Care Home: Southfield House

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What the care home does well Southfield House provides a calm, caring and safe environment to the people who live there. The people that we spoke with were very satisfied with the care that they receive and spoke highly of the staffing team. One resident said `I am being very well looked after here, I only have good things to say.` Another person said `the staff are very kind and caring, they promote my independence which really makes me feel at home.` Another person said `there is absolutely nothing that I can find fault with.` We also spoke with a relative who said `I like coming here so much I have applied to do some voluntary work.` We saw that people are well cared for and are fully involved in planning and reviewing their care. Care plans contain comprehensive information which includes people`s choices and preferences. The environment is very clean and provides a homely environment. There is a rolling programme of redecoration and people`s bedrooms are personalised to their own taste. The garden is very spacious and provides a range of flowers and plants which residents said they like to admire from the lounge windows. People said that the food is very good and that there is plenty of choice. All food is freshly cooked and a lot of the food is locally sourced. One person said `I really enjoy my meals, we always have something nice on the menu.` The service has a lot of quality auditing both internally and externally by The Order of St Johns Care Trust. The people that we spoke with said that they know how to make a complaint although all said that they have never needed to. What has improved since the last inspection? We did not make any requirements or recommendations during the previous inspection however the organisation reports that it continues to make improvements which is instigated following quality assurance audits, residents and relatives meetings and as part of the organisations national strategy. What the care home could do better: We have not made any requirements or recommendations as a high quality service continues to be provided and we saw that the outcomes for people living in the home are excellent. Key inspection report Care homes for older people Name: Address: Southfield House South Field House Woolram Wygate Spalding Lincolnshire PE11 1PB     The quality rating for this care home is:   three star excellent service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Alison Jessop     Date: 1 0 0 9 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. 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. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. 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 mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). 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 CQC 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 24 Information about the care home Name of care home: Address: Southfield House South Field House Woolram Wygate Spalding Lincolnshire PE11 1PB 01775724612 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: www.osjct.co.uk The Orders Of St John Care Trust care home 32 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 dementia old age, not falling within any other category Additional conditions: The home is registered to provide personal care to service users whose primary needs fall within the following categories:- Old age, not falling within any other category (OP) - 30 and Dementia (DE) - 2 The maximum number of service users to be accommodated is 32. Date of last inspection Brief description of the care home Southfield House is a purpose built care home, formerly owned by the Local Authority and now owned by the Orders of St John Care Trust, who manage a group of 16 homes across the county. The home provides care and accommodation for up to 32 people over 65 years, including two service users with a dementia, for personal care only and on the day of the inspection 28 residents were being accommodated. Accommodation is situated on the ground floor. There are four lounges and a spacious dining room, with a separate room designated for smoking. The home is situated in a quiet Care Homes for Older People Page 4 of 24 Over 65 0 30 2 0 Brief description of the care home residential area a mile from the centre of Spalding, which has a good range of shops and facilities. It is situated in its own grounds and includes a large garden laid to lawn and flower-beds, with seating and a patio area for residents to sit out in good weather. There is parking to the front and the side of the Home. A copy of the Service User Guide and Statement of Purpose can be obtained from the manager. The current fees for accommodation range from £406 to £655 a week. Not included in this fee is hairdressing, chiropody, transport to appointments, newspapers and dry cleaning. Care Homes for Older People Page 5 of 24 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: three star excellent service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This was an unannounced visit which formed part of a key inspection, focusing on key standards, which have the potential to affect the health, safety and welfare of the people who use the service. Throughout this report the terms we and us refer to The Care Quality Commission. The visit lasted approximately 4.5 hours and we took into account previous information held by us including the previous inspection report, their service history and records of any incidents that we had been notified of since the last inspection. Before we made our visit the provider had returned the Annual Quality Assurance Assessment (AQAA). This gave us information about their own assessment of how well they are meeting the standards and their plans to improve aspects of the service. The main method used to carry out the inspection is called case tracking, this includes following the care of a sample of three people through their care records and assessing Care Homes