Care Home: Southlands, Highweek

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What the care home does well Residents are enthusiastic about living at Southlands. Many of them are from the immediate area and are pleased that they have been able to remain in the local community and maintain their social contacts. They described the home as wonderful with staff who look after them very well. They said that they are given help with the things they are not able to do and encouraged to do everything else for themselves and maintain the independence they have. They appreciate the freedom to choose how and where they spend their time. They also said that the meals are good with a choice being offered and different diets catered for. They said that they have confidence that any concerns they might have would be dealt with promptly. Relatives also expressed their appreciation of the care provided to their family members. They said that the meals are good and one person said that the staff had put themselves out to help with the diet of their relative who was poorly. They said that they are always made welcome, that the staff and management are very helpful, they keep them informed and answer questions readily. Staff said that the training they have is good and relevant to the work they are doing. They feel well supported by the registered manager and said that they work well together as a team. The registered manager and the operations manager work closely together to ensure that the home is well run and that the needs of those living in the home are met. What has improved since the last inspection? Staff are encouraged to spend time with each resident on an individual basis doing something that they particularly enjoy or wish to do. These `special moments` are clearly identified in the daily records. The cook is involved in care plan reviews and residents` meetings when menus and diets are being discussed. What the care home could do better: Consideration should be given to providing more trips out for those who would appreciate them. Inspecting for better lives Key inspection report Care homes for older people Name: Address: Southlands, Highweek 21 Coombeshead Road Highweek Newton Abbot Devon TQ12 1PY     The quality rating for this care home is:   three star excellent 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: Susan Samways     Date: 0 7 1 1 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. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Older People Page 2 of 25 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Southlands, Highweek 21 Coombeshead Road Highweek Newton Abbot Devon TQ12 1PY 01626363510 F/P01626363510 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Mark Harris Name of registered manager (if applicable) Mrs Carol Dyke Type of registration: Number of places registered: Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category physical disability Additional conditions: The maximum number of service users who can be accommodated is 30. The registered person may provide the following category of service only: Care home only (Code PC) to serice users of either gender whose primary care needs on admission to the home are within the following categories: Old age, not falling within any other category (Code OP) Physical disability (Code PD) Date of last inspection Brief description of the care home Southlands is a registered care home for up to 30 older people. It is a large, detached, Victorian property which is set back off the road. It is a short drive from the main town centre and is on a bus route. Southlands is set in extensive grounds and the sun room opens on to an attractive decked area. The property has been extended and has a lift to the first floor. A new wing includes a second lift which will provide access to all Care Homes for Older People Page 4 of 25 care home 30 Over 65 30 30 0 0 Brief description of the care home floors in the home. Fees range from £280 to £465 per week. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection which was the first since 16th November 2006. Time was spent in discussion with the registered manager and the operations manager and in examining documents and records. Two residents were spoken to on their own and several others in passing. Ten residents and seven staff had completed surveys prior to the inspection. During the inspection residents,staff and visitors were spoken to, some in private others in passing. Since the last inspection a new wing has been built which has six en-suite bedrooms. These were included in a tour of the home. A lift is also included in this wing which will provide access to all three floors. The lift was due to be commissioned shortly after the Care Homes for Older People Page 6 of 25 time of the inspection. Prior to the inspection the Annual Quality Assurance Assessment, completed by the registered manager, had been received. This provided information about how the national minimum standards had been met, what had improved since the last inspection and future plans for Southlands. What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line –0870 240 7535. Care Homes for Older People Page 8 of 25 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 9 of 25 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Prospective residents have a comprehensive assessment made and are invited to visit the home in order to provide all those concerned with sufficient information to make the decision whether Southlands is an appropriate home for them. Evidence: The home has a Statement of Purpose and Service Users Guide copies of which were seen in one of the lounges. Also included was information from the Commission for Social Care Inspection, social services, Age Concern and other organisations. Copies of past inspection reports were also available as were sample menus. The files for three people living in the home, including one recently admitted, were examined. All were found to have detailed assessments covering all aspects of daily living. Their preferences, including the name by which they wished to be addressed and their religion where applicable, had been recorded as well as key information Care Homes for Older People Page 10 of 25 Evidence: about their medical and family history. The registered manager stated that considerable time is spent with prospective residents and their family or representative. This was confirmed by the relative of one person living in the home who was spoken to during the inspection. They said that they had visited the home more than once before deciding that it was the right home. They were pleased with the way that they had been made welcome, that visiting more than once was not a problem and that questions had been answered readily. Care Homes for Older People Page 11 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. People living in the home are involved in planning and reviewing their care. The medication procedure safeguards residents. Staff treat people with respect and are caring and supportive when they are coming to the end of their lives. Evidence: The care plans for three people living in the home were examined. They covered all aspects of care and had been signed by either the resident or their relative. They had been reviewed and signed and dated by the person carrying out the review. Daily records had been completed for each resident as had records of all visits by the G.P. and other visiting professionals. The two residents interviewed said that their care was discussed with them by the registered manager and the senior staff. Both said that the care was very good. One care plan clearly showed the involvement of different health professionals treating the person concerned. It recorded the treatment being given and what the care staff Care Homes for Older People Page 12 of 25 Evidence: need to do or be aware of to support that treatment. A health professional spoken to said that the staff at Southlands could be relied upon to carry out their instructions which made their intervention more effective. They also said that they had a good relationship with the home and that the manager and staff were clear about the limitations of the care they were able to give and when to ask for professional advice and support. The registered manager stated that everyone living in the home has a mobility assessment and these were seen in the files examined. Evidence was seen that people with a history of falls or at risk of a fall are encouraged to wear hip protectors and the advice of a physiotherapist is sought. Medication records were checked and found to be in good order. A monitored dosage system is used with the blister packs for each round being transported around the home in a small medicine trolley. All other medication is kept in a locked cupboard in a locked room. The home has a procedure to follow for anyone who wishes to take responsibility for their own medication. A risk assessment is completed annually to ensure that it is still safe for the person concerned to continue to self medicate and lockable storage is provided for the safe keeping of the medication. Wherever possible the care plans include details of the care the people living in the home wish to have when coming to the end of their lives. This can include the funeral arrangements they have already made or wish to have. The excellent way in which the manager and staff care for people in this situation has been observed on previous inspections and has been commented upon by relatives. They also said that the support was extended to them as well and this was appreciated. Care Homes for Older People Page 13 of 25 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home enables residents to maintain control over their day-to-day lives by promoting choice. Residents are benefiting from a range of activities including physical activities. Evidence: Those who completed surveys said that there were usually activities available for them to participate in if they wished. One person commented that it would be nice if there were more outings. On the day of the inspection three members of staff were running a christmas card making session which involved most of the people living in the home. Other activities include armchair exercises and organised entertainments. One lady who enjoys playing cards has been encouraging others to join her and some people have been knitting scarves and teddies for charities. Some people spoken to said that they prefer their own company and spend time in their rooms reading, watching television or following their own pastimes. The manager stated that as part of the assessment process they endeavour to find out how people like to spend their time and what their particular interests are. They then Care Homes for Older People Page 14 of 25 Evidence: try to arrange activities and entertainments to enable them to continue with these. They also encourage people to maintain their contacts with the local community and some people continue to attend the clubs and social events they did prior to moving in to the home. Evidence of this was seen in the care plans. The manager also encourages the staff to spend time on a one to one basis with each resident doing something that person particularly enjoys e.g. listening to music, looking at photographs or having a chat. These sessions are clearly identified in the daily records. Religious services are held for those who wish to participate. A Church of England communion service is held every three weeks, the Methodist church visits every six weeks and an ex-member of staff has a prayer and hymn meeting in the home each Sunday. Residents spoken to said that they can have visitors at any reasonable time and that the staff of the home always make them welcome. This was confirmed by relatives spoken to who also said that they can see their family member in private and that the home keep them informed about their well-being. Residents are supported by members of their family or their solicitors to manage their financial affairs. The home has a third party advocate to help residents and their families to sort out financial planning if they wish. Records, including receipts, are kept of personal spending money. These are available for inspection by those concerned at any time. The residents spoke positively about the standard of the meals stating that if they didnt like the choices on offer an alternative was provided. The cook is familiar with the residents dietary requirements and preferences. Lunch was observed during the inspection. The meal was well balanced and nicely presented with variations being served according to the residents preferences e.g. mashed potato instead of chips. Care Homes for Older People Page 15 of 25 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The rights of those living in the home are protected and they are safeguarded from abuse by staff being made aware of adult protection procedures. Evidence: Residents spoken to and those that had completed surveys were clear about what to do should they be unhappy with any aspect of their care or the running of the home. The registered manager stated that many potential problems are sorted out during normal contact with the residents during the day and this was confirmed by residents spoken to. No formal complaints had been received during the previous twelve months and no complaints about Southlands have been received by the Commission for Social Care Inspection. All those living in the home are registered to vote, most have a postal vote but the home offers transport to the polling station for those who wish to vote in person. The home has policies and procedures in place regarding the protection of vulnerable adults and training in this is included in the induction programme for all new staff. It also forms part of the NVQ level 2 in care. All staff contacted, including ancillary staff, said that they were aware of adult protection procedures. Care Homes for Older People Page 16 of 25 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is attractive, homely and appropriately equipped providing a clean, hygienic and safe environment. Evidence: Since the