her children and grandchildren as the pictures changed. A member of staff said they often sit down and look at the photographs and have a packet of crisps, which the person said she enjoyed doing. Staff spoke of trips being arranged out of the home and one person was seen being taken out to the pub for a drink after lunch by the activities coordinator. Before going he joked with another person I am going boozing and on return he said I enjoyed a nice pint. The manage said that Calverton has an active community and the home is very much part of that. there were photographs seen on the walls of people visiting a local school and of school children visiting the home. The manger said people attend a local luncheon club and church groups, and that transport is often arranged. One visitor said she is able to come to see her mother when she wants and if she phones is able to speak to her on the phone. Staff said they try to provide people with choices and said they can put their views and ideas forward in residents, meetings. Staff gave examples of how they spend their time, what they wear and what they have to eat. The cook was seen asking people whether they wanted turkey or sausage and onions for lunch. There is a four week menu which provides a choice at each meal. The main meal is at lunchtime . A lighter meal is had at tea time and dishes include soup, salads and assorted sandwiches. Kitchen staff were seen offering and preparing people a piece of fruit during the morning. Lunch was observed on both units. This was served from a heated trolley with meals already plated up. Several people were seen leaving some vegetables on their plate, saying they did not want or like it. There was a mixture of comments made by people Care Homes for Older People Page 17 of 28 Evidence: about their lunch including, It was a very nice lunch, The gravy was too thick and I dont want sprouts on my plate. One person commented after being asked about her lunch, Its been a long time since Ive had someone ask me if I enjoyed my meal. Several comments were made by staff at recent changes to catering arrangements made by the provider, which was described as an attempt to reduce costs. Staff said it would not allow people to receive treats special requests or things like a birthday cake. The manager said it was aimed at promoting more home cooking and reducing pre prepared food such as frozen Yorkshire puddings. The manager said she did not expect standards to drop and people would still have treats, be able to make special requests and have a birthday cake. Care Homes for Older People Page 18 of 28 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 will raise any complaints they have knowing they will be investigated. People feel safe in the home. Evidence: There is a procedure in the home for people to follow if they wish to raise a complaint, which is displayed in the entrance hallway. There is a file of complaints made in the office, which showed there were 10 complaints made in the last 12 months. One is currently under investigation, others concerned a room not being cleaned, a new carpet needed, not enough potatoes at dinner and someone wandering into other peoples rooms. All of the complaints had been either upheld or partially upheld and appropriate action taken. One member of staff said they knew the procedure to follow, but thought the close work and contact they have with families stops the need for any complaints to be made. Another member of staff said she was aware of a recent complaint which was being looked into and she knew the procedures to follow if anyone raised a complaint. People said they would tell staff if they were not happy about anything. Staff knew about the Nottingham and Nottinghamshire safeguarding adults procedures and the homes whistleblowing policy. Training on the safeguarding procedures is Care Homes for Older People Page 19 of 28 Evidence: provided as part of the homes training plan. There have not been any safeguarding referrals made and staff said they were not aware of any safeguarding incidents that have taken place. A group of people spoken with said they felt perfectly safe in the home. Care Homes for Older People Page 20 of 28 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. People live in a comfortably and well maintained environment that provides stimulation for people with dementia. Evidence: Areas of the home visited were clean, tidy and in good repair. The dementia unit is decorated to provide a stimulating environment with pictures and displays designed to stimulate peoples minds and memories. One person said, I like to look at the plants and sit on the bench. A handyman is employed in the home who does any decorating, and is also responsible for maintaining the grounds. There was a cleaner working in the home and staff were seen using protective clothing. There was information about infection control and systems in place for waste disposal and washing soiled laundry. Care Homes for Older People Page 21 of 28 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. People are cared and supported by sufficient staff who have been suitably trained to meet their needs. Evidence: There was one senior care and one carer on duty in the dementia unit and four care staff, one senior care and a nurse on duty in the other unit. In addition there was the manager, activities coordinator, kitchen and cleaning staff. The rota showed that there is one carer less in the afternoon shift, and two carers and a nurse on duty overnight. During a period of observation on each unit people were having their needs seen to in good time. Staff said that they thought the same number of staff were needed in the afternoon as the morning, but the manager said she felt the staffing levels were satisfactory, and she is able to vary them if she thinks it is necessary to do so. There are eight staff who have completed National Vocational Qualification level 2 and a further seven staff are currently working towards this. There are two further staff who have achieved level 3 and two working towards it. A member of staff said she has completed level three and another said she expects to finish level 2 this month. Care Homes for Older People Page 22 of 28 Evidence: A sample of two staff files were seen and these contained the correct recruitment checks and information. Staff training records showed that people receive regular training, and updates are provided when they are required. All staff have completed a course on working with people with dementia and some have completed a more in depth course called Yesterday, Today and Tomorrow. Staff said they get onto courses and there is always training going on. . Care Homes for Older People Page 23 of 28 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. There are suitable management arrangements in the home to ensure the home is run in the best interests of people living there. Evidence: The manager has previously been a registered manager at another home, and has been registered as manager of this home since last year. The manager has completed the Registered Managers Award. The manager showed survey forms to be sent out next month, and the results of a survey carried out last year were in the foyer. These showed a high level of satisfaction and included a number of positive comments such as Treat all residents with respect and a lot of love - brilliant as well as some areas to improve, which included, Keeping relatives informed when residents are ill and more use of the upstairs lounge to sit people in the afternoon The manager said that action has been taken where areas for improvement were identified. Care Homes for Older People Page 24 of 28 Evidence: There is a system for people to have assistance in managing their personal allowances. This is a computer based system and print outs can be provided upon request. The system is regularly audited to prevent any abuse. It was stated on the Annual Quality Assurance Assessment that equipment is tested or serviced as recommended by the manufacturers or other regulatory body. Care Homes for Older People Page 25 of 28 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 26 of 28 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 Ensure care plans are kept under review and updated when changes occur. This will ensure that people receive the care they require 01/04/2009 2 15 16 Review current catering 01/05/2009 arrangements so that people are able to exercise choice over how their lunch is served. This will ensure people receive he food they want at mealtimes. 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 10 Ensure peoples dignity is not compromised when using the hoist. Care Homes for Older People Page 27 of 28 Helpline: Telephone: 03000 616161 or Textphone: or 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) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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