Care Home: The Spinney Hop

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What the care home does well There is an excellent team of staff working at the home. They are welltrained, knowledgeable and caring. Many positive comments were received about staff. One person living at the home said that, "staff are brilliant, they will do anything for you". Several comments were made from staff and people living at the home about how staff enjoyed laughing and joking and cheering people up. The home`s own quality assurance survey showed a very high satisfaction level with 100% of people rating the overall service as excellent or good. The management team and staff worked hard to ensure that people living at the home, as well as visitors were consulted and given opportunities to make suggestions as to how the service could be improved. Several ideas had beenacted upon for example any improvement to the car parking facilities and increased activities was planned. People spoken with that had come to the home for respite care had enjoyed their stay. One person said that, "staff are very patient, I really enjoyed having a bath as I can`t do this at home, I will definitely come again". Training provided for managers and staff is of a high standard. As well as mandatory training many staff had undertaken additional training to increase their knowledge and skills. Recruitment practices ensure that people living at the home are safe and a good standard of person is recruited. Several staff members spoke about good teamwork and communication. One person said that, "I love it here, the staff team are great, we sort out any problems quickly". The home was clean and maintained to good standard. The staff were aware of promoting people`s independence and ensuring that care is provided in a person centred way. The rehabilitation unit provides the opportunity for people to receive intensive support with a view to returning home. Outside professionals that visited the unit were satisfied with the way that staff and managers support the rehabilitation work. What has improved since the last inspection? A great deal of work has been undertaken on the home since the last inspection visit. This includes total refurbishment of the kitchen, an extension of the car park, a new conservatory as well as redecoration and new fabric and furniture in several areas. Residents and staff had put up with a great deal of upheaval during a five-month refurbishment period, however this had now almost come to an end and people were enjoying the improvements. One person living at the home said, "I felt very sorry for staff during the refurbishment", and staff also voiced concern for residents. The landscaping of the outside area was still to be done and the conservatory needed finishing touches. An activities co-ordinator was due to start at the home after all recruitment checks had been undertaken. This was likely to considerably improve the activities provided. The manager was described as having implemented new ideas, but slowly and with a lot of discussion. One person said that morale was now even better and there were many new ideas still around to be tried. CARE HOMES FOR OLDER PEOPLE The Spinney Hop Woodlands Lansdowne Road Brimington Chesterfield Derbyshire S43 1BE Lead Inspector Jill Wells Unannounced Inspection 1st July 2008 09:00 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 The Spinney Hop DS0000035801.V367413.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. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Spinney Hop Address Woodlands Lansdowne Road Brimington Chesterfield Derbyshire S43 1BE 01246 342130 01629 537530 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) www.derbyshire.gov.uk Derbyshire County Council Mrs Lisa Johnson Care Home 37 Category(ies) of Old age, not falling within any other category registration, with number (37) of places The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30th November 2006 Brief Description of the Service: The Spinney is a care home registered to provide personal care and accommodation for up to 37 older people. It is a purpose built care home located at the head of a residential cul-de-sac in its own private grounds. The home is near to the local shops and the village of Brimington. Residents at the home are all accommodated in single, ground floor rooms. The rooms are arranged in 4 wings of the home, each wing having its own kitchen, lounge and dining areas. The home provides 3 short-term care beds and 5 en-suite bedrooms for rehabilitation. There is a large lounge and reception area. The home has well-maintained gardens with accessible seating areas for residents. Fees are £392.18 per week for permanent service users, but a range of prices for short term care service users. Extra charges are made for hairdressing, chiropody, magazines and newspapers. The Spinney Hop DS0000035801.V367413.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 the service is two star. This means the people who use the service experience good quality outcomes. The inspection visit was unannounced and took place over 7.5 hours. There were 29 people living at the home on the day of the inspection. 