Care Home: Southerndown Nursing Home

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What the care home does well Prospective service users and their representatives are encouraged to visit the home, before making a decision to move in for a trial period. The healthcare needs of service users are fully met. Care plans are person centred and are agreed with the service user or representative, as appropriate. Service users are encouraged to to make choices and to remain as independent for as long as possible. Service users and their representatives can be confident that any concerns or complaints would be taken seriously, listened to and acted upon. What has improved since the last inspection? Care planning and risk assessment documentation are maintained to a high standard. The recruitment of a manager and deputy manager. The requirement made at the last inspection regarding medication recording has been complied with. Service users, their representatives and staff can now looking forward to a period of consolidation and the home being able to move forward. What the care home could do better: From records seen and discussion with staff, it was not clear that all staff are receiving formal supervision at least six times per year. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southerndown Nursing Home Worcester Road Chipping Norton Oxfordshire OX7 5YF     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: Marie Carvell     Date: 1 6 0 3 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.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Southerndown Nursing Home Worcester Road Chipping Norton Oxfordshire OX7 5YF 01608644129 01608641737 southerndown@barchester.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Barchester Healthcare Plc Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 87 Number of places (if applicable): Under 65 Over 65 0 0 87 dementia mental disorder, excluding learning disability or dementia old age, not falling within any other category Additional conditions: 87 87 0 1 The registered person may provide the following category/ies of service only: Care home with nursing - (N) to service users of the following gender: Either Whose primary care needs on admission to the home are within the following categories: Dementia (DE) Learning disability (LD). Mental disorder, excluding learning disability or dementia (MD). Old age, not falling within any other category (OP). Dementia (DE) Physical disability (PD) 2 The maximum number of service users to be accommodated is Date of last inspection Brief description of the care home Southerndown Nursing Home consists of two units providing a total of 87 beds for residents aged 60 and over. There are 45 beds in the original house for people who are Care Homes for Older People Page 4 of 25 Brief description of the care home physically frail. An extension (Memory Lane) was completed in 2002 to provide a further 42 beds for residents with mental health needs, generally dementia. The two units are linked by a covered walkway. Registered nurses are on duty 24 hours a day and are assisted by a team of carers and ancillary staff. Spacious lounges and dining rooms are provided on both units and there are extensive grounds surrounding the home. There is a secure area of garden at the back of the main house with fencing and a locked gate, and a secure courtyard garden on Memory Lane. The main house has a mix of single and double rooms, with Memory Lane having only single bedrooms. En-suite facilities are provided in some bedrooms in the main house and in all bedrooms on Memory Lane. Recreational activities are provided on both units and the home has transport that can be used for outings. The fees for this service range from 775.00 pounds per week to 1170.00 pounds per week. There are additional charges for hairdressing, chiropody (none diabetic service users), newspapers, toiletries and some outings. Care Homes for Older People Page 5 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: The last inspection of this service was completed in March 2008. This inspection of the service was an unannounced Key Inspection. We arrived at the service at 9.50 am and was in the service until 5.35 pm. It was a thorough look at how well the service is doing. It took into account detailed information provided by the then manager in November 2008 and any other information that we have received about the service since the last inspection. We looked at how well the service was meeting the standards set by the government and have in this report made judgements about the standards of the service. We toured the premises, examined a sample of records required to be kept in the home, including the case tracking of a sample of service user files and spent time talking to Care Homes for Older People Page 6 of 25 service users individually and in groups. We spent time with the senior administrator and staff on duty. We also spent time talking to the the regulation manager, who visited the home during the inspection and the regional operations manager by phone. In addition we spent time observing how care was being delivered to service users and joined service users for the midday meal in the communal dining room. At the last inspection one requirement was made that all medication administered must be recorded on the service users medication administration record, and that staff must use the appropriate code letter to indicate the reason for omitting a prescribed medication dose. 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.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 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. Service users and their representatives are provided with sufficient information about the home prior to admission to be able to make an informed choice as to whether the home can meet their needs. All service users are provided with a detailed contract/ terms and condition of residency once a decision is made to stay permanently. All prospective service users are assessed prior to admission to ensure that the home can meet their care needs. Evidence: Prospective service users and their representatives are provided with a copy of the Care Homes for Older People Page 10 of 25 Evidence: homes brochure and service user guide, this contains a copy of the last inspection report. All service users receive a detailed contract /terms and conditions of residency, which includes details of the fees payable and any additional costs, once their placement has become permanent. A senior member of staff then undertakes a pre admission assessment to ensure that the home is able to meet the needs of the service user. Prospective service users and their representatives are encouraged to visit the home, before making a decision to move in on a trial period. All service users are admitted for a trial period of four to six weeks, followed by a review, before a decision is made to make the placement permanent. 