Care Home: Southfields Residential Home

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What the care home does well The home has comprehensive support plans which are up to date and regularly reviewed. Staff monitor the health of residents closely, and ensure they receive appropriate treatment and assistance. Staff commitment to residents is strong. This was confirmed by an NHS professional, as well as being shown when a resident went into hospital. Staff also show good communication skills to find out what residents` wishes are. The home`s quality is reviewed monthly and any action required is clearly stated. What has improved since the last inspection? The security of confidential information has been improved by the locking system on the office door, and by putting residents` personal details on separate memory sticks. The home has been informing the Commission promptly of any event that adversely affected the well-being or safety of residents. What the care home could do better: The manager has a programme of continuous improvements which is being followed, including the improvement of support plans, the recruitment of more relief staff,improving the garden and laundry, and promoting more independence and encouraging more use of community facilities. Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Southfields Residential Home 349 High Road Trimley St Martin Felixstowe Suffolk IP11 0RS 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: John Goodship Date: 0 5 1 2 2 0 0 8 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. They reflect the things that people have said are important to them: 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 Adults (18-65 years) 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. Reader Information Document Purpose Author Inspection report CSCI Page 2 of 29 Care Homes for Adults (18-65 years) Audience Further copies from Copyright General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Southfields Residential Home 349 High Road Trimley St Martin Felixstowe Suffolk IP11 0RS 01394277778 01394277778 h2008@mencap.org.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Royal Mencap Society Name of registered manager (if applicable) Type of registration: Number of places registered: Conditions of registration: Category(ies) : care home 4 Number of places (if applicable): Under 65 Over 65 4 0 learning disability Additional conditions: Date of last inspection Care Homes for Adults (18-65 years) Page 4 of 29 A bit about the care home Southfields home is registered to care for four adults with Learning Disabilities. The home, in a converted private bungalow set in a large garden, is situated in the Trimley villages next to the coastal town of Felixstowe. All four bedrooms are single. There are shops and other facilities in the villages as well as access by bus and train to both Felixstowe and Ipswich. Fees currently charged range from 26.00 to 00.00 per week. Care Homes for Adults (18-65 years) Page 5 of 29 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 Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home Care Homes for Adults (18-65 years) Page 6 of 29 How we did our inspection: This is what the inspector did when they were at the care home This was an unannounced key inspection. It focussed on the outcomes for residents measured against the standards described under each outcome area. The inspection took place on a weekday and lasted four and a quarter hours. The manager was present throughout, and we were able to meet all four residents. We toured the home, spoke to three staff, and two residents. We also looked at support plans, staff records training and maintenance records. Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well The home has comprehensive support plans which are up to date and regularly reviewed. Staff monitor the health of residents closely, and ensure they receive appropriate treatment and assistance. Staff commitment to residents is strong. This was confirmed by an NHS professional, as well as being shown when a resident went into hospital. Staff also show good communication skills to find out what residents wishes are. The homes quality is reviewed monthly and any action required is clearly stated. Care Homes for Adults (18-65 years) Page 8 of 29 What has got better from the last inspection What the care home could do better The manager has a programme of continuous improvements which is being followed, including the improvement of support plans, the recruitment of more relief staff, improving the garden and laundry, and promoting more independence and encouraging more use of community facilities. Care Homes for Adults (18-65 years) Page 9 of 29 If you want to read the full report of our inspection please ask the person in charge of the care home If you want to speak to the inspector please contact John Goodship Commission for Social Care Inspection CPC1, Capital Park Fulbpurn Cambridge CB21 5XE 01223 771 300 Care Homes for Adults (18-65 years) Page 10 of 29 If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line - 0870 240 7535 Care Homes for Adults (18-65 years) Page 11 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 12 of 29 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, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. 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 the person 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 . Residents and their representatives can be assured that they will have sufficient information to decide if the home is where they want to live. Residents can be assured that their needs will be assessed before admission and reviewed continuously to ensure that the home can continue to meet their needs. Evidence: The statement of purpose and the service users guide were available in normal text and in pictographs. The two documents contained all the information about the management and staffing of the home, how it was run on a daily basis, what residents could choose to do, and how they should raise matters of concern. There had been no new admission to the home since 2007. The care plan for this person showed that there had been a comprehensive pre-admission assessment involving the prospective resident, their carers and family, and NHS and Social Care professionals. This resident suffered from a mental disorder in addition to their learning disability. The provider was not required to seek a variation of their registration for this person as their primary need for care related to their learning disability. The home had to demonstrate that they were able to meet the residents Care Homes for Adults (18-65 years) Page 13 of 29 Evidence: needs and protect the rights and needs of the other residents. The previous manager had sent us a revised statement of purpose in November 2007 stating that staff had received training in supporting residents with mental health problems. This training had been provided by the intensive support team from the NHS. The acting manager told us that the needs of this person, and another resident with autism, had been greater than originally assessed.This had impacted on the other residents as shown by the incidents recorded by the home and reported to the Commission. Further training had been given. No incidents had been reported since March 2008 when one resident was admitted for assessment to the NHS assessment unit. We were told that the home was now able to meet the needs of these residents in a more positive way as shown by the information in the daily record about each of them. One returned during our visit from a day out with their relative. The relative told us that they were satisfied with the care of their family member. This place is much better for them. The other resident had spent the previous night with their family. All residents had a Mencap tenancy agreement called a Licence to Occupy. This included the terms and conditions of their residence in the home. The home had contracts with the local authority for the funding of each placement. The range of fees at the time of our visit was 726.06 pounds to 800.67 pounds per week. Care Homes for Adults (18-65 years) Page 14 of 29 Individual needs and choices 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 needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. 