Inspection on 26/02/09 for Southlawns

This inspection was carried out on 26th February 2009.

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

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Southlawns 23/01/07

Southlawns 12/01/06

Southlawns 01/09/05

Southlawns 26/01/05

Southlawns 20/08/04

Southlawns 26/03/04

Similar services:

Fairfields Country Rest Home

Poldhu

Queensmount

Trevaylor Manor

Didsbury Court Rest Home

Belma

Hunters Care Centre

Manor Lodge

Extracts from inspection reports are licensed from CQC, this page was updated on 19/06/2009.

Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southlawns Highfield Road Street Somerset BA16 0JJ     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: Jane Poole     Date: 2 6 0 2 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 27 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 27 Information about the care home Name of care home: Address: Southlawns Highfield Road Street Somerset BA16 0JJ 01458443635 01458448860 vera.fellows@somersetcare.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Somerset Care Limited care home 40 Number of places (if applicable): Under 65 Over 65 40 old age, not falling within any other category Additional conditions: Date of last inspection Brief description of the care home 0 Southlawns is a care home providing up to 40 places for older people. It is owned by Somerset Care Ltd and the registered manager is Vera Fellows. The home is based in a residential area in Street, close to the High Street where there are shops and other amenities. The home is on two floors and the first floor is accessible by a through-floor lift. All bedrooms are single, with either en-suite facilities or with wash hand basins. Current fees (26/02/09) at the home range from 390 pounds to 480 pounds per week. Care Homes for Older People Page 4 of 27 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: The quality rating for this service is 2 star. This means the people who use this service experience Good quality outcomes. The focus of this inspection visit was to inspect relevant key standards under the Commissions Inspecting for Better Lives 2 framework. This focuses on outcomes for service users and measures the quality of the service under four general headings. These are:- excellent, good, adequate and poor. This inspection was carried out by one inspector over a one day period. During this time we, The Commission, were able to talk with people living and working at the home, observe care practices, view records and tour the building. Care Homes for Older People Page 5 of 27 Before the inspection the manager completed an Annual Quality Assurance Assessment (AQAA) which gave details about the home, their achievements in the last year and plans for the future. The manager and deputy were available throughout the inspection and all records requested were made available. The following is a brief summary of the inspection findings and should be read in conjunction with the whole of the report What the care home does well: What has improved since the last inspection? What they could do better: The home have moved to a computerised care planning system. All had been personalised to ensure that people receive care in their chosen manner but some would benefit from more detail. This would ensure that staff have clear guidelines and are Care Homes for Older People Page 7 of 27 able to monitor and evaluate care plans. Currently prescribed creams and lotions are recorded in more than one place meaning that it is difficult to tell who administered them. Clearer recording would reduce duplication and make it easier to assess effectiveness. The system for recording personal monies also needs to be clearer. To ensure that people living at the home are fully protected there needs to be a clear audit trail of all money coming in and all money passed to the individual. 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 240 7535. Care Homes for Older People Page 8 of 27 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 27 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People wishing to move to Southlawns receive adequate information about the home and have their needs assessed by a senior member of staff. Evidence: The home has an up to date statement of purpose and service user guide. There is also a colour brochure about the home and the company. Anyone wishing to move into the home has their needs assessed by a senior member of staff, to ensure that Southlawns is the right place for them, before a place is offered. On the day of the inspection the manager was going out to assess a person in hospital who wanted to move into the home. People asked said that they had received adequate information about the home to enable them to make a decision about moving in. The contract states that the first 12 Care Homes for Older People Page 10 of 27 Evidence: weeks of any stay is considered an assessment period to ensure that people have made the right decision. In addition to full residential care the home offers day care and respite care which enables people to spend extended periods of time at Southlawns to ensure that it meets their expectations. Many people spoken with during the inspection said that they had originally come to the home for day care or for a respite break and then decided to move in. The home has two Step up Step down intermediate care beds which are used to offer a period of rehabilitation, after a hospital stay, before people return to their own homes in the community. People staying in these beds receive all care from the home and input from visiting professionals such as occupational therapists and physiotherapists. Care Homes for Older People Page 11 of 27 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living at the home are treated with dignity and privacy is respected. Care plans are personal to the individual but in some cases would benefit from further detail to promote well being. People living at the home have access to healthcare professionals according to their individual need. Evidence: Since the last inspection the home has moved to a computerised care planning system. A sample of three care plans was viewed, all had been personalised to the individual giving guidelines about their specific needs and wishes. Details of personal preferences were recorded to ensure that people continued to receive care and support in their chosen manner. In two of the care plans seen some elements lacked detail about how staff could best Care Homes for Older People Page 12 of 27 Evidence: assist people and how their specific needs should be monitored. This was discussed during the inspection and adjustments were made to one of the care plans at the time. Assessments are carried out in respect of physical healthcare. These include nutrition, skin care and moving and handling. All assessments seen were up to date and gave details of equipment and care required to minimise risks. The management gave assurances that care plans can be printed out for anyone who wishes to view their plan. Staff spoken with said that they discuss care plans with people living at the home to ensure that any changes made are in line with their