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Inspection on 19/05/05 for Southlands Residential Home

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

This inspection was carried out on 19th May 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 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

Southlands is a very well managed home with a friendly and welcoming atmosphere. All the comments made by residents, relatives and health staff show confidence in the good standards of care, the friendliness of everyone who works there and their satisfaction with the clean and pleasant surroundings. One GP described "excellent individualised care". Another GP described "Excellent leadership", and went on to say "confidentiality and respect for residents has always been first class". Many residents said they liked the home, have a choice of what they want to do and are not bored because of the activities. Staff are happy with the training and support they get and feel that all the staff work well together. The home sends out a newsletter to let people know what`s happening at the home.

What has improved since the last inspection?

Each resident has a written plan of care describing their needs and how they are being met. Since the last inspection, more details in the plans about care needs, likes and dislikes have been added. The plans are looked at each month to make sure that any changes have been written down and care staff are clear about the best way to support each resident.

What the care home could do better:

The health and safety of all residents is well managed. However, to make sure that residents are safe in their bedrooms, all upstairs windows need to be fitted with a catch to stop them from opening fully. The manager is arranging to have this done.

CARE HOMES FOR OLDER PEOPLE SOUTHLANDS Withins Lane Breightmet Bolton BL2 5DZ Lead Inspector Rukhsana Yates Announced 19 May 2005 09:30 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 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. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 3 SERVICE INFORMATION Name of service Southlands Residential Home Address Withins Lane Breightmet Bolton LancashireBL2 5DZ 01204 528369 01204 528369 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mrs S A Winterbottom Mr M A Winters Mrs S A Winterbottom CRH Care Home 27 Category(ies) of OP Old Age : Number of Places 27 registration, with number of places SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 30 November 2004 Brief Description of the Service: 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 ensuite 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 18 years. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This inspection was announced and carried out over 8 hours. Most of the day was spent talking with 6 residents, three on their own and two during lunch, a practice nurse and two relatives. The remaining time was spent watching the way in which staff helped residents, and looking around the home. Some paperwork relating to the care and safety of residents was also examined. 4 residents, 4 relatives, 5 GPs and a social worker gave their views of the home by completing questionnaires. What the service does well: What has improved since the last inspection? Each resident has a written plan of care describing their needs and how they are being met. Since the last inspection, more details in the plans about care needs, likes and dislikes have been added. The plans are looked at each month to make sure that any changes have been written down and care staff are clear about the best way to support each resident. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 6 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. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 7 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 Standards Statutory Requirements Identified During the Inspection SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 8 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 standard(s) 3 Each person considering moving to Southlands has their needs assessed, and is given information about the home, before admission. The admission process ensures that new residents know what to expect of the service from the outset. EVIDENCE: Records and discussions show that the manager visits prospective residents, in their own homes or in hospital, to assess whether the home can meet their needs. The files of residents new to the home include an admission assessment, from which a care plan is developed. The assessment includes needs, preferences and relevant risk assessments. Introduction visits are arranged prior to admission if possible. One resident recently admitted from another care home was satisfied with the care, and had clearly been encouraged to exercise her abilities. For example, she took a pureed diet on admission, but had progressed to eating a conventionally presented meal. All residents consulted felt this home was a SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 9 good choice. Staff members demonstrated a good understanding of residents’ needs, likes and preferences. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 10 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 standard(s) 7 and 8 Each resident’s personal, health, social care needs and risk assessments are reflected in their care plan. Care staff involvement in reviewing care plans ensures that they have a good knowledge of each person’s changing needs and how to meet them. EVIDENCE: Care plans detail the actions to be taken by care staff to meet needs. They are reviewed monthly, with changes recorded and acted on. Risk assessments cover moving and handling and falls. If needed, risk assessments are carried out for areas such as pressure sores and nutrition. A visiting Practice Nurse confirmed that health needs are promptly and appropriately addressed. She described Southlands as very homely and said that “The manager is on the ball and deals with any health problems residents have immediately”. In a questionnaire, a GP said “Southlands consistently provides excellent individualised care for all its residents”. Another GP wrote “A very well managed home with excellent leadership. The residents are always helped to a private area for consultation. Confidentiality and respect for the residents has always been first class in my experience”. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 11 Residents and visitors said, in questionnaires and in discussions, that the standard of care is very good. They felt that their social, emotional and physical health needs were known and met. This knowledge was apparent in records that have improved to better reflect care and support needs, and in discussions with the manager and staff. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 12 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 standard(s) 12 and 15 Residents’ needs, likes and dislikes are reflected in a good variety of activities offered and enjoyed at the home. Residents feel they have flexible daily routines and enjoy the meals. EVIDENCE: Residents said they have a choice in their daily routines, including what time they get up and go to bed, where to spend their time, and which activities to take part in. One resident said “I do what I want to do when I want”. Another said “You please yourself when you get up and what you do. Its very good.” Eight residents and four care staff were on a barge trip during this inspection. All of the residents who completed questionnaires felt that the home provides suitable activities. Weekly activities include hair and nail care, film shows, handicrafts, physiotherapy, cards and dominoes. Regular activities include concerts, church services, parties and fetes. Some residents enjoy reading, and are provided with talking books if required. All residents consulted spoke highly of the meals. They confirmed that alternatives are readily provided on request. During lunch, it was clear that care staff are aware of residents’ needs and able to offer help and encouragement in a sensitive manner. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 13 SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 14 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 standard(s) 16 and 18 Residents and their relatives feel able to air their views, confident that the managers and staff will listen and respond to their satisfaction. Written guidelines and staff training help to ensure the protection of residents from abuse. EVIDENCE: Information about how to complain is included in the service user’s guide, and displayed on the notice board in the home. Questionnaires received show that residents and relatives are aware of the complaints procedure. In discussions, it was clear that people felt comfortable in raising issues informally with staff members or the management. There have been no complaints received by the home or the CSCI since the last inspection. Staff have a good understanding of the home’s adult protection and whistle blowing guidelines. Some members of staff have attended a training course covering these topics. The remainder have places booked on future courses. One staff member said “Things are dealt with straight away. The manager is easy to talk to and if there’s an issue, I know she would do something about it”. The process for recruiting staff includes robust background checks to ensure residents’ welfare is protected. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 15 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 standard(s) 19 and 26 Southlands provides a very clean and comfortable environment for residents. The home and grounds are pleasant and well maintained. Plans to fit restricting devices on some windows will ensure the safety of residents. EVIDENCE: Residents said they are very satisfied with the standards in the home, describing their surroundings as “clean and comfortable”. The visiting practice nurse commented that “the cleanliness strikes you when you walk in”. A visitor said the home is “wonderful, very nice and very clean. The lounges are bright and very welcoming”. Bedrooms are homely and personalised with residents’ own belongings. The safe and attractive gardens are enjoyed by residents and their visitors in fine weather. There is a good choice of lounge areas, enabling a range of social and religious activities to take place without being intrusive to those who choose not to participate. Regular safety checks are carried out throughout the home, including fire safety, water temperatures and equipment checks. A variety of aids and adaptations are provided to assist residents, including grab rails, assisted SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 16 baths and showers. The passenger lift and ramps enable wheelchair users to access all floors of the building. Some restricting devices on first floor bedroom windows needed attention to ensure the safety of residents. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 17 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 considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 and 30 The staff group has the knowledge, skills, training and management support it needs to effectively meet the care needs of residents. Training in dementia care will further improve the quality of care provided. EVIDENCE: The staffing rota shows that the manager, a senior carer and three care staff are on duty during the day, and two care staff on duty through the night. Staff members interviewed felt able to carry out their duties effectively within these staffing levels, and confirmed that their training needs are met. Sixteen of the twenty-one care staff have NVQ qualifications in care at Level 2 or above. The manager is a qualified nurse and able to give staff the guidance they need to provide a good standard of care, through formal and informal supervision arrangements. The home employs housekeeping, laundry and catering staff. This allows care staff to concentrate on supporting residents. Residents and relatives spoke highly of the managers and staff, saying they are “caring and very good “. They were confident in the ability of staff to provide a good quality of care. As some residents have dementia care needs, a recommendation is made for care staff to receive specialist training in this area. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 18 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 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31 and 33 Effective management arrangements ensure the home runs smoothly and the needs of residents are the highest priority. Southlands has good systems for seeking residents’ views. The home’s regular newsletter shows residents and others how their views are being used to improve the service. EVIDENCE: The registered manager is a qualified nurse and has owned and managed this home for a number of years. In discussion, the manager demonstrated a detailed knowledge of the needs and background of each resident, and a genuine and committed approach to promoting their physical and psychological well being. The Care Manager and Administration Manager are completing the Registered Manager’s Award, have significant roles in the running of the home and are competent in carrying out their duties. All questionnaires received supported the view that the home is very well run for the benefit of residents. In terms of ongoing improvement, the home considers the views of residents, staff, relatives and others, such as health professionals and produces a SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 19 newsletter every three months that shows how the home is using views to improve the service. SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 20 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 ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 x x x HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 x 10 x 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 3 COMPLAINTS AND PROTECTION 2 x x x x x x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x 3 3 x 3 x x x x x SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 21 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. 1. 2. Standard 19 33 Regulation 23 24 Requirement Windows must be fitted with effective restricting devices. The quality assurance system must be developed to inform an accessible annual development plan for the home. Timescale for action 25 July 2005 3 October 2005 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 Good Practice Recommendations SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 22 Commission for Social Care Inspection Turton Suite, Paragon Business Park Chorley New Road Horwich Bolton BL6 6HG 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 SOUTHLANDS v216979 f56 f06 s8464 southlands v216979 190505 stage 4.doc Version 1.30 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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