8 residents, 6 staff, 3 managers and 3 visiting professionals were spoken with during the visit. Some residents were unable to contribute directly to the inspection process because of communication difficulties, but they were observed during the visit to see how well their needs were met by staff. We also looked at all the information that we have received, or asked for, since the last key inspection on the 30th November 2006. This included: • The annual quality assurance assessment (AQAA) that was sent to us by the service. The AQAA is a self-assessment that focuses on how well outcomes are being met for people using the service. It also gave us some numerical information about the service. • What the service has told us about things that have happened in the service, these are called notifications and are a legal requirement. • The previous key inspection report Records were examined, including care records, staff records, maintenance, and health and safety records. A tour of the building was carried out. What the service does well: There is an excellent team of staff working at the home. They are welltrained, knowledgeable and caring. Many positive comments were received about staff. One person living at the home said that, staff are brilliant, they will do anything for you. Several comments were made from staff and people living at the home about how staff enjoyed laughing and joking and cheering people up. The home’s own quality assurance survey showed a very high satisfaction level with 100 of people rating the overall service as excellent or good. The management team and staff worked hard to ensure that people living at the home, as well as visitors were consulted and given opportunities to make suggestions as to how the service could be improved. Several ideas had been The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 6 acted upon for example any improvement to the car parking facilities and increased activities was planned. People spoken with that had come to the home for respite care had enjoyed their stay. One person said that, staff are very patient, I really enjoyed having a bath as I can’t do this at home, I will definitely come again. Training provided for managers and staff is of a high standard. As well as mandatory training many staff had undertaken additional training to increase their knowledge and skills. Recruitment practices ensure that people living at the home are safe and a good standard of person is recruited. Several staff members spoke about good teamwork and communication. One person said that, I love it here, the staff team are great, we sort out any problems quickly. The home was clean and maintained to good standard. The staff were aware of promoting peoples independence and ensuring that care is provided in a person centred way. The rehabilitation unit provides the opportunity for people to receive intensive support with a view to returning home. Outside professionals that visited the unit were satisfied with the way that staff and managers support the rehabilitation work. What has improved since the last inspection? A great deal of work has been undertaken on the home since the last inspection visit. This includes total refurbishment of the kitchen, an extension of the car park, a new conservatory as well as redecoration and new fabric and furniture in several areas. Residents and staff had put up with a great deal of upheaval during a five-month refurbishment period, however this had now almost come to an end and people were enjoying the improvements. One person living at the home said, I felt very sorry for staff during the refurbishment, and staff also voiced concern for residents. The landscaping of the outside area was still to be done and the conservatory needed finishing touches. An activities co-ordinator was due to start at the home after all recruitment checks had been undertaken. This was likely to considerably improve the activities provided. The manager was described as having implemented new ideas, but slowly and with a lot of discussion. One person said that morale was now even better and there were many new ideas still around to be tried. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 7 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. The Spinney Hop DS0000035801.V367413.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 The Spinney Hop DS0000035801.V367413.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): 1,2,5 and 6. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good information and support is provided to help people make an informed choice about whether the home is suitable to meet their needs. EVIDENCE: The statement of purpose and service user guides were available for prospective people wishing to live at the home. These documents provided all the information that was necessary, although the new contact details of the Commission for Social Care Inspection (CSCI) needed to be amended on all copies. There was also an information booklet provided for each person that included the names of staff, times when meals and drinks were provided, date of residents meetings and useful telephone information. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 10 People that wanted to stay at the home were invited for the day. A staff member said that when a person came for the day, a carer would spend time with them to show them around the home and make introductions. They would discuss likes and dislikes and help them settle. People were encouraged to stay for lunch and tea. Several people spoken with had visted the home for respite care before deciding to make it their home. One person who was there for respite care said that, “I would come again, it’s like a holiday”. Another person said that, “I gave up my home to come here and I’m glad I did”. Copies of assessments carried out by Social Services care managers were seen on peoples records. These were of mixed quality but generally included information concerning each persons health and personal care needs, and family involvement. The home also has a rehabilitation unit with separate accommodation. There was equipment to promote activities of daily living and to deliver short term, intensive rehabilitation and enable people to return home where possible. There is an occupational therapist, physiotherapist, technical instructor and care manager that visits the home to work with the people on the unit. The care manager and occupational therapist were spoken with. They said that staff had a good understanding of the concept of rehabilitation and that communication was good between care staff and the rehabilitation team. They described the management team as, very supportive of rehabilitation with a very positive attitude. People spoken with on the unit were very positive about their experience and confirmed that they could use facilities in the rest of the home if they wished to do so. The Spinney Hop DS0000035801.V367413.