Inspection on 05/10/06 for Southwood House

This inspection was carried out on 5th October 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.

Other inspections for this house

Similar services:

St Marys Nursing Home

Thornham Grove

Chater Lodge

Conifer Lodge

Tixover Care Home

Toynton College (Cluster Five)

Egerton Lodge Care Home

Cedar Court Nursing and Residential Home

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

CARE HOME ADULTS 18-65 Southwood House Southwood House 44 - 45 Doddington Road Wellingborough Northamptonshire NN8 2JH Lead Inspector Judith Roan Unannounced Inspection 5th October 2006 10:30 Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 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 Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 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. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southwood House Address Southwood House 44 - 45 Doddington Road Wellingborough Northamptonshire NN8 2JH 01933 276473 01933 226969 welshth@sanctuary-housing.co.uk www.sanctuary-care.co.uk Sanctuary Care Ltd 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) Mrs Patricia Ann Garley Care Home 15 Category(ies) of Physical disability (15) registration, with number of places Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection Newly Registered Service Brief Description of the Service: Sanctuary Care bought Southwood House in April 2006 from Ashley Homes. The home provides accommodation in single and shared flats in which service users have access to a lounge, kitchen, bedroom and adapted bathrooms. The building also provides communal areas and a central kitchen that prepares a mid-day meal. The home is situated near to the town centre of Wellingborough with easy access for wheelchair users to local facilities. Fees are calculated to meet the individual needs of each service and vary depending on complexity. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The focus of inspections undertaken by the Commission for Social Care Inspection (CSCI) is upon outcomes for service users and their views of the service provided. This process considers the home’s capacity to meet regulatory requirements, minimum standards of practice; and focuses on aspects of service provisions that need further development. The primary method of inspection used was ‘case tracking’ which involved selecting three service users and tracking the care they receive through review of their records, discussion with them, the care staff and observation of care practices. The Inspector also received questionnaires completed by seven service users and a volunteer that has contact with the home. The questionnaires seek to ascertain the satisfaction of service users, relatives/visitors and professionals as to the standard of care and service provided. All questionnaires provided good feedback of the quality of personal care and gave suggestions on how they would like more social opportunities within the home. The home’s registered manager also completed a pre-inspection questionnaire. What the service does well: What has improved since the last inspection? This is a new registration of the home under new owners. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 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. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 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 Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 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): 1,2,3,4,5 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The admission process ensures that needs are assessed and that service users are fully involved within the process. EVIDENCE: The assessment process begins with contact to the service by a care manager or specialist worker to discuss the needs of a service user and whether the service may be appropriate in meeting their needs. Information is initially through a comprehensive assessment form completed by the referring professional in discussion with the service user. An initial visit is then planned at which time further information is gathered to inform the assessment. The service users’ views are central within the assessment process and ensure that the service can meet their identified needs. Service users can visit the service prior to admission. At the end of the first four weeks a review is undertaken to discuss whether the placement has met the service users’ needs, and that they are happy within the home. All service users are asked to sign a tenancy agreement, that sets out the terms and conditions of their stay within the home. The agreement with service users sets out expectations for the service users and the service to be provided. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 9 In discussion with service users during the inspection it was confirmed that the admission process was informative and inclusive. Service users are given good information about the service at Southwood through the Service Users’ Guide. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 10 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): 6,7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users can expect that practices within the home promote their involvement, self-determination and independence. EVIDENCE: Service users and their carers jointly develop support plans. Service users have a key worker that supports them with individual activities. The amount of time is individually negotiated with each service user dependent on their assessment. There is considerable diversity in how needs are met which cause unbalanced opportunities for service users with less 1-1 hours. Case files demonstrated that risks assessments are comprehensive. Any risks that are identified on the initial assessment and in ongoing reviews are recorded with strategies to minimise risks to service users. Regular review meetings are programmed monthly with carers, and at least once a year with service users and members of their support network. Reviews are always undertaken when needs change. The network of support available to service users enables them to be fully involved with decisions made. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 11 Self-determination is an integral part of the service provided by Southwood House that service users value. Service users are fully aware that personal information is shared on a need to know basis. Records held in the home are securely kept in locked files and room. Carers work throughout the twenty-four hours with waking night staff available to attend to service users’ personal care needs. Case records set out clearly the goals and needs of service users and state how these are supported. The inspector can confirm that any specific requirements relating to personal care is clearly stated. All new carers shadow experienced carers until they are confident in carrying out specific tasks. Agency carers are also well briefed before providing support for service users. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 12 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): 11,12,13,14,15,16,17 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Opportunities for social and community involvement are not provided equally within the service user group. Care practices within the home ensure that service users have choice of meals and are provided with varied and balanced diet. EVIDENCE: Service users are individually supported to access a range of activities within the community. Some attend local colleges and day services while others choose to spend their time within the home listening to music, reading, using their computers or watching TV. There is a limited centrally organised activity programme within the home that service users would like to see increased. One service user said they were ‘bored’ another said that there is less to do at weekends than in the week and that ‘there is never enough staff to do the choice of activity’. It is clear from some of the questionnaires completed by service users that this is an area that requires development. There was a trend, from comments made, that there is insufficient time for some service users to access the Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 13 community. However, some service users said they were very happy and had adequate 1-1 support and that said that ‘the service is brilliant’ Service users do determine their own social activities. This is dependent on the amount of 1-1 hours that are funded. There is wide difference in the amounts of time agreed. Service users are encouraged to be actively involved within community and visitors are welcome. An issue early in the year when thieves targeted the home has been resolved by an increase in the security arrangements at the home. Arrangements still enable freedom of movement by service users to access the community. A lack of access to vehicles despite a monthly contribution to use vehicles also adds to the dissatisfaction expressed by some service users and their supporters. Service users appear to be unsure what rights their contributions give in relation to the use of the home’s vehicles. The weekly menu seen by the Inspector demonstrated that the diet was healthy and balanced. Service users purchase their own food for breakfast and tea, so have total control and choice of what to eat. The main meal at lunchtime offers choice and meets the needs of those service users with special diets. Service users who require specialist equipment to be independent with eating and drinking are well supported with good access to therapists and adapted equipment. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 14 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): 18,19,20,21 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users’ physical and emotional health needs are met. However, medications systems within the home are not sufficiently robust to fully protect service users. EVIDENCE: All service users resident at the home need high levels of physical support with personal care. A trained staff team ensures that service users are well supported in meeting their physical and mental well being. On admission service users register with a local General Practitioner for any continuing medical needs. Service users are supported to attend appointments with specialist at the hospital. A review of medication was undertaken during the inspection that confirmed administration was not fully in line with the Royal Pharmaceutical Guidelines in relation to recording. The recording of medication used was not within a monitored dosage system which failed to identify when a new packet was started. It did not indicate whether the service user had been offered the medication and had refused as not being needed. This made it difficult to track the amount of medication that was presently in stock. In discussion with the registered manager it was agreed that the present system would be reviewed. Service users were not at risk and all confirmed that they received their Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 15 medication as prescribed. Service users medication is kept within their flats and safely stored within a locked cupboard. Service users have excellent access to therapist who support to use specialist equipment that aids their independence. One service told the inspector that they travel unsupported within the local area and can access public transport that meets the needs of service users in wheelchairs. They feel safe in the knowledge that they have good support from the staff at the home if they have difficulties. Staff confirmed that there is a system to support service users when their wheelchair has malfunctioned to collect them immediately. An adapted vehicle is available to aid service users to access community activities. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 16 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): 22,23 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. Service users are listened to when they have a concern and protected by abuse awareness policies and practices within the home. EVIDENCE: Some service users confirmed that that were aware of the homes complaints procedure others were unsure; all said they would feel comfortable in expressing any concern. A copy of the procedure can be found in the Service Users’ Guide, this is available to all service users. Staff members are fully aware of the vulnerable adult procedures and are able to take positive action to protect others. In discussion with staff the Inspector was told that they would always report any concern to the Registered Manager or senior on duty. The Registered Manager and staff team have successfully supported a service user that was unhappy at the home to return to their home area to be nearer their family. At present another service user who is not totally satisfied with their support is being supported to gain more key worker time and to look at independent accommodation. The home has a comprehensive whistle blowing policy that carers are issued as part of their induction programme. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 17 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): 24,25,26,27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. A well maintained home ensures that service users live in a safe and comfortable environment. EVIDENCE: In touring the home the inspector noted that the home was overall well maintained and kept clean by a dedicated house keeping team. However, one service user said that there is an issue at weekends and that the level of service is not as good as on weekdays. Service users are accommodated in either single or double occupancy flats. Each flat has a separate lounge kitchen and bathroom. All flats are fitted with specialist bathing equipment to meet the needs and preferences of individuals. All equipment is maintained to a high safety standard. The organisation has completed all the required safety checks for the building and keeps good records of these activities. Service users agreed that the home felt relaxed and provided comfortable communal areas where they could meet for activities. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 18 Service users have personalised their own rooms and are maintained according to the tenancy agreement. On meeting with one service user, during the inspection, it was noted that new flooring of their choice had been supplied to meet their needs. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 19 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): 31,32,33,34,35,36 Quality in this outcome area is adequate. This judgement has been made using available evidence including a visit to the service. The trained, competent and supported staff team ensure that the service is professional and meets identified service user needs. EVIDENCE: The staff team is well established and knowledgeable about the needs of service users. There are vacancies within the staff team and this does impact on the delivery of care to service users as agency carers are used. Service users spoken with (and from comments from surveys received) all disliked having changes and said that at times this affected the quality of the service. Robust recruitment procedures ensure that all relevant checks are undertaken prior to carers commencing their employment. Carer’s files are kept in secure cabinets within the office. Carers receive supervision on a regular basis and records are kept. Copies of the supervisions are available if requested and all records are signed. All carers have job descriptions that are issued as part of their contract of employment. The home’s policies and procedures ensures that all service users are protected. A comprehensive induction programme ensures that all carers understand the homes’policies and procedures. The new owners have been working on the introduction of policies and procedures. Carers confirmed that they had been Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 20 supported to read the new policies and procedures as they are introduced. In the interim period the policies and procedures from the previous owners have been used. This has been agreed through discussion with the provider relationship manager of CSCI to ensure a smooth transition. Training is a high priority for the staff team with the registered manager continuing to identify training needs within regular supervisions. The carers spoken with had all undertaken National Vocational Qualifications (NVQ). The new induction programme introduced by the new owners prepares new staff to move onto the NVQ course on its completion. A record of training is kept within the home for all staff. The high level of physical intervention required by the service users at the home necessitates carers having to attend specialist training to meet their ongoing needs. The Registered Manager and the staff team keep abreast of current training and development of practice within their specialist field of work to ensure the safety of the service users. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 21 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): 37,38,39,40,41,42,43 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to the service. The home is effectively managed and ensures that service users receive a quality service where their views are respected and their safety is safeguarded. EVIDENCE: The Registered Manager ensures that she is fully informed about what is happening within the home by meeting with service users and staff on a regular basis. The Registered Manager is well supported within the organisation by regular visits to the home, and the completion of a report that is sent to the CSCI by their line manager. Reports have been received on a monthly basis from Sanctuary Care with additional notifications being sent as required. The registered manager has demonstrated that she is fully aware of their responsibility under registration. Sanctuary Care is to introduce their own quality assurance system later this year at which time service users, staff and others will be asked to give their views about the service. The registered manager is currently working with the Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 22 findings from the previous review that was shared with the new owners and is being used as a basis to move forward. A full set of policies and procedures are held within the administrative office at the home. These are being reviewed and integrated with those of the new owners as part of the transition. Carers are signing to confirm that they have read the new policies as they are introduced. During the inspection the inspector was able to confirm that all health and safety checks had been completed and were up to date to ensure the safety of staff and service users. Service users finances are in the main self-managed. Support is available for service users, as required, within a robust system to protect service users interests. Records are generally well maintained in the home and are protected using the Data Protection guidelines. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 23 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 3 2 3 3 3 4 3 5 3 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 4 23 4 ENVIRONMENT Standard No Score 24 3 25 3 26 3 27 3 28 3 29 3 30 3 STAFFING Standard No Score 31 3 32 3 33 3 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 4 3 3 3 3 LIFESTYLES Standard No Score 11 3 12 2 13 2 14 3 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 2 3 3 3 3 3 3 3 3 Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 24 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. 2. 3. Refer to Standard YA12 YA13 YA20 Good Practice Recommendations That service users have equal access to a range of activities within the home and community. The contribution made by service users to access vehicles is equitable and fair. The medication recording needs to follow Royal Pharmaceutical Societies guidelines to account for the administration of individual medication. Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 25 Commission for Social Care Inspection Northamptonshire Area Office 1st Floor Newland House Campbell Square Northampton NN1 3EB National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Southwood House DS0000067510.V314053.R01.S.doc Version 5.2 Page 26 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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