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Inspection on 03/01/06 for Southfields Residential Home

Also see our care home review for Southfields Residential Home for more information

This inspection was carried out on 3rd January 2006.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Excellent. 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The home has good and comprehensive care plans, which are kept up-to-date with regular reviews. The manager and staff monitor the health of residents closely, and ensure that they receive appropriate treatment and assistance. Staff commitment to residents is strong. This was demonstrated by the care given to residents who were ill or admitted to hospital. Staff also show good communication skills with residents to find out what their wishes are. Relations with the social housing landlord are good, with agreement to the refurbishment of the kitchen, and the provision of hand rails as advised by the Occupational Therapist.

What has improved since the last inspection?

There were no requirements from the last report. Action was being taken to improve the decoration and flooring in a shared bathroom. A room was being cleaned and re-decorated ready for a prospective new resident. Action was being taken to improve a fire exit route to maintain a resident`s privacy.

What the care home could do better:

The report recommends that the manager and staff seek ways to offer residents more socially inclusive activities, with their agreement.

CARE HOME ADULTS 18-65 Southfields Residential Home 349 High Road Trimley St Martin Felixstowe Suffolk IP11 0RS Lead Inspector John Goodship Unannounced Inspection 3rd January 2006 14:50h Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 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 Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 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 Adults 18-65. 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 Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION Name of service Southfields Residential Home Address 349 High Road Trimley St Martin Felixstowe Suffolk IP11 0RS 01394 277778 01394 277778 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.mencap.org.uk Royal Mencap Society Mr Leslie Clifford Care Home 4 Category(ies) of Learning disability (4) registration, with number of places Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 17th August 2005 Brief Description of the Service: Southfields home is registered to care for four adults with Learning Disabilities, one of them over 65 years old. The home, in a converted private bungalow set in a large garden, is situated in the Trimley villages next to the coastal town of Felixstowe. All four bedrooms are single. There are shops and other facilities in the villages as well as access by bus and train to both Felixstowe and Ipswich. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was unannounced and was the second of the inspection year. It took place in the afternoon. There was one resident present at the start of the inspection, and the other two arrived from their day centre later. The manager and two staff were present. The inspector was not able to communicate directly with the residents, but it was clear from observation that they were able to communicate well with the staff. The three current residents have different and recognisable care needs. This report has had to try to present evidence of care practices without revealing confidential information which could identify the person. What the service does well: What has improved since the last inspection? What they could do better: The report recommends that the manager and staff seek ways to offer residents more socially inclusive activities, with their agreement. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 6 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 Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 2,3,4,5. Residents are not admitted on a permanent basis until all parties are happy with the decision. EVIDENCE: Following the transfer of an older resident to a care home with nursing, the home was planning the first new admission for many years. After several referrals by the allocation team, which had not been pursued, a prospective male resident had been offered the place. All residents would then be male. The very comprehensive pre-admission assessment identified all the key areas and would form the basis for the care plan. The manager was working with the family and the individual to ensure that all were agreed that the choice of this home was the right one. The room was to be re-carpeted and furnished, and the resident would bring some items of their own. It would then be possible to offer some overnight and short stays to assess the appropriateness of the admission for the new and the existing residents. All residents had a Mencap tenancy agreement describing the terms and conditions of their residence. The contract was with the funding authority. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 9 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 6,7,8,10. Residents are able and supported to make many choices about their daily lives within staffing and funding constraints. They attend reviews to ensure their wishes are expressed. The home respects their privacy and maintains confidentiality. EVIDENCE: On the day of the inspection, one of the residents had decided not to go to the day centre in Felixstowe. He had been unhappy with day centre arrangements for some time as documented in his file, and reported in previous inspection reports. Reviews with Social Care Services had led to the provision of a one-toone support worker for two days a week, which supported him to visit his family once a week, and do what he wished on the other day. The resident had asked for this support on each weekday, but the funding authority was unable to finance this. The manager had raised the topic of direct payments as a solution to the resident’s wishes, but no progress had been made with the funder to set these up. Although there were no formal residents’ meetings, the three residents were consulted all the time on everyday issues about the running of the home. This was observed during the inspection. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 10 One resident was anxious to speak to the manager on a matter, and declined to speak in front of the inspector. The manager arranged to talk to them in private. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 11 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the 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. All residents take part in activities of their choice, and maintain family links. The home could increase the links to the local community to support activities which promote social inclusion. EVIDENCE: All the current residents had leisure interests of their own, and the home supported them as far as possible. All took part individually in shopping for the home with staff. One trip was about to set off at the end of the inspection and the resident appeared eager to take part. There was little activity which brought the residents into contact with the local community. All shopping for instance was done in Felixstowe. The manager felt that staff would like to do more in this area, and with the move of the resident who required two staff at all times, the released staff time could be used to develop this. Current residents had contact with their families, some on a weekly basis when they went to their parents’ home. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 12 Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 13 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 18,19. Residents receive personal support in the way they prefer as far as possible. Their health is closely monitored and the staff provide excellent support even if the resident is in hospital. EVIDENCE: Evidence described under Standard 7 explained the support which one resident would have liked, and how this had to be limited at the moment. All residents were being monitored on aspects of their health. Extensive notes recorded the action taken by the home and the medical interventions needed to address the issues. The manager and staff were well informed about the needs of each resident. One person who had had a increased number of falls had been assessed by the Occupational Therapist, who had recommended that hand rails be fitted both inside and outside the home. The landlord had agreed to do this work. The orthotic clinic had also advised on the correct use of special footwear. Another resident was under the care of the psychiatrist for problems associated with their behaviour. Staff were keeping a behaviour chart to track incidents and triggers. Previous reports have noted the care given by staff at the home and in hospital to one resident. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 14 Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 15 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): These standards were not inspected this time. They were met on the last inspection. EVIDENCE: Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 16 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 24,25,30. Residents live in a well-maintained home, with personalised rooms, and hygienic facilities. EVIDENCE: The Housing Association which owned the property had agreed to refurbish the kitchen. The manager was aware of the need to balance the freedom of access of the residents to the kitchen against the danger of staff being called away in an emergency leaving the resident in the kitchen unsupported. The final layout would be discussed with the Association’s representative, as well as learning from recent Mencap projects. The vacant room was to be redecorated and furnished more appropriately for the probable new resident, as the room had been set up for the previous person who had not been mobile. This room had been designated as a fire exit route. The requirement that residents must be able to exercise privacy by locking their room doors conflicted with the fire safety regulations. The manager had sought advice from the fire service, and the door was to be fitted with an electronic release door lock linked to the fire alarm. The door would automatically unlock for access to the fire exit. This would be fitted before the Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 17 new resident moved in. The new resident would be able to personalise their room as much as they wished. Other residents had done so. One of the shared assisted bathrooms was scheduled to be redecorated and the floor made safe where it met the side of the bath. The hedge down the south side of the garden, which had become very overgrown, had now been cut down to a level which allowed more light to that side of the bungalow. In order to cope with the additional washing needs caused by the health care needs of one resident, the home had installed a new washing machine with a sluice cycle. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 18 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35. Residents benefit from staff understanding their roles, and being trained to undertake them. EVIDENCE: One of the carers had been nominated as the back care assessor for the home and had been trained by Mencap to do this role. They also acted as the health and safety officer. Moving and handling risk assessments had been completed for each resident. The home was fully staffed. No new person had been recruited since the previous inspection in August 2005. One person however had been seconded to another Mencap project for three months. Cover was being provided by existing staff and occasional agency staff. This had not been such an issue while there had been only three residents. All staff had completed or were working towards the NVQ Level 2 or above. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 19 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. 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 are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 37,38,39,42. The residents can be confident that their home is run for them as they wish. The manager and staff, and Mencap, are trying to improve the quality of residents’ lives at all times. EVIDENCE: The manager had almost completed NVQ Level 4. Some extra evidence had been required by the assessor on one topic. The last staff meeting had taken place on 29 November 2005. One topic discussed was health and safety, particularly moving and handling. Another was the introduction by Mencap into each home of a Home Improvement Plan. This would list all the national minimum standards, and show what action and improvements the home intended to make to meet and surpass those standards. The one for this home was still being written and would be a useful document to examine at the next inspection. Although there were no formal residents’ meetings, the three residents were consulted all the time on everyday issues about the running of the home. This Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 20 happened during the inspection with two of the residents. Another resident had asked to speak to the manager about a personal matter. The manager checked to see if it they wished to discuss it with the inspector, but they did not. The manager then arranged to talk to them after the inspection. Attention to health and safety issues had been shown through staff responsibilities, and environmental changes. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 21 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 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 X 2 3 3 3 4 4 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 X 23 X ENVIRONMENT Standard No Score 24 3 25 3 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 3 32 3 33 X 34 X 35 3 36 X CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 3 X 3 LIFESTYLES Standard No Score 11 X 12 3 13 2 14 3 15 3 16 X 17 X PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 4 X X 3 3 3 X X 3 x Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 22 NO 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard YA13 Good Practice Recommendations The home should provide opportunities for residents to take part in locally inclusive projects. Southfields Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 23 Commission for Social Care Inspection Suffolk Area Office St Vincent House Cutler Street Ipswich Suffolk IP1 1UQ 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 Residential Home DS0000024490.V275772.R01.S.doc Version 5.1 Page 24 - 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. 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