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,and 11. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Although medication records were not in good order, peoples health and personal care needs were met and the principles of respect, dignity and privacy were put into practice. EVIDENCE: The care records of three people living at the home were seen. The care plans (personal service plans) were specific to each individual for example likes a cup of tea at 6 a.m. with milk, no sugar . There was also a daily living plan that was also person centred and encouraged promotion of independence for example, encourage to brush own hair and teeth. Individual records for people that had been at the home long-term or for rehabilitation also included moving and handling plans, falls risk assessment, nutritional assessment and tissue viability risk trigger tools. However they were not always regularly reviewed and risk assessments were not being done for people at the home for The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 12 respite care. There was a monthly report completed by the care workers, but not a clear system to ensure that changes to a persons needs were changed on care plans. Records were available for care staff to read to ensure that they were aware of each persons needs. Staff member said that, there is a handover at the start of every shift where we go through logs and update each other. We are given information about new people and told to look at their care plans. There was no social history for each person to enable staff to be aware of any significant events in a person’s life. This was highlighted at the previous inspection visit. Although there were records of optician, dentist, chiropody and district nurse visits, the files did not include GP visits. The manager explained that these records were on the computer and on daily logs. This system may not give easy access to information from GPs. Records, staff and people living at the home were all able to confirm that GPs and other health professionals were contacted and visited when required. One person said that, I have needed the doctor a lot lately, you ask to see who you want, and they come . A district nurse that visited the home during the inspection visit was spoken with. She said that they were very well organised, and good at reporting concerns promptly and appropriately. She also believed that staff were very caring. Medication was stored in trolleys and cupboards in a separate room. The same room was also used to store peoples’ personal information, including care plans and archived records. This room was not locked, and although the notice on the door said that the door must be closed when not in use, the door was propped open throughout the day when the room was empty. At the previous inspection visit there were concerns about the temperature of this room and the effect that this may have on medication. The staff were recording the temperature and it was regularly 29°C, which is likely to affect the stability of medication stored in this room. Either the manager or a deputy manager administered medication. All had received medication training. The medication administration records were seen and were generally in good order. However records that were handwritten were not signed or countersigned that the record had been checked. There were some inaccuracies between the handwritten records and the pharmacist label, for example one did not record that the medication was chewable, another did not record that the person must avoid alcoholic drinks. There was a gap where medication had not been signed as given or refused. An audit trail was not possible to check if this had been given, as there was no record of the number of tablets that had been received by the home. There were photos on most people s records apart from people that had visited for respite care or rehabilitation. One person’s records were seen who manages their own medication. There were no signatures in place that the medication had been given to and received by the person. Although there were The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 13 shortfalls in medication records, there was no evidence that people were at significant risk from this. Controlled drugs were securely stored and the controlled drugs register was checked and found to be accurate. There was a locked fridge for medication that required refrigeration. The room was cluttered with chairs, preventing safe access to cupboards and the medication fridge. This was highlighted at a health and safety inspection in January 2008. People spoken with said that they were treated with respect by staff. Care staff spoken with were very aware of the importance of respecting peoples privacy. A carer spoken with said that, youve got to put yourself in their shoes when you care for people . They then described how personal care was always done in bedrooms, with the door and curtains closed and staff would tell the person what they were about to do, and give them reassurance if needed. One person living at the home said that staff always knocked before they came into bedrooms. A carer spoken with described how staff saw providing care and comfort to people that were very poorly as very important. They said that, we care about people and making their last days as comfortable as possible they also described how they spent as much one-to-one time as they could with people who were very poorly. The Spinney Hop DS0000035801.V367413.