last inspection a new wing has been built which provides six en-suite bedrooms. This increases the number of people who can live at Southlands by five to a maximum of thirty. An existing ground floor bedroom will revert to a lounge which gives additional communal space. The residents spoken to said that they liked their rooms which they described as lovely. They had been able to bring some of their own furniture to the home and had personalised their rooms. They also appreciated the varied communal space which includes a large lounge/diner, which opens onto a decked area overlooking the garden, and a smaller quiet lounge. The registered manager said that rooms are redecorated as they become vacant or there is a vacant room to temporarily accommodate someone while their room is done. The home was found to be clean and hygienic and people commented that this was always the case. Staff have had training in infection control and a senior member of staff now has responsibilty for overseeing issues regarding infection control for the Care Homes for Older People Page 17 of 25 Evidence: home. Cleaning procedures are recorded daily and are regularly auditted. The registered manager stated that the dependency levels of the residents is increasing. As a result more specialist equipment is being used such as hoists and variable height beds. These are available in the home and are regularly serviced. The district nurses support the home in caring for more dependent and poorly residents by providing hospital beds and pressure relieving mattresses and cushions. Several people are also dependent on wheelchairs to move distances around the home. Fortunately the home has sufficient space to accommodate this. Care Homes for Older People Page 18 of 25 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staff recruitment procedures and training programmes safeguard the people living in the home. Evidence: This was an unannounced inspection and on arrival sufficient staff were found to be on duty. The rotas seen showed that this was the norm and residents and relatives also said that there are always sufficient staff on duty. At night there is one member of staff awake and another sleeping in with the registered manager on call. Cooks and domestic staff are also employed so care staff can concentrate on directly caring for those living in the home. With the addition of the new wing the registered manager stated that staffing levels are under constant review. Two staff files were examined. These showed that an adequate recruitment procedure had been followed including taking up references, checking identities and carrying out police checks. This was confirmed by the seven staff who returned surveys and the staff interviewd on the day of the inspection. All new staff follow the homes induction training programme. This includes health and Care Homes for Older People Page 19 of 25 Evidence: safety, fire training, manual handling, first aid and initial training regarding the protection of vulnerable adults as well as familiarisation with care plans and the needs of the people living in the home. New staff work closely with the manager and senior carers until they are assessed as being confident and competent in providing care. Staff training records showed that they had undertaken training in manual handling, medication, fire safety, infection control, nutrition and the protection of vulnerable adults. Staff who completed surveys and those spoken to during the inspection said that they have training which is relevant to the work they do and that they are kept up to date. Staff are encouraged to obtain NVQ level 2 in care and at present five of the staff have this qualification and another is working towards it. A senior member of staff has NVQ level 3 and another is working towards it. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience excellent quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The management style is open and receptive to the views of the people living in Southlands and others involved with the home. Evidence: The registered manager is very well qualified, experienced and competent to run the home. During the inspection people living in the home, visitors and staff were seen to approach her with confidence and to be well received. Staff who completed surveys and those spoken to said that they felt well supported and clear about what was expected of them. People living in the home said that the manager and staff listened to them and acted on what they said. They said that they felt able to ask questions, make suggestions or raise any concerns they might have. The registered manager and the operations manager have clearly defined roles with the registered manager concentrating on the care of the people living in the home and the recruitment,training, support and supervision of the staff. The operations manager Care Homes for Older People Page 21 of 25 Evidence: has responsibility for the building and for the business side of running the home. They work cosely together and meet every month to monitor the homes performance and to discuss how things can be improved. Records are audited and spot checks carried out to ensure that policies and procedures are being correctly followed. Both managers are well known to the people living in the home, their relatives and other visitors to the home. The views of those living in the home are regularly sought through care plan reviews and residents meetings. The cook is also involved in these when menus and diets are being dicussed. Staff said that they often meet with the manager and feel well supported. Formal staff supervision is in place. New staff have supervision at the end of their first week, their first month and after three months. All staff have supervision at least every three months. The manager frequently works alongside staff and is therefore able to ensure that a high standard of care is provided. People living in the home are encouraged to manage their own monies for as long as they are able or wish to do so. Where day to day money is looked after by the home it is kept safely with records and receipts kept for all transactions. These records are available for inspection at any time by the resident concerned or their representative if applicable. The manager ensures that safe working practices are employed at all times. Staff are trained in the correct procedures to use and there is a comprehensive manual for them to use as reference. Risk assessments have been completed for all areas. Safety checks and the servicing of equipment are carried out at the required intervals and records of these were seen to have been kept. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 23 of 25 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. No. Refer to Standard Good Practice Recommendations 1 12 Consideration should be given to providing outings for those who would enjoy them. Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 or Textphone: or Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. 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