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Inspection on 13/01/09 for Southlands Residential Home

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

This inspection was carried out on 13th January 2009.

CSCI 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.

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

From speaking with residents, a visitor and information on returned surveys, it was clear they were happy with the care provided and liked the staff. Visitors are made welcome at most times during the day, but are requested to avoid, if possible meal times. Residents were satisfied with the food stating they got enough to eat and it was nicely cooked. There have been few staff changes, so residents are looked after by people they know and can trust. The premises were clean and safe and the standard of the accommodation was good.

What has improved since the last inspection?

The home has met the requirements and recommendations made at the last inspection. The replacement of new windows is ongoing and several areas had been decorated. The range of activities within the home had improved, including regular trips out to local venues. Improvements to the garden area has enabled residents to help with gentle gardening tasks and some have helped to plant bulbs. A complete new menu had been introduced acting on suggestions from residents.

What the care home could do better:

Information on the returned AQAA indicates that the home needs to maintain a full activities programme. To continue to ensure that training remains up to date, and to constantly keep abreast of legislative changes. The home must carry out regular fire drills and information must be recorded. Training for staff in first aid needs to be arranged.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southlands Residential Home Withins Lane Breightmet Bolton Lancashire BL2 5DZ     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Judith Stanley     Date: 1 3 0 1 2 0 0 9 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Southlands Residential Home Withins Lane Breightmet Bolton Lancashire BL2 5DZ 01204528369 01204528369 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mrs S A Winterbottom,Mr M A Winters Name of registered manager (if applicable) Mrs S A Winterbottom Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home Southlands is a privately owned care home providing residential care for older people. It is situated close to a bus route, at the end of short private access road in the Breightmet area of Bolton. The home is a large, detached building with 27 places on two floors. There are 13 single rooms (3 of which have en-suite facilities) and 7 double rooms. The grounds include a car park and large, enclosed gardens. Mrs Winterbottom has jointly owned, managed and worked at Southlands for 20 years. The current charges range from 337 pounds and 35 pence to 406 pounds and 35 pence. A top up fee is also charged. 0 Over 65 27 care home 27 Care Homes for Older People Page 4 of 25 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 inspection of Southlands Care Home was unannounced and was carried out over a period of six hours on one day. The visit was just one part of the inspection. Before the visit took place we (the Commission) asked the manager to complete a questionnaire that we call an Annual Quality Assurance Assessment or AQAA for short. It gives us information about how the home is meeting the needs of the residents and includes future plans for further development. To find out more information about the home we sent surveys to residents and staff. Three residents returned surveys and all indicated their satisfaction on the quality of Care Homes for Older People Page 5 of 25 care and the services provided. One said, It was the nicest and cleanest home I visited. It is homely and friendly and the staff are very caring. I would recommend this home to the Queen if she needed one. Although no staff surveys were returned, staff spoken with during the day were complementary about the management and the day to day running of the home. They said that they were offered good training which was relevant to their role. Staff confirmed that they had a good staff team and the needs of the residents living at the home were well met. During the course of the day we looked at staff files, staff training, activities, menus etc. Staff and residents and a visitor to the home were also spoken with. What the care home does well: What has improved since the last inspection? 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 set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 Care Homes for Older People Page 7 of 25 240 7535. Care Homes for Older People Page 8 of 25 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 9 of 25 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. There are systems in place to assess and monitor individual needs, ensuring that a suitable service is provided based on personal needs and prefences. Evidence: The home has a statement of purpose and a services user guide. This information informs people of the management and staffing structure of the home and about what goes on in the home and what services and facilities are available. This helps people to make an informed choice about moving in to the home. Prospective residents are welcomed and are encouraged to visit the home before making a final decision that this is the right home for them. We (the Commission) selected two residents files (care plans) to work with throughout the inspection. Care Homes for Older People Page 10 of 25 Evidence: We looked to see that those two residents had a contract/statement of terms and conditions in place. There was a contract for each resident regardless of how their care was being funded. Before any new resident is admitted in to the home a pre admission assessment is carried out by a senior member of staff. The assessment covers areas such as: levels of dependency, toileting, mobility, skin condition, nutrition, motivation, oral care, foot care, communication, personal preference etc. The assessment is carried out at the most convenient place for the prospective resident, this could be at their own home or at the hospital. The assessment makes sure that the home and staff can meet the health, personal and social care needs of the individual. At least one