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 and 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The range of activities and standard of meals offered was good, which met the needs and wishes of people living at the home. EVIDENCE: Records of activities showed a variety had taken place, including reminiscence, quizzes, bingo, floor darts and regular outings. There was a notice board in each dining area displaying activities that were planned. On discussion with staff the notice board was not an accurate reflection of any actvities that had been provided. A member of staff said that, we try to do activities every day but when we are busy, it tends to be the thing that we have to cancel. The manager told us that they had recently recruited an activities co-ordinator for 25 hours per week and had plans to greatly improve activities that were provided when the person starts. Residents meetings were held regularly on each wing. Minutes of these meetings showed that people were well consulted concerning trips out, entertainment, meals, and other aspects of daily living at the home. People had recently taken a vote on a day trip to Skegness. The minutes showed that The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 15 the manager had made herself available after the meeting for anyone that wished to speak with her in private. The manager told us that peoples religious needs were met with a volunteer coming from the local church on Sunday for hymn singing and the local minister visiting occasionally. Staff told us that residents could go to bed and get up when they wished to do so. A member of staff said that, people can choose to stay in bed and can stay up to the early hours if they want to. People were encouraged to bring their own personal possessions with them and bedrooms that were seen were comfortable and had been personalised. There had been recent upheaval concerning meals, due to a total refurbishment of the kitchen. Kitchen staff had been working in another homes kitchen and bringing food from there. This had been ongoing for 5 months. Record showed that people living at the home had been offered the option of temporarily moving to an alternative home whilst work was being done, but all had declined the offer. People living at the home, as well as staff were grateful to be returning to normal. One person spoken with said that, its only been three days since weve had the kitchen back but there is a big improvement in the food already. There was a main meal provided at lunchtime. People were offered a second option if they did not want the main meal. Several people were seen eating an alternative meal. All the people that were spoken with said that the food was of a very good standard. One person spoken with said that, the food is wonderful, the meat is so tender it does not need cutting . Information provided was that all care and catering staff had received training in safe food handling. Staff spoken with confirmed this. The cook was spoken with. They said that they had now returned to the planned menus. She described how she went around every morning talking to each person about the lunch and tea options. Fresh fruit and vegetables were used and bowls of fruit were placed around the home several times a week. The Spinney Hop DS0000035801.V367413.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 and 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People who use the service are able to express their concerns and are protected from abuse. EVIDENCE: There were no complaints recorded at the home since the last inspection visit. The complaints procedure was displayed at the home. However the new address of the Commission for Social Care Inspection (CSCI) had not been changed. People spoken with said that they would talk to staff or the manager if they had a complaint. Records of residents meetings showed that people were encouraged to voice their concerns with staff or a member of the management team at any time. There was also a comments book in the entrance hall. Comments in this book concerning the car parking had been the reason the parking had been improved. Training records showed that care staff had attended training in safeguarding vulnerable adults and care staff confirmed that they had attended this training and were aware what to do if they suspected abuse of a vulnerable adult. A member of staff spoken with was aware of the need to report any poor practice from work colleagues, although she had never had to do so. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 17 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): 19,20,21,22,24,26. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Significant improvements have been made to ensure that people live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: The home is a purpose-built building based on four wings, which are colourcoded. There are 37 single rooms, all with a wash hand basin. The 5 bedrooms in the rehabilitation unit have en suite facilities, including a shower. A tour of the building showed that the home was clean and well maintained. People spoken with said that they were happy with the level of cleanliness at the home. A domestic assistant was spoken with. They confirmed that there were enough domestic hours to keep the home clean. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 18 Information from the service was that the wing corridors have been redecorated and new blinds purchased. Decoration of dining and lounge areas has taken place with new curtains and higher chairs. The reception lounge area has been re decorated, re-furbished, and had new curtains and accessories. People spoken with said that the home was now much brighter and homely. There was now a seating area in the entrance. There was a large flat screen TV with SKY and a music centre in the reception lounge, as well as smaller TVs in all lounge areas. The car park has been extended after concerns expressed by visitors. The kitchen has had a full refurbishment. A conservatory has been built for people who wish to smoke. People were offered an alternative home whilst the extensive work was undertaken, but all declined. There were 2 toilets and a bathroom on each wing, which met peoples