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 can expect to be supported to make decisions about their lives. Evidence: We examined two care plans, which are called Support Plans in this home. Information had been drawn from the initial needs assessment on admission. Both showed that they were regularly reviewed, when necessary sooner than the planned six months if there had been a significant event such as the hospital admission of one resident. The plans showed the different level of support needs of residents. One person did not need support with personal care but needed prompting. The daily support record was set out in a person centred way and was written from the point of view of the resident. It listed the things they chose to do each day and how they made those choices, what they had done to help in the home, such as cooking, cleaning and laundry, what they had to eat, activities inside and outside the home. One record said: I stayed in bed till 11.30 as I was not well. All plans were written in this way. The manager was a trainer for Mencap on person Care Homes for Adults (18-65 years) Page 15 of 29 Evidence: centred planning. Risk assessments were present in the plans covering topics such as road safety, bathing, being in the kitchen, triggers for challenging behaviour, and walking out of the home. Ways to reduce or eliminate the risks were clearly laid out for staff. Care Homes for Adults (18-65 years) Page 16 of 29 Lifestyle 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 can take part in activities that are appropriate to their age and culture and 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 and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. 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 can expect to take part in activities of their choice and to maintain family links if they wish. They can expect to be offered a healthy diet according to their needs. Evidence: All the residents had leisure interests of their own which were recorded in their care plans and in the daily record. The home supported them as far as possible. One resident had a love of riding on, and watching trains. They returned to the home during our visit from a trip to the station. A resident liked to sort cards. There was a large box beside them. Staff were encouraging them to sort them as the next batch would probably arrive soon as people put their Christmas cards out. According to staff and the support plan, this person also liked going to the cinema and to the library and shopping. Two residents had their own cars which staff used to take them out. The home also had its own vehicle. Care Homes for Adults (18-65 years) Page 17 of 29 Evidence: Other recorded activities included going bowling, having lunch out, walks along the sea front, going to the Gateway Club, and a monthly visit to Bettys nightclub. One resident in particular liked to dance so they enjoyed Bettys, the manager told us. The manager told us that the staff had been looking at what activities were available in order to offer more choice to residents. The manager was also encouraging staff to have skills in delivering support to all the residents, not just sticking to certain activities with the same residents. This would widen the choice to residents of activities and of staff to support them. The AQAA told us that families were encouraged to visit. We spoke to one parent who brought their family member back from a day out with them. They were satisfied with the care given, and felt that this was the best place for their relative. An NHS professional told us that staff made numerous special arrangements in respect to my clients particular needs. A staff member commented that there is good team work, a lot of activities for residents, and good relations with families. The manager told us that three of the residents have good links with their families. The fourth resident had said that they did not wish to visit their parent. The landlord, a housing association, had arranged for the kitchen to be refitted and reorganised for improved hygiene and better access. It was being finished off on the day of our visit. The home had made alternative arrangements for residents to have their meals. A corner of the sitting room had been turned into a small food and beverage area for breakfasts and light meals. Takeaways and visits to the local pub were used for main meals. One resident remained on a special diet because of their digestive disorder. Their support plan included an eating chart and a weight record.The manager told us that they had stopped ordering food on the internet. They now had good links with local butchers, grocers and greengrocers, which enabled residents to help with shopping. The home was also offering more choices at breakfast by for example putting boxes of cereal on the table for residents to choose which they wanted. Care Homes for Adults (18-65 years) Page 18 of 29 Personal and healthcare support 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 receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people 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. If people are approaching the end of their life, the care home will respect their choices and help them to 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 . Residents can expect to receive the support they wish and to have their health monitored and their health needs met. They can be assured that they are protected by the homes medication policy and procedures. Evidence: Evidence from support plans showed that three residents needed support with personal care. The fourth resident needed encouragement and prompting to care for themselves. Staff were well informed about the healthcare needs of the residents, and support plans evidenced this. One resident had been admitted to hospital for the correction of a long standing digestive disorder. The manager told us that he rostered staff to be with this person in the hospital during the daytime to maintain the support they needed, particularly with feeding and communication. Another resident had been referred to a specialist assessment unit after several instances of challenging behaviour towards other residents and staff. There was evidence in the health action books of the involvement of health professionals including the primary care team and the intensive support team. Advice Care Homes for Adults (18-65 years) Page 19 of 29 Evidence: had been sought from the GP on the day of our visit about the illness of a resident. Health aspects described in the action books included medication, dental and eye care, hearing, sleeping and eating. We examined the medication records which were fully and properly completed. Record sheets had a photo of each resident at the front. A sample stock check of one drug showed that the amount remaining tallied with the amount dispensed and administered. The training records showed that all staff had received training in the safe administration of medication from the supplying pharmacy. Care Homes for Adults (18-65 years) Page 20 of 29 Concerns, 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. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. 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 can expect the homes complaints procedure to ensure that their concerns are listened to and acted on. They can be assured that the homes policy and staff training will protect them from abuse. Evidence: The homes complaints procedure was clear and up to date. There was a complaint record book but no complaints had been received by the home or by the Commission. Staff received training in the safeguarding adults procedure on joining the home, and then were required to re-familiarise themselves with the policy and procedure and sign to confirm that they understood. A member of staff we interviewed was clear on what might constitute abuse and what action they would take. The home had referred several incidents in the last fourteen months to the Adult Safeguarding team, one concerning possible financial abuse. This had happened outside the homes control and was settled quickly. The other two referrals concerned the behaviour of one resident towards other residents. No action was taken by Adult Safeguarding but the home implemented some environmental and training measures to reduce the risk of any recurrence. Care Homes for Adults (18-65 years) Page 21 of 29 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, comfortable, 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. People have enough privacy when using toilets and bathrooms. 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 can expect to live in a well maintained home, with personalised rooms and hygienic facilities. Evidence: As described under Outcome Area 3, the kitchen was finally being refitted by the landlord. We had been informed that this was planned three years ago. Temporary arrangements had been made during the refitting which was almost complete on our visit. The AQAA told us that the lounge carpet had been replaced in the last twelve months. Vacant rooms had been redecorated before new residents came to live there, and were then decorated according to the new residents wishes. One resident told us that their room was comfortable and suitable for their needs. The manager told us that the laundry was the next job to be done by the landlord to improve hygiene and give staff a better working environment. The garden was very large but with no suitable access for those with mobility problems. It was also beyond the capacity of the home or the provider to maintain properly. Care Homes for Adults (18-65 years) Page 22 of 29 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, qualified 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. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. 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 can expect to be supported by competent and qualified staff, and protected by the homes recruitment procedures. Evidence: Although the home had no permanent vacancies at the time of our visit, the manager told us he was trying to build up the number of relief staff to prevent any use of agency staff, and ensure that all staff were trained to the same standard. There was a relief staff member on duty during our visit who had started there recently. They confirmed to us what they had done during their induction. We examined the files of two staff who had started in the last twelve months. These evidenced that all the required documentation was present such as references, disclosure certificates and photo identification, to help protect residents. We saw the training programme for the year which covered such topics as safeguarding adults, medication, people handling, first aid, lone working and fire training. Staff had also had training in active support from the intensive support team in relation to two residents. Seven of the nine permanent staff have achieved NVQ at Level 2 or above. We interviewed a member of staff who confirmed the training they had received since starting. They showed a good understanding of the needs of all the residents and in particular how to communicate with them, using words, pictures and Care Homes for Adults (18-65 years) Page 23 of 29 Evidence: facial characteristics. We observed staff communicating easily with residents in a friendly and patient way. Staff were able to tell us how residents preferred to spend their day, what they liked to eat, and how they encouraged them to help as far as they were able in the daily life of the home. Care Homes for Adults (18-65 years) Page 24 of 29 Conduct and management of the 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 have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because 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. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. 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 can be assured that the home is run in their best interests, with their health and safety protected. Evidence: The acting manager had been in this post since May 2008 after the full-time manager left. He also managed another home, in Woodbridge, for a similar group of residents. A deputy manager had been appointed to Southfields but never took up the post. As there was a deputy at the other home, the manager was spending more time at Southfields at the moment. The administration of the home was being reviewed by the manager, particularly in updating and tidying files, setting up an archive system and ensuring the security of personal data. He told us that no information about residents was now held on the computer. Each resident had their own memory stick which kept secure. Since the last inspection visit, the office had been fitted with a keypad lock for greater security. The provider and the placing authority were assessing the suitability of the residents for supported living. Therefore the future management of the service was not yet decided. Individual assessments needed to be done, and the manager told us there Care Homes for Adults (18-65 years) Page 25 of 29 Evidence: would be a six month consultation period prior to any changes. The home had a monthly visit from a senior manager, which included a quality review report. The review covered all areas of staffing, management, environment and care. The home had a continuous improvement plan that was reviewed monthly by this process. It included a list of required actions. Staff meetings were held regularly. We saw the record of the most recent one in November 2008. We saw the accident and incident records. Although there was no particular pattern of the type of incident or residents involved,an analysis of these records might have highlighted risk areas. No staff were authorised to sign for any cash withdrawals from residents bank accounts. Each resident signed at the bank when they wished to withdraw money. We checked the cash held in the office for one resident. The total tallied with the amount in the payments and withdrawals book. The fire log was inspected and showed details of regular maintenance of equipment, drills and tests. Care Homes for Adults (18-65 years) Page 26 of 29 Are there any outstanding requirements from the last inspection? Yes No 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 Adults (18-65 years) Page 27 of 29 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 Description 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 Description 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 Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone : 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web:www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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