Care Home: Southfields House Residential Care Home

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What the care home does well The relaxed, homely and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team, the dedication and close involvement of the providers and their open and inclusive management style. Through working closely, sensitively and consistently with the residents, staff have developed a sound understanding of their individual care and support needs. Residents are encouraged and supported to maintain links with their family and make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning, colour schemes and activities. What has improved since the last inspection? Information made available to prospective residents, including the Statement of Purpose and the Service User Guide has been recently reviewed and updated, so as to accurately reflect the services provided and the current situation within the home. The pre-admission needs assessment process has been reviewed and expanded since the last inspection to include an individual`s dependency levels and any history of falls. Since the previous inspection, the tumble drier and washing machine have been upgraded and replaced with high quality appliances. What the care home could do better: The format for recording care plan reviews should be amended to include the date and specific reason for the resident`s signature, which would usually indicate that the individual has read or understands the plan and agrees with the content and any changes made. The current quality assurance system should be extended to seek the views of residents` relatives and other visitors to the home. CARE HOMES FOR OLDER PEOPLE Southfields House Residential Care Home Southfields Road Eastbourne East Sussex BN21 1BZ Lead Inspector Nigel Thompson Key Unannounced Inspection 12th October 2007 10:00 X10015.doc Version 1.40 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 Southfields House Residential Care Home DS0000021214.V348614.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 Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service Southfields House Residential Care Home Address Southfields Road Eastbourne East Sussex BN21 1BZ 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) 01323 732077 Mr David Exon Mrs Milagros Exon Mr David Exon Mrs Milagros Exon Care Home 16 Category(ies) of Old age, not falling within any other category registration, with number (16) of places Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. 2. The maximum number of service users to be accommodated is sixteen (16). Service users must be older people aged sixty-five (65) years or over on admission. 27th July 2006 Date of last inspection Brief Description of the Service: Southfields House is a care home registered for sixteen (16) older people. The home is situated in a residential area of Eastbourne, within a short walk to Eastbourne Town Centre, the library and the Railway Station. The home provides a dining room that looks out to a large, well-maintained garden. There is a lounge on the ground floor and a dining/lounge room on the first floor. All communal and private areas are accessible to service users and a stair/chair lift is provided for easy access. There are three bathrooms, two with assisted bath seats. Information about the service, including the recently updated Statement of Purpose, Service User’s Guide and CSCI reports is made available to prospective residents or their relatives, on request, as part of the admission process. The current range of fees at Southfields House, as of 12 October 2007, is £335 - £500 per week. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. This key unannounced inspection took place over five and a half hours in October 2007. It found that the majority of the National Minimum Standards that were assessed had been met or partially met and the overall quality of care provided was satisfactory. Residents spoken to during the inspection expressed satisfaction with the home, the staff and the service provided. The purpose of this inspection was to assess compliance with the requirements of the previous inspection and to generally monitor care practices at the home. On the day of the inspection there were fifteen residents living at the home. The inspection involved a tour of the premises, examination of the homes records and discussion with seven residents, the two joint owner/managers and three members of staff. The focus of the inspection was on the quality of life for people who live at the home. Responses from a CSCI service users’ survey, regarding their views on the home and quality of care provided, now form part of the inspection process and have also been included in this report. What the service does well: The relaxed, homely and welcoming environment has evolved over many years and reflects the stability and commitment within the staff team, the dedication and close involvement of the providers and their open and inclusive management style. Through working closely, sensitively and consistently with the residents, staff have developed a sound understanding of their individual care and support needs. Residents are encouraged and supported to maintain links with their family and make decisions about their lives. Where appropriate and practicable, they are involved and regularly consulted on many aspects of life in the home, including menu planning, colour schemes and activities. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 6 What has improved since the last inspection? 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. The summary of this inspection report can be made available in other formats on request. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. 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 this service. The thorough admission policy and procedure ensures that residents are admitted only on the basis of a full needs assessment, undertaken by people competent to do so. Prospective residents have the opportunity to visit the home and know that it is able to meet their individual care and support needs. EVIDENCE: Information for prospective residents, including the Statement of Purpose (containing the Mission Statement; Philosophy of Care and the home’s Aims and Objectives) and the Service User Guide has been thoughtfully and imaginatively produced to a high standard and both documents were found to be comprehensive and informative. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 9 It was noted that details had been recently reviewed and updated, so as to accurately reflect the services provided and the current situation within the home. A copy of the most recent CSCI inspection report is made available to residents and other visitors to the home. In addition, information for prospective residents is also provided on the home’s web site. Documentation, including comprehensive Social Care Assessments and full care needs assessments, carried out by the manager, relating to two most recent admissions to the home was inspected and found to be generally up to date and well maintained. It was evident through discussion from examination of relevant documentation that the pre-admission needs assessment process has been reviewed and expanded since the last inspection to include an individual’s dependency levels and any history of falls. As part of the admission procedure, the managers confirmed that prospective residents are invited to visit the home, to look around and meet with staff and existing residents. They also have the opportunity to stay overnight before moving in. A four-week trial period enables both ‘parties’ to establish suitability and the level of compatibility with other residents A formal written contract has been developed and implemented and is routinely provided to each new resident or their representative, incorporating a statement of terms and conditions of residency. The managers confirmed that Intermediate Care is not provided at Southfields House. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8, 9 & 10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Care plans enabling staff to meet the assessed needs of residents in a structured and consistent manner are routinely reviewed to reflect any changes. Residents are protected by the home’s medication policies and procedures. They are treated with respect and encouraged to make decisions about their day-to-day living. EVIDENCE: Personal care plans are in place for each resident and are clearly and directly linked to the individual’s assessed needs. Plans that were inspected were found to be accurate, generally well maintained, and up to date. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 11 The manager confirmed that residents or their relatives are involved or have the opportunity to be involved, in developing or reviewing their individual care plan. In plans that were examined, it was noted that monthly reviews are recorded and every six months the plan is discussed with and routinely signed by the individual resident. Following discussion with the managers, it is recommended that the format for this be reviewed and amended to include the date and specific reason for the resident’s signature. (To agree the content and any changes made.) All residents are registered with local GPs and have access to other health care professionals, including District Nurses and physiotherapists, as required, via the surgeries. It was noted, in care plans that were examined, that appointments with, or visits by, such health professionals are appropriately recorded. During the last year, management and care staff in the home have evidently benefited and gained valuable experience in dealing with the after effects of strokes, from their close collaboration with speech and occupational therapists from the ‘Stroke Team.’ Policies and procedures are in place for the control, storage, safe administering and recording of medication. The managers confirmed that regular monitoring of the systems is carried out by a local pharmacist and all staff involved in administering medicines receive appropriate training. This was supported by documentary evidence and through discussions with care staff. A prime objective of the home is evidently ‘to respect privacy and dignity’. As part of their induction programme, all staff receive instruction on the principles of dignity and respect. This was confirmed, through discussions during the inspection, and evident from direct observation of staff interacting with residents in a sensitive and professional manner. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 14 & 15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are enabled and supported to maintain contact with family and friends as they wish. They benefit from appropriate recreational and leisure activities and menus that are balanced and nutritious, reflecting their individual likes and preferences. EVIDENCE: Residents’ social and recreational interests and preferences are identified and recorded in their individual care plan, as part of the pre admission assessment process. A programme of activities has been developed, following consultation with residents. However the general response to organised activities within the home is evidently varied and ranges from: ‘enthusiasm to indifference.’ Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 13 Independence continues to be promoted and encouraged within the home and the managers confirmed that, wherever possible, residents are enabled and supported to make choices and take decisions affecting their life and daily routines. Visiting in the home is evidently unrestricted and residents may see friends or relatives in the lounge or in the privacy of their own room. Despite the recent departure of the cook, residents at Southfields House continue to be provided with a varied, wholesome and nutritious diet. At lunchtime a choice of meals is available and special diets can always be catered for. A weekly menu is displayed, reflecting individual preferences and including seasonal variations. Positive comments received from residents during lunchtime indicated satisfaction with the standard of meals provided: ‘The food is always very good here – and the portions are very generous.’ Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): 16 & 18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The open and inclusive atmosphere within the home enables residents, staff and visitors to express any concerns, confident that they will be listened to and acted upon. Residents are safeguarded from abuse through adequate staff training and relevant policies and procedures. EVIDENCE: The joint manager/providers continue to operate an ‘open door’ policy and are clearly considered to be very approachable and understanding. Residents and members of staff spoken to during the inspection confirmed that, should they have a concern or complaint, they would have no hesitation in speaking to either manager and each person was confident that they would be listened to. The home’s complaints policy and procedures were examined and found to be satisfactory. A simple and concise complaints procedure is clearly displayed in the hallway, for the benefit of residents, their friends, relatives and other visitors to the home. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 15 The home has produced policies and procedures relating to adult protection and abuse, including a whistle blowing policy. However, following discussion with the managers, outdated references to ‘the Registration and Inspection Unit’ as ‘the investigating agency’ are to be withdrawn. On further examination of these policies and procedures, it was evident that relevant documentation has been reviewed and updated, in accordance with the recently implemented ‘Sussex Multi-Agency Policy and Procedures for Safeguarding Vulnerable Adults’. The managers confirmed that all staff have access to and are expected to watch relevant training DVDs including: ‘Abuse in the Care Home’, followed by a question and answer session. The majority of staff have also received specific adult protection training, provided by an external trainer. This was supported during discussions with staff and evidenced through relevant training records, including individual certificates, made available for examination. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 16 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 19, 20, 23, 24, 25 & 26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents enjoy a calm and peaceful environment within the home and benefit from accommodation that is safe, comfortable, well maintained and decorated to a satisfactory standard. EVIDENCE: As with many of the environmental standards, the situation at Southfields House remains largely unchanged, with its homely and welcoming atmosphere. During my ‘guided tour’ of the premises, including residents’ accommodation and communal areas, it was evident that the well-maintained décor and Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 17 adequate furniture and furnishings continue to provide a comfortable, pleasant and homely environment for the residents. From discussions with management and staff it is evident that the welfare and comfort of the residents clearly remains a priority at Southfields House. It was noted that two boilers, installed in parallel, heat both the domestic water and central heating circuits, such that if one were to break down the other could continue to supply heat while the other was repaired or replaced. Residents’ rooms were found to be clean, comfortable and generally well maintained. It was evident that many of the rooms have been personalised, with pictures, family photographs and other small items of furniture and belongings, to reflect individual taste, choice and preference. Since the previous inspection, it was noted that the tumble drier and washing machine have been upgraded and replaced with high quality appliances. On the day of the inspection, it was evident that infection control procedures within the home are in place and are closely adhered to. Levels of cleanliness and hygiene remain generally high throughout. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 18 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 27, 28 29 & 30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. There is sufficient trained and competent staff on duty at all times to meet the assessed needs of the residents. The safety and protection of residents is improved by robust recruitment procedures and appropriate staff training. EVIDENCE: Appropriate staffing levels are evidently in place to meet the current assessed care and support needs of residents. A staff rota has been developed, showing details of which staff are on duty at any time and their designation. In addition to the comprehensive induction programme undertaken by all newly appointed staff, the manager confirmed that appropriate core skills training is provided, including first aid, moving and handling, food hygiene and fire safety. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 19 This was confirmed through discussions with staff and supported by training records examined. As previously documented, it is evident, from discussions with members of staff that the joint managers continue to operate an ‘open door’ policy, with staff feeling confident and able to discuss any issues at anytime. Following a comprehensive re-assessment of the service, Southfields House has successfully retained the Investors In People Award. The managers are clearly aware of the need for thorough and robust recruitment procedures, to help ensure the safety and protection of service users. Individual staff files that were examined were found to be generally well maintained, containing necessary information, including proof of identity and satisfactory Criminal Record Bureau (CRB) and Protection of Vulnerable Adults (POVA) disclosures. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 20 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 31, 32, 33, 35, 36, 37 & 38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents benefit from effective management and thorough quality assurance systems. Satisfactory health and safety policies and procedures, within the home, help to ensure the protection of residents and staff. EVIDENCE: As previously documented the proprietors of Southfields House are also the joint registered managers. Both are qualified and competent to run a care home and both have extensive managerial experience with this client group. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 21 The managers are clearly motivated, positive and approachable and have successfully developed an open and inclusive atmosphere within the home. It is evident, from staff spoken with during the inspection, that they feel valued and supported: ‘They are both so kind, helpful and supportive and always ready to listen.’ Effective quality monitoring and consultation with residents is ongoing and includes satisfaction questionnaires for residents, regarding the care and support they receive. Positive responses to a recent survey indicate a high degree of satisfaction with the home and the services provided: ‘Mum is very satisfied and would like to make special mention of the kindness and concern shown.’ ‘I have been in two other homes and this is the best!’ Following discussion with the managers, however, it is recommended that a similar survey be introduced to obtain feedback from residents’ relatives and other visitors to the home. The managers confirmed that the health, safety and welfare of residents and staff remain of paramount importance within the home. As previously documented, staff training is provided in many aspects of safe working practices, including moving and handling; food hygiene; fire safety and first aid. Fire safety systems are regularly checked and outcomes recorded. By coincidence, fire extinguishers throughout the home were being serviced, by outside contractors, on the day of the inspection. All accidents are appropriately recorded and reported as required. Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 22 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 3 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 3 X X 3 3 3 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 3 X 3 3 3 3 Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 23 Are there any outstanding requirements from the last inspection? No 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. Refer to Standard OP7 Good Practice Recommendations It is recommended that the format for recording care plan reviews be reviewed and amended to include the date and specific reason for the resident’s signature. (To agree the content and any changes made.) It is recommended that the current quality assurance system be reviewed and extended to seek the views of residents’ relatives and other visitors to the home. 2. OP33 Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 24 Commission for Social Care Inspection Maidstone Local Office The Oast Hermitage Court Hermitage Lane Maidstone ME16 9NT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © 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 Southfields House Residential Care Home DS0000021214.V348614.R01.S.doc Version 5.2 Page 25 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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