needs. There were grab rails and other aids around the home to assist people and maximise their independence. There were adequate storage areas to ensure that equipment etc was stored safely. There was a small hairdressing room, and the hairdresser visited weekly. Bedrooms that were seen were comfortable and homely. People had personalised their own room. People spoken with visiting for respite care had not been offered a key to their room. This was discussed with the manager who said that only people at the home long-term were offered a key. One person that was at the home for respite care said that she wished there was a TV in her bedroom and a second person agreed. She explained that hers at home had subtitles as she was hard of hearing and was having difficulty with the communal TV. A care assistant was asked about this and subtitles were available on the communal TV, although not all care staff knew how to do this. There were signs displayed directing people to each wing, although one person said that they kept getting lost. There was a keypad fitted to the front door and external doors were all alarmed. The manager had undertaken a security risk assessment. The outside area had a summer house, several seating areas, and a greenhouse where a volunteer tended tomatoes. Landscaping was planned after the work on the car park area. Staff were raising funds for an additional new patio area. Several people spoken with enjoyed spending time outside. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 19 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 and 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The recruitment practices and staff training programme were good and ensured that people were protected by competent, well-trained staff. There were sufficient numbers of staff to support the people who were using the service. EVIDENCE: On the day of the inspection visit there were 29 people at the home, which included two people on the rehabilitation unit and three people for short-term care. The home had 8 vacancies. Staffing fluctuated between two and five care assistants each day. The fluctuations were due to care staff having a staggered start to their shifts, for example there were two carers on from 2:30 p.m. for one hour, three carers from 3:30-4 p.m. and five carers from 4:30 p.m. Dependency levels were being monitored and at the time of the visit were low, and staff were able to confirm this. The manager explained that the staffing hours were set and were not likely to be increased if dependencies or occupancy increased. It was evident from observations that there were sufficient staff on duty to meet peoples needs at the time of the visit, however this would not be the case if dependencies and occupancy increased. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 20 A member of staff said that staff regularly needed to escort people to hospital which puts pressure on care staff that are left ”. It was evident from discussions and observation that all staff were very caring and worked very well as a team. Staff made various comments including, the staff team are great, we sort out any problems quickly and, I like everything about working here, we work as a team. There were also several comments made concerning staff having fun with people. One person said that, we always have a laugh and joke with staff, it keeps us going. A second person said, staff are brilliant, they will do anything for you. A domestic assistant explained how they always ‘passed the time of day’ and had a chat with people whilst cleaning. Staff records that were examined showed a safe recruitment procedure. Application forms were being completed, references and criminal record bureau (CRB) checks were being done. There was an induction programme in place that met the Skills for Care standards and included first aid, food hygiene, moving and handling, hoist training, dementia care, safeguarding adults and bereavement. Information received was that staff turnover was very low with only one person leaving in the last 12 months. This ensured consistency for people living at the home. The link worker system worked well. Managers tried to match the personalities of staff with people living at the home that they were linked with. Staff tried to ensure that the person they were linked with had anything that they needed. The manager described a well-developed training programme, with training records to support this. 21 out of 27 staff had National Vocational Qualification, (NVQ), at level 2 or 3. As well as the mandatory training provided, some staff had been trained in nutrition and well-being, end of life and bereavement care, sensory impairment awareness and wheelchair training. There was also evidence in files that research was done on relevant conditions that a person may have in order to to inform staff. This ensured that staff were competent and knowledgeable. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 21 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): 31,32,33,37 and 38. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is a very knowledgeable and experienced management team, with effective quality assurance systems, ensuring that people are listened to and ideas and suggestions are acted on where possible. EVIDENCE: The manager and two deputies had completed the Registered Managers Award (RMA), and the third deputy was undertaking NVQ 4. The management team had a great deal of experience between them and staff spoken with felt that they worked well together and communicated effectively with staff. It was evident from discussions and observation that the manager is enthusiastic, The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 22 dedicated and committed. Records that were required were well organised and in good order. A staff member said that, the manager has implemented new ideas slowly and with a lot of discussion”. Staff and people living at the home commented how the environment had improved and lots of new ideas had come from the manager. A senior manager visits the home to support the manager. They were completing monthly reports, which were thorough and highlighted any action that needed to be taken. There were a number of ways that the manager ensures that people were given an opportunity to comment on the service. This includes an annual quality assurance survey sent out to people living at the home and their families. The results were compiled together and action taken to address any issues or suggestions. The results of the 2008 surveys were displayed. They showed that there was a very high level of satisfaction from people living at the home as well as staff. 