person living at the home had a diagnosis of a dementia related illness. Some other residents have communication and memory problems. Seven of the staff had completed training in caring for people with dementia. This training should be completed by all staff. New staff will be given a insight in to caring for people with dementia on their induction programme by Bolton Social Services. Care Homes for Older People Page 11 of 25 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. People who live at Southlands have their needs met and their care is provided in a manner that protects their privacy and dignity. Evidence: The care plans for two residents were examined. Care plans are built up from the initial assessment and include personal details such as: mental health, personal care, social care, nutrition, mobility and communication. Risk assessments covering areas such as bathing, moving and handling and falls were in place. Supplementary information includes personal care, records of weights and bathing. There is a handover/communications book, which is completed by staff during the day and at the end of each shift. This informed staff of any changes in the needs of the residents, if the doctor has been sent for, what sort of day people have had. Comments are not recorded for each resident, only if there had been any changes or events. Feedback from residents and from those who returned comment cards was complementary about the staff and the care provided. One resident wrote, The staff Care Homes for Older People Page 12 of 25 Evidence: are absolutely brilliant- a stunning group of people. Another said, Staff are marvelous with everyone in the home. The services of opticians, dentist, chiropodist were assessed either at the home or in the community as and when necessary. Staff ensure that hospital appointments are kept and staff will accompany the resident if need be. Three residents returned surveys and all indicated that they receive the medical support as needed. One wrote, The doctor is called straight away if needed. The medication of the two residents files we were working with was checked. The medication had been administered at the correct time as prescribed and the individual MAR (drug record) had been completed and signed. Staff who administer medication had undertaken training and had been assessed as competent. There were no residents receiving any controlled drugs at the time of the visit. Residents who were able to comment indicated that staff respected their privacy and dignity. During the inspection, staff were observed to treat residents with respect and consideration. Residents were observed to be well groomed in nicely laundered clothes. Staff were seen to knock on doors before entering rooms and toilets and wait for a response. Care Homes for Older People Page 13 of 25 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 provided with activities and a variety of home cooked food, which they enjoy. Evidence: The staff offer a range of activities to suit the needs and capabilities of the residents. Activities are planned and include: bingo, board games, handicrafts, cards, concerts etc. There are two people that visit the home on alternate weeks and work with the residents doing gentle exercises and physiotherapy. One person spoken with said with their help she had regained the use of her arm and hand. Staff have introduced more trips out of the home using Bolton Council Transport. Last summer the home celebrated its twentieth anniversary of opening with a big party for residents and guests. The home welcomes and encourages visitors to the home. The manager does request that where possible visitors try to avoid meal times. This is to allow the residents to enjoy their meals with the minimum of disruption. Residents can meet with their visitors in any of the communal areas or in the privacy of their own room if they wish. One visitor spoken with was very pleased with the home and staff and the care Care Homes for Older People Page 14 of 25 Evidence: provided. The choices residents make each day varied, dependant up on their mental frailty, but those residents who were able to comment, chose what time to get up and when they went to bed, what clothes to wear and what to eat and whether or not to participate in activities. The menus were planned and were displayed in the dining room. The meals planned were well balanced, well cooked and nicely presented. Residents had a choice of breakfast dishes including cereals, porridge, fresh fruit, prunes, toast and preserves, sometimes kippers, eggs etc and a choice of tea or coffee. A lighter lunch was served and residents were offered chicken in a creamed sauce, with French fries or hash browns, followed by a choice of dessert or cheese and biscuits. Residents spoken with after lunch expressed their satisfaction of the quality and quantity of the food served. The main meal is served late afternoon, the main choice to be offered was sausage and creamed potatoes, peas and onion gravy followed by homemade chocolate eclairs. Alternatives to the main choice were available. At some meal times residents can enjoy a glass of wine to accompany their meal. The dining room was nicely laid out and tables were set with appropriate crockery and cutlery, napkins and condiments. Staff were available to assist residents that required help with their meal. A choice of hot and cold drinks and snacks were available throughout the day. Suppers and drinks, including milk drinks are offered before residents retire. Care Homes for Older People Page 15 of 25 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. Good safeguarding procedures help to ensure that people remain safe in this home. The complaints procedure is clear and accessible meaning that residents and their representatives feel listened to and taken seriously. Evidence: A complaints procedure was in place, this gives details of how a complaint would be investigated. Information on the AQAA indicated there had been no complaints since the last inspection. No formal complaints had been received by the CSCI. The returned residents surveys indicated that residents knew how to make a complaint and to whom. Residents spoken with said they would tell any of the managers and staff if they were unhappy with anything. There had been no adult safeguarding referrals or investigations