Inspection on 25/09/09 for Southfield Court Care Home

This inspection was carried out on 25th September 2009.

CQC found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

Southfield Court Care Home 17/07/08

Southfield Court Care Home 07/06/07

Southfield Court Care Home 15/08/06

Southfield Court Care Home 23/02/06

Southfield Court Care Home 13/01/05

Southfield Court Care Home 17/06/04

Southfield Court Care Home 03/03/04

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Extracts from inspection reports are licensed from CQC, this page was updated on 17/02/2010.

Key inspection report Care homes for older people Name: Address: Southfield Court Care Home Off Southfield Road Almondbury Huddersfield Yorkshire HD5 8RZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Cheryl Stovin     Date: 2 5 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 27 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 27 Information about the care home Name of care home: Address: Southfield Court Care Home Off Southfield Road Almondbury Huddersfield Yorkshire HD5 8RZ 01484432433 01484432441 southfield.court@fshc.co.uk www.fshc.co.uk Tamaris Healthcare (England) Ltd care home 50 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): 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 Additional conditions: The maximum number of service users who can be accommodated is: 50 The registered person may provide the following category of service only: Care Home with Nursing - Code N, To service users of the following gender: Either, Whose primary care needs on admission to the home are within the following category: Old age, not falling within any other category - Code OP, maximum number of places 50, Dementia - Code DE, maximum number of places 50 Date of last inspection Brief description of the care home Southfield Court is a modern, purpose built care home providing nursing care for older people. The ground floor provides accommodation for up to twenty-four people needing general nursing, and the first floor is for up to twenty-six people suffering from dementia. The home is situated behind the shops in Almondbury village. It is approximately two miles from Huddersfield but within a couple of minutes walk of all local amenities, including the bus stop. There is level access to the entrance of the Care Homes for Older People Page 4 of 27 Over 65 0 50 50 0 Brief description of the care home home. In the home, access to the first floor is gained either by stairs or a passenger lift. There is a garden including a secure area where service users may sit. There is ample parking at the front of the home. The fees range from £398 to £630 per week (July 2009). Additional charges include hairdressing and private chiropody. Information about the home and the services provided are available from the home in the Statement of Purpose and Service User Guide. Care Homes for Older People Page 5 of 27 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: This report brings together evidence of the key inspection of Southfield Court which included a visit to the service on 13th July 2009. During this visit a full tour of the building took place, we looked at records and talked to people living at the home, visitors and to management and staff. The home completed an Annual Quality Assurance Assessment (AQAA) which was returned promptly. The document gave useful information about the service provided and future developments the home is planning. We have reviewed our practice when making requirements, to improve national consistency. Some requirements from previous inspection reports may have been deleted or carried forward into this report as recommendations, but only when it is considered that people who use services are not being put at significant risk of harm. In future, if a requirement is repeated, it is likely that enforcement action will be taken. Care Homes for Older People Page 6 of 27 The weekly fees the home charges are between £398.15 and £630. People pay their own personal expenses, such as chiropody and hairdressing. The purpose of this inspection was to assess the quality of the care and support received by the people who live at Southfield Court. The visit to the home was carried out over one day by one inspector, a total of 7 hours were spent at the home. Care Homes for Older People Page 7 of 27 What the care home does well: What has improved since the last inspection? Since the last inspection the management team have put significant effort into making changes and improving working practices resulting in people receiving better care. Staff are now committed to promoting peoples privacy and dignity and people were seen to be treated with respect. Staff have received specialist training in dementia care and they confirmed that this has made them understand peoples behaviours more. This has altered the way they work with certain individuals. The standard of food served has been addressed and people we spoke to said that they enjoyed their meals. The dining experience for people living on the dementia unit has been enhanced. Two sittings are now in place to make sure that there are enough staff to assist people to eat and to keep disruptions to a minimum. Care plans now contain more detail as to how to meet peoples health and personal care needs. Person centred planning has been introduced and relatives and friends now Care Homes for Older People Page 8 of 27 contribute in writing the care plans. The complaints procedure has been reviewed and the manager now personally handles the investigations to make sure people are listened to and their views taken into account. What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 9 of 27 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 27 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 are assessed before they are admitted to the home, to make sure their needs can be met. Evidence: Where possible the home encourages people and their families to visit and talk to the people who already live at the home, their relatives and the staff. The home invites them to come and spend time there, have lunch and tea and maybe take part in the days activities. This means that the homes staff can get to know the persons needs and the individual has the information he or she needs to make a decision. Before moving into Southfield Court, peoples needs are assessed, to make sure that the home has the necessary equipment and staff have the skills to care for people properly. The manager or one of the nursing staff carry out these assessments. This assessment, as well as Social Services care needs assessments, forms the basis Care Homes for Older People Page 11 of 27 Evidence: for the individual plan of care and support. People are given written information about the home which makes sure that they