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. Care plans and risk assessments are maintained to a high standard. The healthcare needs of service users are fully met. Service users feel that staff treat them with respect and their right to privacy is upheld. Evidence: Service users files are well organised. Since the last inspection all care planning documentation has been revised and are now maintained to a high standard. Care plans are person centred and are agreed with the service user or representative, as appropriate. All service users have a named nurse and key worker. Each care plan includes comprehensive risk assessments, which are reviewed regularly. The healthcare needs of service users are met by two local GP practices, who visit the home weekly and as required. A range of healthcare professionals visit the home on a Care Homes for Older People Page 12 of 25 Evidence: regular basis. From discussion with service users, nursing, care staff and examination of service user records, the healthcare needs of service users are fully met. Time was spent with service users in private and communal areas. Service users were mostly satisfied with the level of care provided. Staff were observed to interact with service users in a respectful and professional manner. All service users spoken to, felt that staff treated them with respect and their right to privacy is upheld. At the last inspection a requirement was made that medication administered must be recorded on the medication administered record and that staff must use appropriate codes to indicate the reason for omitting a prescribed medication dose. This has been complied with. From discussion with a head of unit, nursing staff and examination of the storage, administration and recording of medication administered, all were found to be well maintained. A recent pharmacist visit was satisfied with all medication practices in the home. As in many other care homes, there is a wide range of racial, ethnic and faith backgrounds represented within the staff group compared with the current service users. From discussion with the nursing and care staff, we consider that the home is able to provide a service to meet the needs of individual service users of various religious, racial or cultural needs. However, there are indications that service users sometimes find that staff cannot communicate effectively because English is not their first language. This was raised as a concern by several service users and it is understood that this is being addressed by the company, who are organising English lessons. 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. Service users are encouraged to make choices and to remain as independent for as long as possible. There are a wide range of activities arranged to meet the social needs of service users. A varied, wholesome and nutritious diet is provided to service users. Evidence: There are two enthusiastic activities organisers in post, both work full time. Activities are well publicised throughout the home, with a weekly Whats on and a monthly Events and Social Diary. Activities undertaken are recorded on a daily activities record which validates the information recorded in service user care plans. A monthly review of activities and evaluation sheet is completed by one of the activities organisers, records are well maintained. Various one to one and small group activities were observed during our visit. Service user meetings take place, these are chaired by the activity organiser for that unit. Many of the service users have friends and family who visit regularly. Service users Care Homes for Older People Page 14 of 25 Evidence: are encouraged to maintain links with community groups and clubs. Religious ministers visit the home and services are held. Arrangements can be made for service users to attend local places of worship, if requested. Information about spiritual needs are recorded in service user files. Service users confirmed that usually routines in the home are flexible and that they are able to spend their days as they choose. We joined service users for lunch in the communal dining room. The menus was displayed and service users expressed their satisfaction of the high standard of catering in the home and the choice of meals provided. Menus demonstrated that service users are offered a varied,wholesome and nutritious diet. The meal was delicious, hot and attractively served by the chef. Several service users enjoyed a glass of wine with their meal and confirmed that this was the usual practice. Staff were observed to be attentive and to assist service users in a discreet and dignified manner. 