Care Home: Southwater Residential Home

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What the care home does well People who use the service and their relatives have the information they need to decide whether Southwater is the right home for them to move into. The admission procedure shows that staff makes sure they can meet the persons needs. People receive a good standard of personal care. One person said " The love and kindness they show me is wonderfull". Communication with health care professionals in the community is good. The care people receive is good and provided in a safe and respectful way. Medicines are also well managed at the home by the senior staff. Staff at the home ensures people see the doctor or other health care professionals when they need to. The care planning systems and documentation at the home are generally good and mean that staff know how to care for some one in a safe way. People have access to a very good and varied programme of activities and trips and are able to maintain contact with their family and friends. People tell us that the food is very good at the home and any issues regarding dietary requirements, preferences or weight issues are sensitively managed. People who use the service and their relatives can be confident that their complaints and concerns will be listened to and acted on. People are safe at the home. Staff have had training to recognize signs of abuse and know how to report any suspicions or poor practice. Southwater is a safe and pleasant place to live and work. The owner and her staff group have suitable qualifications and experience to care for people who require personal care. The home is well managed by the Provider. What has improved since the last inspection? The owner has shown a good commitment to improving practice. On the last inspection three requirements were made which had timescales for improvement attached to them. Two of these requirements have now been met with improvements to health & safety at the home. We also made eleven recommendations promoting good practice; these have also been addressed meaning that people living at the home are safe and well cared for. What the care home could do better: Recruitment practice must be made more robust so that people living at the home can be assured that the people that care for them are competent to do so. Key inspection report Care homes for older people Name: Address: Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this full review a ‘key’ inspection. Lead inspector: Caroline Rowland-Lapwood     Date: 0 5 1 2 2 0 0 9 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 25 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 25 Information about the care home Name of care home: Address: Southwater Residential Home 3-4 Conway Crescent Paignton Devon TQ4 5LG 01803524140 NONE Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Mary Lamont,Mr Thomas Lamont care home 18 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The home may accommodate two named service users with the category DE(E) Date of last inspection Brief description of the care home The previous inspection took place on 7th January 2008. Southwater Residential Home is registered to provide accommodation and care for a maximum of eighteen people in the registration category of `Old Age, not falling within any other category. It is made up of three houses joined together with a conservatory running along the entire front of the building, and a small but pleasant garden behind. There is a stairlift to the first floor. Two bedrooms are up a flight of stairs with a stairlift, but with three steps at the top. There is ample car parking space at the front of the house. Southwater is in a residential area of Paignton and is close to the town centre and the bus and railway stations. Care Homes for Older People Page 4 of 25 Over 65 18 0 1 9 1 2 2 0 0 8 Brief description of the care home Information is available from the home on request in the form of a written Statement of Purpose and a Service Users Guide. Copies of inspection reports are kept at the Home and are also available on the CSCI website. The current fees range from #330 to #400 a week, although additional charges may be made for hairdressing, newspapers, clothing and all other items of a luxury or personal nature. Care Homes for Older People Page 5 of 25 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Health and personal care Daily life and social activities Complaints and protection Environment Staffing Management and administration peterchart Poor Adequate Good Excellent How we did our inspection: This key unannounced inspection consisted of a visit to the home on Thursday 3rd December 2009. One inspector performed this inspection. During this time we spoke to the owner who is the person who has day to day responsibility for the service and several care and ancillary staff. We spoke or observed most people who live in the home. We case tracked three people who use the service. Case tracking means we looked in detail at the care three people receive. We spoke to staff about their care, looked at records that related to them and made observations if they were unable to speak to us. We looked at three staff recruitment records, induction and training records and policies and procedures. We did this because we wanted to understand how well the systems work and what this means for people who use the service. We checked compliance on requirements made at the last inspection. All this information helps us to develop a picture of how the home is managed and what it is like to live at Southwater. Care Homes for Older People Page 6 of 25 Care Homes for Older People Page 7 of 25 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 8 of 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. The admission procedure is good and means that staff has enough information to decide whether they are able to meet the needs of the person. The home does not provide intermediate care. Evidence: Each person is admitted following an assessment performed by the owner, Mrs Lamont. This assessment is used alongside assessments made by other health care professionals. Together this information is used to make an initial plan of care. There have been no recent admissions but people said they had chosen the home by word of mouth and recommendation from friends. One person said she came to visit the home before moving in. Care Homes for Older People Page 10 of 25 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The health and personal care people receive is provided in a respectful dignified way. The care planning systems at the home are satisfactory and reflect how health and personal care needs are met in a safe way. The management of medicines is good. Evidence: During the inspection people looked cared with the finer details such as eye care, nail care and appropriate foot wear present. People told us that they were pleased with the attention they received from the majority of the staff. One person said This is the closest place to home, they cant do enough for me. People living at Southwater have access to a range of health care services both at the home and in the community. People have access to local and national NHS services Care Homes for Older People Page 11 of 25 Evidence: and routine screening programmes. Each person has a GP who attends when staff requests a visit. One person said If I need the doctor they just ring him and he comes, no problem. Health care needs are monitored in the care plans. The care plans have been improved and are organised to show different areas of the plans. Each plan contains assessments for such issues as falls, nutrition, moving and handling and more general risks. Risk assessments included nutrition and falls. These assessments are reviewed each month or where a change occurs. Specialist health care professionals are sought for advice and guidance. Progress of the person is recorded in notes made by the staff and also by health care professionals such as chiropodist and Doctors. The management of medications is performed well at the home. We looked at the treatment room where medications are stored in a locked cupboard. The owner is generally responsible for management of the medication from receipt to disposal. Medicines are supplied mainly in a monitored dose system. There were no controlled drugs being