know what services and facilities to expect. Intermediate care is not provided in the home. Care Homes for Older People Page 12 of 27 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 personal and healthcare needs are met and the care plans accurately reflect peoples care and support needs. People are protected by the medication administration systems. Evidence: The care records of six people living at the home were seen. The care plans contained sufficient detail to show what peoples health and personal care needs are, and how the care and support is to be given. The home has introduced person centered care planning and relatives and friends are now involved in the care planning process. Advice is sought from health care professionals, for example, the community mental health team and a psychogeriatrian, to assist in managing the challenging behaviours of some people living at the home. The care plans and associated risk assessments are reviewed at least monthly. Since the last inspection all staff have received specialist dementia care training. Staff told us that the training has helped them understand peoples behaviours and Care Homes for Older People Page 13 of 27 Evidence: subsequently improved the care they give to people. We saw some incidents of challenging behaviours during the visit. Staff responded to these quickly and calmly and diffused the situation before it could develop any further. All of the care records seen contained a life history of the person which contained useful information about peoples previous interests and significant events and details of people important to them. This helps the staff understand the person as a whole and assists them to help people to follow their own interests. Staff were seen to be treating people with privacy and dignity, for example, knocking on peoples bedroom doors and discreetly adjusting their clothing that they had attempted to remove. The medication system was inspected on both units. Six medication charts were examined and these were generally completed correctly. The home completes weekly stock balances and daily fridge temperatures. Controlled drugs are effectively recorded and the clinical manager on the dementia unit was extremely knowledgeable in how to administer, record, store and dispose of medication. The nurse on the nursing unit was observed administering medication in a professional and effective manner. The monitored dosage system is used and medication audits take place. Care Homes for Older People Page 14 of 27 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 are supported to take part in a wide range of activities. People are offered a good choice of meals to make sure their dietary needs and preferences are met. Evidence: There is a warm and welcoming atmosphere in the home and visiting relatives confirmed that this is always the case. One visitor said Im absolutely delighted, as soon as I walked through the door it became apparent this this was the home we were looking for. There is a wide range of activities on offer for people to participate in if they choose to do so. Two personal activity leaders are employed and they have a good knowledge of peoples interests and abilities. Activities are provided on an individual as well as group basis. A record is kept of all activities that people undertake and photographs are displayed of social events held. Some people like to go out and about and the activities staff encourage and assist with this. Some people, who like dogs, particularly appreciate it when the PAT dogs visit. Peoples religious and spiritual needs are now assessed and ministers of religion regularly visit the home. Care Homes for Older People Page 15 of 27 Evidence: People can exercise choice in when they get up and go to bed and can choose where to spend their time. Some people choose to spend time in their own rooms and others in the communal areas. People told us that they were satisfied with the lifestyle that they experience whilst living at Southfield Court. Visitors were seen to be welcomed into the home and said that they are always kept informed of important issues affecting their relative or friend. Visitors told us that the home is absolutely marvellous and the best of the bunch. Time was spent observing the mealtime on the dementia unit as at the last inspection it was described as chaotic. The staff team have put considerable effort in to improving the dining experience for people living on the unit. Meals are now taken in two sittings to make sure that enough staff are available to assist people and to give one to one support to prevent any incidents occurring. The tables are set immediately before the meal is served and were seen to be attractively set. The main meal of the day is served at lunchtime and the lunch being served on the day of the visit was gammon and parsley sauce, served to potatoes and two fresh vegetables, of chicken salad. People were asked to choose at the tables what they wished to eat. The choice of food was attractively served and people were seen to be making an informed choice of what they wanted to eat. The kitchen has recently been awarded a five star rating following an inspection by environmental health officers. This means that the standard of food hygiene has been assessed as excellent. Care Homes for Older People Page 16 of 27 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 are aware of how to raise a concern or make a complaint if they are dissatisfied with the service. The staff have received suitable training and understand the adult protection policies and procedures, however, people are not always kept safe from harm from other people living at the home. Evidence: The home has a complaints procedure which is clearly displayed in the home. The procedure for handling any complaints received has been reviewed since the last inspection and the manager now has a much stronger role in handling complaints. A record is kept of any complaints received. There have been three complaints made since the last inspection and records seen show how the complaint was investigated and what the outcome was and what action was taken. People we spoke to knew who to speak to if they were unhappy about anything at the home. One person living there said I would speak to the manager, but I have no complaints whatsoever. The home is very good at notifying the Commission of any incidents that take place between people living at the home. The home also routinely notifies the local authority and the majority of these incidents are handled in accordance with safeguarding Care Homes for Older People Page 17 of 27 Evidence: procedures. We looked at one persons care records. In the care record they were described as being at risk of abuse from other residents as they are unaware and unable to identify