reported by the home since the last inspection. All staff had undertaken training in the protection of vulnerable adults to ensure that residents are protected from abuse in any of its forms. Staff complete refresher courses as required. Care Homes for Older People Page 16 of 25 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. Southlands provides a safe and comfortable home that is well maintained and decorated and furnished to a good standard. Evidence: From a tour of the premises, it was evident that the home is maintained to a good standard both internally and externally. Several windows had been replaced with new double glazed units. There was evidence to show that rooms were being decorated and refurbished as required. The communal areas were clean and comfortable and well equipped. We looked in several bedrooms, these were seen to be clean, warm and comfortable. Most residents had bought some of their own belongings and mementos with them to personalise their rooms. The bathrooms were clean and had suitable aids and adaptations to assit residents when bathing. There was some evidence of communal toiletries and creams seen in bathrooms. All toiletries should be kept in individuals rooms and taken to the bathroom when residents are ready to bathe. The manager was asked for these to be removed immediately. The outside of the home is well maintained and the grounds were seen to be neat and tidy. One resident said how nice it was to sit outside in summer. Care Homes for Older People Page 17 of 25 Evidence: Systems were in place to control the risk of cross infection. Staff were seen wearing different protective clothing when carrying out different tasks. There was a ample supply of liquid soap and paper towels. The laundry is sited away from food preparation and food storage areas and does not intrude of the residents. We spoke with a member of the domestic staff, who obviously took pride in her work in keeping the home clean and free from any offensive odours. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People receive the care and support from staff who have the skills to support them correctly. Evidence: On the day of the inspection staffing levels were sufficient to meet the needs of the residents. A written rota is maintained and showed which staff were on duty and at what time. Domestic and catering staff help and support care staff. Staff morale appeared good and the staff team worked well together. Several of the staff had worked at the home for a number of years. This provides residents with reliable and consistent care by people they knew and can trust. The atmosphere in the home was friendly and relaxed. Interactions between staff and residents were frequent, natural and warm. During the day staff were seen to respond speedily to requests for assistance from residents. The files of four staff employed were looked at. All contained a written application form, not all files had two written references, this was discussed with one of the managers, who will ensure that any new staff submit two written references. There was evidence that staff have had a Criminal Records Bureau (CRB) check prior to Care Homes for Older People Page 19 of 25 Evidence: commencing work. Some of the newer files had other forms of identification, such as copy of a passport and driving licence. A staff development programme is in place and records of training are maintained. All new staff completes a full induction programme on commencement of work. The home meets the standard of having at least 50 of care staff qualified with a National Vocational Qualification (NVQ) at level 2 or above in care. Staff spoken with were happy with the range of training provided and confirmed it was relevant to their role. Care Homes for Older People Page 20 of 25 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. Southlands is being run in the best interests of people who live there and their welfare is promoted and protected. Evidence: The homes registered manager has a many years experience of working and caring for elderly people. The home also has a care manager and administration manager working along side the registered manager, both of whom have the Registered Managers Award. There is always one of the managers on call if needed. The way in which the home is managed is open and transparent. Any of the homes managers can be approached at any time by staff, residents or their families. This was observed on the day of the inspection. Systems were in place for self monitoring in the home, which included satisfaction questionnaires and staff meetings which are minuted. The managers have daily chats Care Homes for Older People Page 21 of 25 Evidence: to residents and have informal meetings, these are not minuted. The home has the Investors in People Award. It was discussed with the administration manager that the result of surveys should be made available to residents and other interested parties. This is an area that she will look in to. Some residents have handed over small amounts of money to the manager for safekeeping. We checked the money against the balance sheets of the residents whose files we were working with and no discrepancies were noted. Policies and procedures had been developed that are based on providing good quality care and accommodation. These are reviewed regularly and revised when appropriate. Equipment and systems used in the home were serviced and maintained, and records were kept and easily accessible. With the pre inspection information, the manager provided a list of maintenance and associated records. A random sample of these certificates were checked and seen to be valid. Fire safety records showed that all fires tests and maintenance procedures had been undertaken regularly, however a fire drill was way overdue. The manager was asked to address this as soon as possible. We checked the accident reports. All accidents, injuries and incidents were suitably recorded and the CSCI are informed as necessary. Care Homes for Older People Page 22 of 25 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 23 of 25 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 Care Homes for Older People Page 24 of 25 Helpline: 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 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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