for Older People Page 6 of 24 their care. We spoke to six people who use the service, one relative, one volunteer and three members of staff. The acting manager was present throughout the visit and the general outcomes of the visit were discussed with her at the end of the inspection. Care Homes for Older People Page 7 of 24 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 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 24 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 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Peoples care needs are carefully considered to ensure that their individual needs can be fully met before they move into the home. Evidence: We looked at the care records of three residents and saw that a comprehensive needs assessment had been completed prior to admission. The records also included information from other sources such as social services and this had been used to from the care plan. Peoples preferences relating to their care had been obtained, this included establishing if they prefer their personal care to be provided by male or female carers. People who may be interested in accommodation are welcome to visit and meet staff. The Order Of St Johns Care Trust make available a quarterly magazine which tells them about news across the organisation. The people that we spoke with said that they received a lot of information about the service before they moved in. Care Homes for Older People Page 10 of 24 Evidence: Care Homes for Older People Page 11 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Care is provided to a very high standard and peoples choices and wishes are respected and independence is fully promoted. Evidence: We looked at the care plans for three residents. The care plan contained easily accessible and clear information on areas of care such as personal safety and falls, communication, eating and drinking, nutrition, continence, personal care, mobility, mental state, pressure area care and prevention, body maps, resting and sleeping, pain, breathing, religious and cultural beliefs, socialisation and medication. Each resident had agreed and signed their care plan and we saw evidence that they are formally reviewed every six months or more often if necessary. We saw that the residents have access to various health care services and notes were kept on file when GPs and other health care professionals had visited. The Annual Quality Assurance Assessment which is self assessment that had been completed by the acting manager of the service told us that residents are able to go out to their own GP surgery if they request rather than book a home visit. The residents also have Care Homes for Older People Page 12 of 24 Evidence: access to an optician, dentist and chiropodist who visit the home. We saw that one resident was receiving end of life care. She looked very comfortable and a bed had been provided in the residents bedroom for close relatives to be able to stay with the resident over night. Staff had recorded where care had been provided and when food and fluid had been taken. Pressure sore prevention measures were also in place. We looked at the medication systems. We saw that records were accurately maintained. The Care Team Leaders undertake a thorough audit of medication systems and a report is sent to the companies quality assurance department who also carry out unannounced audits on medication systems. The residents that we spoke with said care is provided in a sensitive way. Another person said I like the fact that whenever possible my care is provided by a male carer. Another person said they encourage me to do as much as I can for myself, they really encourage me to be independent but are there to help if I need them. Care Homes for Older People Page 13 of 24 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. Residents have access to a stimulating programme of activities to suit their individual needs. Evidence: An activity co-ordinator is employed to work in the home 20 hours a week. Activities include Bingo, painting, quizzes, reminiscence, music, entertainment, sing along, visits to garden centres and shops etc. Residents attended a tea dance at one of the other local care homes in the group where entertainment was provided in a marquee. The home has access to a mini bus so residents can be taken out. Some residents were taken on holiday to Mablethorpe during the summer. The manager stated that the summer fete raised over £1000 which will be used to increase the outside entertainment to once a month. A theatre production show is also due to visit the home. Residents spoken to said I have never been bored and we all have a nice time. The service has employed four volunteers who help to provide one to one stimulation to residents. One volunteer said I love working here, I help to lay the dinner tables and chat to the residents. Care Homes for Older People Page 14 of 24 Evidence: Residents spoke highly of the food. One person said if you dont fancy what is on the menu you can ask for something different. One day I fancied a jacket potato with prawns and they made it for me. Another person said the food is great, we get a good choice and the puddings are wonderful. The atmosphere in the dining room was relaxed, residents were observed enjoying a drink of shandy. One resident said I have this every day with my lunch and really look forward to it. Care Homes for Older People Page 15 of 24 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. The service has a robust complaints procedure where complaints are thoroughly investigated. Evidence: A copy of the complaints procedure is maintained in the entrance hall to the home. The residents that we spoke with were aware of how to raise any concerns they may have. One resident said I would be able to speak with the manager if I had any complaints. Another said I cant think of anything wrong. One complaint has been received by the service in the last 12 months which is currently being investigated. All complaints received are