wishes. All appointments with healthcare professionals are recorded and these show that people have regular access to GPs, district nurses, chiropodists and other professionals according to their individual needs. People living at the home said that they are able to see visiting professionals in private but staff are happy to support them if they request this. There is a small consulting room at the home meaning that people living there do not have to invite professionals to their personal rooms if they do not wish to. One visiting healthcare professional was spoken with. They stated that the home were always welcoming and shared information appropriately. They confirmed that they were always able to see people in private. Everyone asked felt that their privacy was respected. It was observed that staff offered assistance to people in a manner that was respectful and maintained their dignity. Many people living at the home have personal phones and there is a pay phone in a quiet area to ensure that people are able to make personal calls in private. One person said staff are nice and polite. The home uses a monitored dosage system for medication and only senior staff, who have received specific training, administer medication. The Medication Administration Records (MARs) were viewed and it was noted that all medicines are signed for when received into the home and when administered or refused, this gives a clear audit trail. Prescribed creams and lotions are usually administered by care staff who sign a separate sheet. The senior member of staff on duty then signs the MAR leading to confusion about who administered the prescription. In some cases MARs and cream application records did not tally with each other making it difficult to monitor their effectiveness. There is appropriate storage for medication including controlled drugs and medicines that require refrigeration. The home carries out regular audits of medication administration to ensure that records are well maintained and practices in the home remain safe. Care Homes for Older People Page 13 of 27 Care Homes for Older People Page 14 of 27 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a variety of food on offer to suit all tastes. The main meal of the day is a sociable and relaxed occasion. There is a range of organised activities that people can join in with if they wish to. Visitors are welcomed into the home at anytime. Evidence: People living at the home are able to choose what time they get up, when they go to bed and how they spend their day. One person said I am able to do what I like and am still in control of my life. Another person said I can please myself, it feels like home. There is a dedicated activities worker and organised activities every day for those who wish to join in. People said that there was no pressure to join in with group activities. The activity worker also offers one to one sessions for those who prefer. Forthcoming activities are published in the home to enable people to organise their time and choose what they would like to join in with. Care Homes for Older People Page 15 of 27 Evidence: Many people spoken with said that they enjoyed their own company and liked to occupy themselves. On the day of the inspection people were knitting, reading, watching TV and completing jigsaw puzzles. Some people went out with friends and family. People said that they were able to have visitors at anytime and that visitors were always made welcome. It was observed that people were able to see their visitors in their personal rooms. Since the last inspection the home has installed a computer giving people access to the internet and various games. One person was seen using the computer during the day. A gardening club has also been set up and raised beds are in place to enable people with all levels of ability to take part in gardening. Last year the club grew vegetables that were eaten in the home. The Annual Quality Assurance Assessment (AQAA) states that a plan for the coming year is to expand the range of fruit and vegetables grown. One of the local churches visits each month to offer Holy Communion and two people spoken with said that they went out to local churches each week. The home uses the companys corporate menu that has been designed to ensure that a wide variety of nutritionally balanced meals are offered. Everyone asked stated that the food in the home was good and that there was always a choice of meals. We were invited to have lunch with people living at the home. The food was well presented and the atmosphere was relaxed. It was observed that people who did not wish to have lunch in the main dining room were served in the lounge. Lunch was a sociable occasion, one new person was escorted to a table and introduced to the other people at the table. Some staff sat with people living at the home to eat their lunch and the manager said that this in encouraged. Some people who choose to spend the day in the privacy of their rooms said that they liked to go to the dining room for lunch as it was nice and sociable. Care Homes for Older People Page 16 of 27 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living and working at the home are comfortable to discuss any concerns and are confident that action would be taken to address any issues raised. Evidence: The home has policies and procedures in respect of making a complaint, recognising and reporting abuse and whistle blowing. One complaint has been received in the last 12 months. There is evidence in the home to demonstrate that the complaint was fully investigated in line with agreed timescales. People living at the home said that they knew how to make a complaint and would be comfortable to raise any concerns or worries with a member of staff. One person said If Im not happy I say so, Other people said that they would either raise concerns with a member of staff or take their issue to the residents meeting. Staff stated that they had received training in recognising and reporting abuse and had all received a leaflet outlining the whistle blowing policy. All said that they felt able to talk about any concerns with the management in the home and were confident that any issues raised would be addressed. Care Homes for Older People Page 17 of 27 Evidence: There is evidence of a robust recruitment procedure that minimises the risks of abuse to people who live at the home. Care Homes for Older People Page 18 of 27 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Southlawns provides a comfortable environment for the people who live there. Standards of cleanliness are good. The newly developed garden provides a safe and pleasant outside space for people to use and enjoy. Evidence: Southlawns is a purpose built home built some years ago. It is within walking distance of the town centre of Street. All areas are fitted with a fire detection and call bell system. Accommodation is arranged over two floors with a passenger lift between. At the time of the inspection all radiators in the home were being replaced with cool wall adjustable radiators to allow people to control the temperature of each room. The work was being managed to ensure minimum disruption to the people living at the home. Some