100 of service users that responded rated the environment, staff, food, visiting arrangements and the overall service as excellent or good. They had made a suggestion that there should be more activities. This was likely to happen when the new activities co-ordinator starts work. Regular residents meetings and amenities committee meetings were taking place, and it was evident that the management team encouraged open discussion and consultation about every aspect of the home. The manager was quick to respond to peoples ideas and suggestions in order to improve the home. The manager had written a business plan as well as a budget action plan to look at improving the service whilst addressing any budget overspends. Regular health and safety checks were being done. A sample of test certificates were seen including fire alarm, emergency lighting and portable appliance testing, and found to be up to date. Annual health and safety audits were completed which covered fire, first aid, electrical appliances, medication and equipment. The manager had recently held a meeting with people living at the home to ensure that they were aware of the fire procedures. Staff were observed using gloves and aprons where appropriate. Information received from the service was that all policies and procedures were in place and had been reviewed. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 23 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 3 3 HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 2 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 X 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 3 3 X 3 X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 4 4 3 X X X 3 3 The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 24 Are there any outstanding requirements from the last inspection? 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 Timescale for action 02/10/08 2. OP9 13(2) 3. OP37 17(1)(b) The temperature of the room where medication is stored must be below 25°C as directed by manufacturers to ensure potency and stability of medication. Handwritten records on 02/08/08 medication administration records must be accurate against the pharmacy label, include the quantity of medication received at the home, and be signed by the person that has written a record. A second person should check and sign the record for accuracy. This is to ensure safe medication administration and a clear audit trail. People’s individual records and 02/08/08 medication must be stored securely at all times to ensure safety and confidentiality. The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 25 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. Refer to Standard OP1 OP7 Good Practice Recommendations The statement of purpose and service user guides should be revised with the new address and telephone number of CSCI so that people can contact us if they wish to do so. New people admitted to the home, including people for respite care should have risk assessments in place. Every persons risk assessments concerning their health should be regularly reviewed. This is to ensure that action can be taken if significant risk is identified. Care plans (personal service plans) should be updated to reflect any changes of a persons needs that have been identified in the monthly review and daily recordings so that staff can provide consistent care. A social history should be obtained for each person on admission so that staff can provide person centred care. A photo should be in place for all new people at the home, including people staying for rehabilitation and respite care to ensure that staff can easily recognise individuals when providing care and administering medication. The medication administration records should be signed to record that medication has been passed to an individual who is to manage their own medication. That person, if possible should also sign that they have received their medication to ensure a safe audit trail. The area where records and medication is stored should be cleared of clutter to ensure a safe working environment. Individuals admitted to the home for short-term care should be assessed for and offered a key to their bedroom where possible to promote their privacy and independence. Consideration should be given to providing televisions in peoples bedrooms that are staying for respite care to promote their privacy and independence. The complaints procedure displayed at the home should be revised to include the new address and telephone number of CSCI. All staff should be aware of how to use the subtitles facility on televisions around the home so that people living at the home that are hard of hearing have an equal opportunity to follow any programme. DS0000035801.V367413.R01.S.doc Version 5.2 Page 26 3. OP7 4. 5. OP7 OP37 6. OP9 7. 8. OP38 OP24 9. 10. 11. OP24 OP16 OP22 The Spinney Hop The Spinney Hop DS0000035801.V367413.R01.S.doc Version 5.2 Page 27 Commission for Social Care Inspection East Midland Regional Office Unit 7 Interchange 25 Business Park Bostocks Lane Nottingham NG10 5QG 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 The Spinney Hop DS0000035801.V367413.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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