Inspection on 22/11/05 for Southfields House EPH

This inspection was carried out on 22nd November 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Southfields House EPH 07/08/07

Southfields House EPH 30/10/06

Southfields House EPH 23/05/05

Southfields House EPH 19/07/04

Southfields House EPH 27/04/04

Similar services:

Byars Care Home

St Marys Nursing Home

Bramble Lodge

Parkmanor Residential Home

Thornham Grove

Hunter`s Lodge

London Road Neurological and Specialist Care Unit

Carlton Care Home

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Southfields House EPH Farmhill Road Southfields Northampton Northants NN3 5DS Lead Inspector Mrs Pat Harte Unannounced Inspection 22nd November 2005 10:00 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 Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Southfields House EPH Address Farmhill Road Southfields Northampton Northants NN3 5DS 01604 499381 01604 790719 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.northamptonshire.gov.uk Northamptonshire County Council Mr Phil (Ian Philip) Terry Care Home 46 Category(ies) of Dementia (2), Dementia - over 65 years of age registration, with number (30), Old age, not falling within any other of places category (46), Physical disability over 65 years of age (5) Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. 3. 4. 5. 6. 7. 8. 9. No person falling within the OP category can be admitted where there are already 46 people of OP category already in the home No person falling within the DE(E) category can be admitted where there are already 30 people of DE(E) category already in the home No person falling within the DE category can be admitted where there are already 2 people of DE category already in the home No person admitted within the DE category will be below the age of 60 The total number of service users within the DE(E) and the DE category must not exceed 30 No person falling within the PD(E) category can be admitted where there are already 5 people of PE(E) category already in the home To be able to accommodate one named service user who has needs within the MD(E) category To be able to accommodate one named service user who has needs within the LD(E) category Total number of service users in the home must not exceed 46 Date of last inspection 23rd May 2005 Brief Description of the Service: Southfields House is a residential care home owned by Northants County Council. The Manager is Mr. P. Terry. The Home provides permanent places for up to 46 older people over the age of 65 years, including up to 5 people who have a Physical Disability and up to 30 People who may have a diagnosed Dementia. Residents with Dementia needs are cared for in dedicated areas. The Home has one high dependency unit for Residents with behavioural needs; two staff are deployed to this unit on all daytime shifts. The Home also has specific conditions that it may continue to provide care for 2 existing, named Residents one with a Mental Disorder and one with a Learning Disability. The Home is situated on the outskirts of Northampton close to local shops and is easily accessible by public transport. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 5 The premises offer ground floor accommodation and all Residents are provided with single bedrooms. There are six self-contained units with their own lounge/dining/kitchenette and bathroom and toilet facilities. In addition there are seating areas by the main entrance and a conservatory area providing Residents with additional communal space. Residents have access to garden areas. The Home is enclosed by security fencing and is accessed through gates operated by remote control. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 6 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection is upon outcomes for Service Users and their views of the service provided. Inspection planning took one hour and consisted of a review of the last inspection report and requirements, the Home’s service history including notifications and events. The primary method of inspection used was ‘case tracking’ which involved selecting three Residents and tracking the care they receive through review of their records, talking with them and the care staff. In addition six staff, seven Residents and one visiting Relative were spoken with to gain their opinions on the service. A partial tour of the premises took place, a selection of records was inspected and observations made on care practices. Discussions were held with the Registered Manager. The Inspection took place from late morning and in the afternoon over a period of four hours and was carried out on an unannounced basis What the service does well: The Home has a committed staff group. Residents spoken to felt that their relationships with staff were very good and that staff provided them with good care and support and valued and respected as individuals. Routines are relaxed and flexible and Residents confirmed that they are enabled to continue the routines they have followed through their lives and maintain their independence as much as is possible. Staff ensure that Residents Health Care needs are closely monitored with prompt referral made to Medical Professionals where necessary. Residents with dementia care needs are well supported, monitored and supervised. Meals are varied, well balanced, of good quality and nicely presented. Residents stated that they are given a good choice of options in the daily menu and account is taken of their likes and dislikes and special diets. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 7 Any complaints or issues raised are taken very seriously and are thoroughly investigated with resolution sought. What has improved since the last inspection? 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. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, 3, 4 & 5 Prospective Residents are provided with information to enable them to make informed choice regarding their placement. The pre-admission assessment is thorough and effective in ensuring that the needs of people admitted to the home can be met. EVIDENCE: The admission process ensures that all prospective Residents are visited and assessed by staff from the Home to ensure their needs can be met. Residents and their relatives have opportunities to visit the Home and are given information on the services and facilities. Residents spoken with felt that staff were well briefed on their needs and the care to be provided. Staff spoken with felt that they were provided with good information on their Residents needs, routines and wishes. During the Inspection a new Resident was admitted. Her reception was sensitively handled with staff and the Manager on hand to show her around and introduce her to other Residents and staff and help her to unpack. The Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 10 Resident suffered with Dementia and was confused and disorientated. Staff were constantly on hand to reassure her and help her to settle. Individual records are kept for each of the Residents and inspection of the records showed that the assessment process was thorough, specific assessment tools were used to identify needs and risk and assessments were carefully documented. Contracts are provided to all Residents with copies maintained on individual Residents files. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Overall care plans clearly documented Residents needs and provided a good level of instruction and guidance for staff on how the care was to be carried through including guidance on how Resident’s with Dementia are to be supported. EVIDENCE: Care plan formats have been reviewed and all existing care plans have been updated to a new format. Three Residents care plans were inspected. Two of the plans showed a holistic approach and extensive and detailed guidance and instruction for staff on how the care was to be provided. However the third care plan was lacking in detailed instructions for staff. Some of the care needs were not documented, for example the continence programme, and timings for routines were not given. The Manager showed that he is monitoring the development of care plans and is addressing shortfalls in the level of detail. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 12 Attention was paid in two of the plans to ensuring that information is gathered on Residents’ Life Histories, however in the third care plan inspected no information had been recorded. Staff commented that the information is particularly important to give them a better understanding of the needs of Residents with Dementia and that the information enabled them to communicate more effectively with their Residents and help them deal with their frustrations and anxieties. Discussions with staff showed that they knew their Residents well. Strategies for the management of behaviours for Dementia care Residents were in place and were known to staff. Two of the care plans showed that detailed account had been taken of Residents wishes in relation to their preferred routines and how the care is to be provided. Plans detailed tasks that Residents’ could undertake for themselves showing that they were encouraged to maintain their independence as much as possible. Staff demonstrated that they felt respect for and valued each Resident as an individual. Observations confirmed that Residents are encouraged to take as much control over their lives as possible. Staff showed a sensitive approach to Residents with Dementia needs offering constant reassurance and ensuring they were given freedom of choice in their routines and were encouraged and assisted to take decisions for themselves where possible. Health care needs were clearly documented. Residents commented and records showed that staff responded quickly to any changes and made referrals to the appropriate Medical Professionals. Residents were enabled to see their General Practitioners quickly. Care plans gave clear instructions on how staff were to monitor health needs. The variance on the content of the plans was discussed with the Manager who showed that he was aware of inadequate detail and instruction in some plans and is addressing this area to achieve consistency. Following a recent audit of the Home’s Medication system conducted by the Manager it is clear that some medication has not been administered in accordance with the prescribed doses, some medication amounts held do not tally. The Manager notified the Commission of the discrepancies and is undertaking an investigation. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 13 Observations showed that the Care Supervisor on duty carried through the mid day medication round safely and efficiently. Medication was securely and appropriately stored. Observations confirmed that Staff ensure the protection of Residents privacy and dignity when carrying through personal care. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Residents are enabled to maintain their independence as much as possible and exercise control and choice in the way they wish to lead their lives. The meals in the Home are good, offering choice and variety and catering for special dietary needs and individual likes and dislikes. EVIDENCE: Residents felt routines were relaxed and flexible and that their preferences on rising and going to bed times were respected. They felt that they were free to decide on how and where they wished to spend their time and that they were encouraged to maintain their independence. The Home has an open visiting policy and Residents confirmed that they were enabled to receive their visitors in private if they wished. One visiting Relative stated that she was always made to feel welcome whenever she visited the home and that staff made time for her to discuss her Resident’s progress. She commented that she was kept well informed of any changes in her Resident’s needs and health. Consistent and regular staff are deployed to the units dedicated for the care of Residents with Dementia to provide continuity of care. Staff ensured that these Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 15 Residents were supervised and monitored constantly. They were enabled to make free choice in how and where they wished to spend their time and were supported to walk around the Home when they wished. It was clear that staff interacted well with their Residents and provided them with a range of meaningful and suitable activities on both an individual and group basis. A number of Residents were spoken to and everyone who commented on the food said it was good, that they had choice and their special and likes and dislikes were catered for and respected. Residents are asked to comment and offer suggestions on the menu and changes are made accordingly. The midday meal was efficiently served and nicely presented. Staff helped Residents with their meals where necessary. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Systems are in place to protect Residents from abuse and to ensure that complaints are listened to and acted upon. EVIDENCE: Residents confirmed that they had been given the Home’s complaints procedure which is also displayed in the Home. Residents spoken with felt confident and able to raise any issues or concerns with staff. A complaints record is maintained. The record showed that all complaints or concerns are taken very seriously and are fully investigated with resolution sought. The Manager showed that he analyses the complaint issues for indicators of patterns or themes and discussions evidenced that he takes prompt action to address practice issues. No complaints have been received by the CSCI. Robust procedures for the Protection of Vulnerable Adults are in place. Staff demonstrated, through discussions, their full understanding of the reporting procedures. Records and notifications received by the Commission confirm that any allegations are reported to the relevant Authorities. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 21, 22, 23, 24,25 & 26 Residents are provided with a safe, comfortable and homely environment. EVIDENCE: The premises were in good order, clean, warm and comfortable. Since the last Inspection considerable refurbishment and maintenance work has been carried out to comply with requirements, improve the appearance of the Home and address safety issues. Alterations have been made to improve the electric lighting of the Home, to date about 50 of the work has been completed with a second phase planned shortly to complete the work. Thermostatic individual radiator valves have been fitted to all radiators to enable the temperature control of individual rooms. Some corridor and bedroom areas have been redecorated and re-carpeted to improve the general appearance. Toilet and bathroom floors have been replaced, where necessary, to provide easy hygiene maintenance. Broken safety glass in the conservatory rook has been replaced. It is acknowledged that considerable work has been Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 18 carried out but more time will be needed to complete the re-decoration programme. Standards of domestic and hygiene maintenance were viewed as very good throughout the areas of the premises viewed. Residents stated that cleaning routines were carefully organised to ensure no disruption to their routines. Residents are enabled to personalise their rooms as they wish and have their furnishings and belongings around them. Due attention was paid to ensuring a safe environment. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 & 30 Sufficient numbers of care staff are deployed to meet the needs of current Residents. EVIDENCE: Residents spoken with said that the staff were very kind, committed and caring. Relationships between staff and Residents were good. On the early shifts there are 8 Carers on duty with the ratio changing in the afternoon and evenings to 7. The high dependency Dementia care unit is staffed with 2 regular carers during day and evening shifts. All other units have an allocated carer and the staffing numbers allow for 2 additional “floating” carers in the mornings and 1 on duty during the afternoons and evenings. 4 night care staff provide night care with one carer deployed to the high dependency unit. In addition at least one Residential Care Supervisor is on duty from 7.30 am to 10.00pm to supervise and lead the shift. Ancillary staff include Catering, Domestic staff and a Handyman ensuring that care staff are free to care for their Residents. The Manager showed that he continually monitored staffing levels taking into account Residents’ needs and dependency levels. Discussions with the Manager, staff and Residents confirmed that the staffing numbers were sufficient for the current needs of the Residents, staffing can be adjusted where necessary. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 20 Staff were observed to respond swiftly to Residents needs and to answering call bells. However a Resident and staff members raised issues on response times to the High Dependency Unit particularly on the evening shifts. There are times when Residents are unsettled and staff back up is required. One instance was quoted where staff from the unit waited half an hour for the required assistance and this placed them and their Residents at risk. The Manager was aware of complaints in this area and is currently investigating practice and addressing issues. Discussions with staff confirmed that they are provided with core training and regular updates. Specialist dementia care training has also been provided and staff are encouraged to undertake a National Vocational Qualification. Staff spoken with showed a commitment to the well being of their Residents and knowledge of the Home’s aims and objectives and policies and procedures. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36 & 38 The Management of the Home is effective and efficient and Residents are encouraged to be involved in the running of their home. The banking system for Residents personal allowances is not in their best interests. EVIDENCE: The Manager demonstrated his commitment to the well being of his Residents. Home and to his duties and responsibilities. Staff spoken with felt that the Managers were easily accessible to them and was willing to discuss any issues, guide them in practice and offer support. They confirmed that systems for informal as well as formal supervision were in place. Residents felt the Managers were readily available to them. They commented that regular Residents meetings were held and that the Managers consulted with them and sought their individual views and opinions. Residents’ Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 22 satisfaction surveys are also carried out. Residents felt that they had trust and confidence in both the Manager and the staff group as a whole, relationships were observed to be very good. The Records for the safekeeping of Residents’ moneys and valuables were in good order. However Residents’ personal allowances managed by the County Council are held in a central Residents account that does not pay interest on moneys deposited. The Manager is currently addressing this area to ensure that Residents best interests are safeguarded. Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 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 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 3 9 2 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 2 3 3 3 3 3 3 3 STAFFING Standard No Score 27 3 28 2 29 X 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 2 3 X 3 Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 24 Are there any outstanding requirements from the last inspection? Yes 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 OP19 Regulation 23(2)(p) 23(2)(d) Requirement An action plan is to be submitted showing the update and anticipated timescales for the completion of the alterations to the electric lighting and the redecoration programme. Timescale for action 31/12/05 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 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 Southfields House EPH DS0000034882.V265509.R01.S.doc Version 5.0 Page 26 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!