areas of the home would benefit from redecoration and works are planned for Care Homes for Older People Page 19 of 27 Evidence: when the plumbing work has been completed. All bedrooms in the home are for single occupancy and rooms seen had been personalised to reflect the tastes and needs of the individual occupant. People spoken with were happy with their rooms. There is a range of communal areas where people can socialise. There is large lounge and dining room and various small lounges located on both floors. Since the last inspection the back garden has been redesigned and now provides a very pleasant area with seating, a greenhouse and raised beds. Many people commented on how nice it was to spend time outside on warmer days. There is a laundry which is well equipped and appropriate to the needs of the home. All areas seen on the day of the inspection were warm, clean and fresh. People living at the home said that the home was always clean and praised the domestic staff. At a recent environmental health inspection the home was awarded 5 stars (excellent). Care Homes for Older People Page 20 of 27 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Robust recruitment procedures minimise the risks of abuse to people who live at the home. Staff in the home receive good ongoing training and are well motivated. Evidence: The home employs 27 permanent care staff, 20 (74 ) have a National Vocational Qualification in care at level 2 or above. In addition to care staff the home employs 11 ancillary staff such as cooks and care support workers. Staff observed, and spoken with, on the day of the inspection were well motivated and cheerful. Staff appeared confident in their roles and had a commitment to providing a quality service to the people living at the home. Staff spoken with said that there was good communication between staff and a good sense of teamwork. All staff receive a thorough induction when they begin work and there are good opportunities for ongoing training. Staff spoken with were very positive about the training opportunities and said that they received regular supervision where they were able to request specific training. Records of induction and training were seen in personal files. These showed that staff receive training in all health and safety matters Care Homes for Older People Page 21 of 27 Evidence: and training specific to the needs of the people living at the home. Everyone felt that there were usually enough staff on duty. People living at the home said that call bells were answered quickly and this was observed during the inspection. One person said If I need help, its there, they are always quick to help. Many people complimented the staff on their skills and attitude. People said that staff were excellent, staff are kind and look after you, and staff are always polite and happy to help. The recruitment files of three recently appointed members of staff were viewed. These gave evidence of a robust recruitment procedure which includes obtaining written references and undertaking appropriate checks against the Protection Of Vulnerable Adults (POVA) register and Criminal Records Bureau (CRB). The home currently has two vacancies for care staff and two for ancillary workers. One person living at the home was involved in recent interviews for new staff. Other people living at the home said that they too would like to be involved in the selection of new staff. Care Homes for Older People Page 22 of 27 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is effectively managed by people who have appropriate skills and experience. To ensure that safe systems are in place the records relating to personal monies need to be reviewed. There are systems in place to monitor the quality of care and seek the views of interested parties. Evidence: The registered manager in the home is Vera Fellows, there is also a full time deputy manager. Both hold appropriate qualifications and have many years experience of working with older people. There is a clear staffing structure in the home ensuring that lines of responsibility and Care Homes for Older People Page 23 of 27 Evidence: accountability are clear. Either the manager of deputy is always on call. Everyone asked felt that the management in the home was open and approachable. One member of staff said you can go to the manager at anytime and she is always ready to listen. If theres anything you dont understand you can always ask. All staff receive formal recorded supervision and the management work alongside staff to offer support and guidance to less experienced staff. The manager stated that this is also a way of monitoring the quality of care in the home. In addition to the informal monitoring of quality there are formal quality assurance procedures which include regular audits and surveys to interested parties. Completed questionnaires showed a high level of satisfaction with the service provided. They also demonstrated how any issues raised had been addressed. There are regular meetings for people living and working at the home, people said that these were an opportunity to share ideas and opinions as well as information. The area manager visits the home on a regular basis and written reports of these visits were seen. The manager stated that they do not act as a financial appointee or power of attorney. They do collect financial benefits for 4 people and hold personal allowance for a significant number of people. Records of personal finance were viewed and found to be confusing, with monies recorded in more than one place for some people. A sample of monies was checked and these monies correlated with amounts written on records but it was unclear how the records had been calculated and where the money had come from. Assurances were given that personal monies are audited on an annual basis by someone independent of the home. Systems are in place to ensure the health and safety of people who live and work at the home. The building is well maintained and equipment is regularly serviced and tested. Staff receive regular training in health and safety to ensure that practices in the home are kept up to date. Certificates of insurance and registration are displayed in the home. Care Homes for Older People Page 24 of 27 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 25 of 27 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 35 17 (2) Schedule 4 (9) The 31/03/2009 registered person must review the recording procedures and practices for personal monies received and kept in the home. To ensure that clear records are maintained that minimise the risks to people living at the home. Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 7 The manager should ensure that care plans are sufficiently detailed to give clear instructions to staff and ensure that their effectiveness can be monitored. The manager should review the recording procedures for prescribed creams and lotions to ensure that it is clear who administered. 2 9 Care Homes for Older People Page 26 of 27 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. 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. Care Homes for Older People Page 27 of 27 - 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!