danger and move away due to reduced mobility. There were, however, no clear guidelines in place to say how this risk is to be managed. Guidlines should be in place to keep people safe. All staff receive Protection of Vulnerable Adults (POVA) training. Staff spoken to displayed a good understanding of safeguarding issues and knew what action to take if they witnessed of suspected that being were not being treated properly. Care Homes for Older People Page 18 of 27 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 clean, safe and comfortable environment. Evidence: The home is situated in a residential area near to the centre of Almondbury. There are local shops and facilities nearby and good public transport links to Huddersfield town centre. Southfield Court consists of two separate units. The ground floor caters for people who require nursing or residential care and the first floor provides accommodation and care for people with dementia and related conditions. The home is well maintained throughout and is in the process of a programme of complete redecoration and refurbishment. Advice has been sought from Bradford University as to how to aid orientation for people living on the dementia unit. Specialist signs and different coloured doors have been installed as a result of this. A full tour of the building showed that the home is clean and fresh throughout. People said that this was always the case. People said that they were satisfied with the facilities provided in their bedrooms. People are encouraged to bring their own personal possessions with them to make sure that their rooms reflect their own tastes and interests. The majority of the rooms seen were personalised and homely. Care Homes for Older People Page 19 of 27 Evidence: Communal areas are spacious and comfortable. There is safe and accessible outdoor space for people to use in the warmer weather. Staff were observed wearing protective clothing, washing their hands in-between attending to people and using different coloured bags for laundry. Staff confirmed that infection control training has been completed. Sluice areas were kept clean and the domestic staff were aware of how to maintain hygiene needs. Staff have also undertaken food hygiene which helps prevent cross contamination when serving food and drink. Care Homes for Older People Page 20 of 27 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. Peoples needs are met by a well trained and motivated workforce. Evidence: There are sufficient staff on duty at all times of the day and night to make sure that peoples needs are met. There is always a Registered Nurse on duty supported by a team of care assistants. Staffing levels on the day of the visit were as follows: 1 nurse plus 4 carers on duty downstairs, and upstairs on the dementia unit 2 nurses plus 4 carers. At night there are 2 nurses and 3 carers. There are also activities co-ordinators and sufficient catering, domestic, laundry and maintenance staff. Staff spoken to during the visit, confirmed that, in their opinion the numbers of staff on duty was sufficient to give them time to sit and talk to the people living there. The home places a high priority on staff training and development. There is a programme of national Vocational Training (NVQ) in place and the home is working towards at least half of the care staff achieving their award. When this is attained it will mean that the workforce are qualified and competent to meet peoples needs. All staff are required to undertake induction training to Skills for Care Council Care Homes for Older People Page 21 of 27 Evidence: specification and to undertake mandatory training which includes: food hygiene, infection control, dementia awareness and challenging behaviour, health and safety and moving and handling training. People are protected by the rigorous and safe recruitment practices that the home adheres to. Staff recruitment files seen confirmed that all staff have a Criminal Records Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosure before being employed at the home as well as two written references. All of the nursing staff have their Personal Identity Number (PIN) checked to confirm that they are registered and fit to practice. People said that the staff were attentive and attended to their needs promptly. One person living at the home told us that the carers are superb another said they are the best. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People live in a generally well managed and run home Evidence: The registered manager of the home is qualified and competent to run the home. She is a registered general nurse and an experienced manager. She has undertaken training in dementia care mapping, is a qualified district nurse and has many years experience caring for older people. People spoken with felt she was approachable, professional and effective in her role. One person said The manager is marvellous, very approachable and professional. Another person said The home is well run, it was fine when Mum moved in but it has improved two fold in the last year. There are financial procedures in place which makes sure that any money being held is kept safely and accounted for. There are health and safety policies and procedures in place which makes sure that peoples safety and welfare is protected. Care Homes for Older People Page 23 of 27 Evidence: Formal quality monitoring systems are in place to make sure that the standard of care and facilities are kept to a high standard. The quality audits take place twice a year and the results are collated and published. The overall satisfaction score at the last audit was 94 . At present there are no people living at the home who are subject to a deprivation of their liberty authorisation, under the Mental Capacity Act 2005. We received the homes annual self assessment. It contained information about the home and the services that are provided, the improvements they have made and their plans for the coming twelve months. More detail would have given us us a fuller picture of the service. Care Homes for Older People Page 24 of 27 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 25 of 27 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 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 18 To make sure that people are kept safe and prevented from risk of harm. Suitable arrangements should be put in place to prevent people living at the home being placed at risk of harm from other people living at the home. To make sure that peoples needs are met by a qualified staff team a minimum of 50 of the care staff should hold the National Vocational Qualification level 2 in care. 2 28 Care Homes for Older People Page 26 of 27 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. 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