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. Service users and their representatives can be confident that any concerns or complaints would be taken seriously, listened to and acted upon. Policies and procedures are in place to protect service users from possible abuse. Evidence: The homes complaints procedure is displayed in the entrance hall and a copy is provided to service users in the service user guide. Since the last inspection twenty two complaints have been received by the home either verbally or in writing. Recording of complaints are clear and detailed, stating action taken and outcome. Regular auditing of complaints takes place by a senior representative of the company. Service users spoken to were clear about the procedure for reporting complaints or concerns. Comments included Id speak to my family for them to deal with, I would speak to X ( one of the activities organisers), she would know what to do, The office staff are helpful and would deal with any concerns that I had, Never needed to complain, Most of the staff would help if I had a complaint or if I was worried about something. In the last twelve months we have not received any information regarding complaints about this service. Care Homes for Older People Page 16 of 25 Evidence: All staff receive training in the homes policies and procedures in protecting service users from possible abuse, including whistle blowing procedures. This was confirmed by staff on duty and evidenced in training records. One safeguarding adult referral and investigation has taken place in the last twelve months. No referrals have been made for inclusion on the Protection of Vulnerable Adults list (POVA). The home has a copy of the Oxfordshire safeguarding adults procedures and senior and nursing staff were familiar with the process for reporting safeguarding concerns. Care Homes for Older People Page 17 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. The home provides safe, well maintained and comfortable accommodation. The layout and location of the building is suitable for its stated purpose. Service users expressed their satisfaction of the premises and facilities available. Evidence: The location and layout of the building is suitable for its stated purpose. Service users expressed their satisfaction of being able to personalise their bedrooms, the communal areas of the home, the facilities available and the garden. The home is well maintained and there is an ongoing programme of refurbishment and redecoration, including a rolling bedroom carpet replacement. Some corridors have been redecorated and carpets replace. The housekeeping staff work hard to ensure that the home is clean, pleasant and free from unpleasant 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. Staffing levels are adequate to meet the needs of the service users. Staff recruitment procedures are robust and protect service users from possible harm. Staff are well trained and able to carry out their duties with confidence. Evidence: From discussion with the nursing, care staff and examination of duty rosters, staffing levels appear to be adequate to meet the needs of the service users. In the last year twenty eight care/nursing staff have resigned for a variety of reasons, including transfers to other Barchester care homes, career moves, returned to home country or work permits expiring. Exit interviews take place, when possible. The home currently has vacancies for ten full time care assistants and a full time registered nurse. All staff complete a detailed induction programme that meets Skills for Care standards and care staff are encouraged to undertake National Vocational Qualification ( NVQ) training at level II. We were advised that twenty three of the thirty eight permanent care staff have completed NVQ level II. The home has robust recruitment procedures in place. Two members of staff conduct Care Homes for Older People Page 19 of 25 Evidence: all interviews and this is recorded, written references and police checks are completed before the member of staff of staff is employed in the home or attends induction training. The home has a training and development programme in place. All staff complete mandatory training and undertake specialist training as appropriate. Nursing staff are assisted with their continuous professional development. Staff were observed to be courteous, patient and professional in their approach to service users throughout the inspection. 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. The home is being run in the best interests of the service users and service users benefit from a well managed home. Service users, staff and service user representatives are now looking forward to a period of consolidation and the home being able to move forward. Evidence: The previously registered manager resigned in January 2009 and the deputy manager post has been vacant since March 2008. The person now managing the home was appointed in March 2009 and until March 2008 had been the homes deputy manager. She is a well qualified and experienced manager and nurse. It is understood that an application for registration is to be submitted shortly. In discussion with staff on duty, her return to manage the home is welcomed. Unfortunately she was on annual leave on the day of this inspection. A deputy manager has now been appointed and her first day in post coincided with the inspection. Both the manager and deputy manager Care Homes for Older People Page 21 of 25 Evidence: posts are supernumerary to the homes staffing levels. In discussion with staff on duty, several said that the new manager was making several changes to the running of the home and this was seen positively and that morale in the home was good. Staff and service users felt that the home was being well run and in the best interests of the service users. Procedures are in place for dealing with service users monies and valuables , financial records are well maintained and any expenditure is receipted. All staff with supervisory responsibility have received supervisory training. Following the inspection in March 2008, we received a written action plan detailing action to be taken to develop formal staff supervision. From records seen and discussion with staff on duty, it is not clear that all staff are receiving formal supervision at least six times per year. Communication systems in the home are well organised with regular meetings taking place for all grades of staff. Meetings are well attended and are minuted. Policies and procedures are reviewed on a regular basis. Reports written by a representative of the company are completed on a monthly basis, following an unannounced visit to the home, these were available for examination by us. Time was spent with the maintenance manager and a sample of records relating to health, safety, fire and welfare were examined and found to be well maintained and up to date. 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: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.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 25 of 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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