acknowledged in writing and recorded. A copy of the complaint is also sent to head office where complaints are monitored each month. We spoke with three members of staff who were aware of how to report any allegations of abuse or neglect. One of the staff had only been in post for one month but was very clear about how to identify abuse and neglect and report any concerns. The service has not been subject to any adult safeguarding investigations in the last 12 months. Care Homes for Older People Page 16 of 24 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. Southfield House provides people with a clean, comfortable and homely environment to live. Evidence: The home has several small lounges where residents can relax or participate in activities. The communal rooms including the dining rooms were nicely decorated and well maintained. We looked in the bedrooms of those residents that said we could and found that they were nicely decorated and residents are encouraged to bring personal items of furniture with them when they move into the home. On the day of the inspection the handyman was decorating one of the bedrooms getting it ready for a new resident. The communal hallways are also undergoing refurbishment. The garden is large and spacious and there were many flower beds filled with seasonal plants, which some of the residents helped to plant out. The home has won The Order of St Johns Care Trust Garden of the Year Competition. There is a summer house and a large courtyard. The home looked very clean and no unpleasant odours were detected. Care Homes for Older People Page 17 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The service is provided by a highly qualified, caring and competent staff team. Evidence: On each shift there is a Care Team Leader who is responsible for managing the care team and administering the medication. The shift patterns and staffing levels are adjusted according to the needs of the residents. We spoke with one of the Care Team Leaders who said I think people get good care and their needs are met. The residents always come first. On the day of the inspection the Care Team Leader had dealt with an incident where a resident became unwell and resuscitation had been performed. The staff team dealt with this in a calm manner and although the outcome was not good, they continued to offer support to residents in a very professional way. The residents we spoke with said the staff are very nice, I get on well with them all. Another person said The staff are wonderful, we are all like brothers and sisters, its really homely. We looked at the recruitment files for two new staff and saw that a thorough procedure is in place to recruit and vet new staff. New staff complete an e learning induction within the first 12 weeks of employment. Progress of new staff is checked at regular intervals and on-going supervision is provided. Care Homes for Older People Page 18 of 24 Evidence: The manager reports that until recently when a new member of staff was employed, the service had an 100 NVQ qualified staff team. We spoke with a new member of staff who has been in post for one month. They had received training in moving and handling, first aid and adult safeguarding prior to working with the residents. The carer said I feel the relationship between the carers and the residents is really good. All staff have received training on the Mental Capacity Act which is new legislation protecting peoples rights and choices and empowers them to make decisions. Care Homes for Older People Page 19 of 24 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 excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a robust quality assurance system which ensures that people are safe and satisfied. The manager is highly competent to run the service and ensures that the organisational policies and procedures are followed. Evidence: The Orders of St Johns Care Trust have recently moved 12 of their 16 home managers around to different homes. The acting manager stated that the move has had a positive effect. She also stated that her application for registration at this service is in progress. The acting manager has an NVQ 4 and her mandatory and other specialist training is being continually updated. The Order of St Johns Care Trust have very focused and regular systems in place for monitoring quality outcomes. Regular surveys are sent to residents and relatives for their views and outcomes are fed into a national database so that trends can be monitored. Other quality auditing processes are carried out on medication procedures, financial procedures, food and meals, environmental health, fire safety, policy and Care Homes for Older People Page 20 of 24 Evidence: procedures, risk assessments and health and safety. Regular residents and relatives meetings are also held. We looked at the financial procedures for the safe storage and recording of residents personal finances. All items of value are safely stored and accurate records maintained which are audited both internally and externally. We saw that risk assessments are carried out on both the environment and on peoples individual care needs. Each risk assessment had been regularly reviewed and people were encouraged to take risks whilst measures had been put in place to protect them. The Fire Safety Service had carried out an inspection of the premises in July 2009. A couple of requirements were made however the manager stated that plans are in place to meet these in the near future. Each resident has an individual fire risk assessment on their care plan. Care Homes for Older People Page 21 of 24 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 22 of 24 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 23 of 24 Helpline: Telephone: 03000 616161 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) Care Quality Commission (CQC). 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 CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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