used at this time. The records of administration were clear. To aid identification of the person to receive medication the records have photographs of each individual person living at the home that were in receipt of medication. Used medications are placed in a returns container that securely held medication. All medications for disposal are recorded and signed for on collection as per the company and government policy. People who use the service were treated with respect during the inspection. They were offered choice regarding meals and addressed using their chosen term of address. As a team, staff displayed very positive interactions which caused positive experiences for people in the home. Interactions seen on the day of inspection were appropriately affectionate, kind and professional. Care Homes for Older People Page 12 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 social and therapeutic activities provided for people are good. People also benefit from a wholesome balanced diet. Evidence: People told us that they chose the time of rising and retiring, with or without assistance. One person said I often have a little lie in, its no bother. Staff were seen and heard to knock and wait before entering bedrooms. Some people told us that they chose to remain in their rooms as, I am happy here but can join in if I want to Others said they joined in some of the activities. One person said, We love the Grannys tea party its good fun we get to tell some jokes its very lighthearted. Staff explained that there are activities every day between 3-4PM these includes armchair fitness, quizzes or board games, a musician comes in once a month and the people said they enjoyed the singing. Every weekend after lunch the owner holds what they call a Grannys tea party whereby they all get together and talk about their week, have some fun, tell some jokes whilst enjoying tea and cakes. We spoke to Care Homes for Older People Page 13 of 25 Evidence: three people who took part in this some comments made include its great, Its lovely and I really enjoy it. Records are kept of activities provided. Opinion on the food was it was good and in sufficient quantity. One person said The food is lovely and whatever I say I want they give it to me Surveys returned to CQC showed that people always liked the food, one person said the food is wonderful, plenty of choices. Care Homes for Older People Page 14 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. People who use the service and their relatives can be confident that their complaints and concerns will be listened to and acted on. The knowledge procedures and training in place for the Protection of Vulnerable Adults help to protect people. Evidence: The Care Quality Commission has received no complaints about this service since the last inspection. Staff we spoke to said they felt able to talk to the owner about any worries or concerns. They also said they would have no hesitation to complain if the situation arose and would report poor practice. Staff said they had attended Protection of vulnerable adult (POVA) training and had been informed of the different types of abuse and how to report them. All staff were aware they could speak with the CQC if they were concerned about abuse. Training records showed that staff receive adult protection training to ensure they are aware of the issues and know who to raise any concerns with. People spoken with confirmed that they were happy living at the home and all said they felt safe at the home. All staff has a criminal records bureau police check and a POVA register check performed before they are able to work. Care Homes for Older People Page 15 of 25 Evidence: 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. Southwater is a safe, clean and comfortable place to live and work. Evidence: The location of the home is good, as it is close to the town centre and seafront. Its layout is homely and attractive and comprises of three house joined at the front along the conservatory. There are three staircases. The one to the far right of the home has a stair lift fitted. A stairlift is also in situ on the staircase to the left of the building. The communal areas, sitting room and dining area are bright and comfortable. We looked around the home, generally it was decorated to a good standard, however some areas were looking a little tired and worn and in need of attention. The home owner told us this is ongoing. People told us they liked their private bedrooms and had been able to personalise this space with items of furniture and mementos brought from home. In order to reduce the risk of scalds and burns to people, hot water temperatures are controlled and radiators seen in bedrooms were covered. The garden is a pleasant and safe space for people to enjoy. Care Homes for Older People Page 17 of 25 Evidence: The home was clean and free from offensive odours throughout. People responding with surveys said the home was always clean and fresh. The laundry was clean and well organised with the necessary equipment in place. Staff receive training in infection control and hand sterilising gel is readily available and also at the main entrance for visitors to use to minimise infection. The laundry floor needs attention as it is concrete and not easily cleanable. 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 adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Staffing levels are sufficient to ensure that peoples needs are met in a timely way and experienced and friendly staff support people well. People are not fully protected by a robust recruitment practice, improvements must be made. Evidence: People living at the home spoke highly of the staff. Their comments included, Staff are very kind indeed, They are lovely people and are there when you need them and They are very good, I get on with all of them. One survey simply said 10/10 for everything! The majority of people responding with CQC surveys told us staff were always available when needed. All of the staff returning surveys told us there was always enough staff to met peoples needs. During our visit peoples needs were attended to in a timely and unhurried way. Currently the home owner is on call at night. People said that if they needed help she responded quickly. However, this is not a safe nor sustainable situation and night staff should be recruited to ensure safety is maintained. We discussed this with the home owner and shesaid she was about to advertise to recruit some more staff for night duties. We looked at the recruitment practice within the home to ensure people are protected. Care Homes for Older People Page 19 of 25 Evidence: All staff returning surveys told us that employment checks such as Criminal Record Bureau (CRB) check and references had been undertaken. We looked at three staff recruitment files. Not all the required checks had been obtained before staff started working at the home ( two written references are required). Staff told us they had good training opportunities and good support from the management. All staff responding with surveys said they had received induction training, which helps them to understand how to work safely and respectfully with people. Other training, including mandatory training is well addressed. Records showed that staff had also undertaken training such as adult protection, medication and the principles of person centered care. Care Homes for Older People Page 20 of 25 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home is well managed, with good systems in place to ensure that peoples views are sought and acted upon. Health and safety within the home is promoted meaning people live in a safe environment. Evidence: The owners Mr & Mrs Lamont have been running Southwater for twenty one years and live on the premises so they are available at all times. Staff told us that they felt well supported by the owner and that they met with her regularly. One person said that the owner is really good, nice to work for. We saw a commitment on the owners behalf to gain peoples viewpoints about the service through informal and formal methods involving the people living at the home. It is recommended they seek further feedback from professionals vising the home as to how they may continually improve. Care Homes for Older People Page 21 of 25 Evidence: Staff and records confirmed that mandatory training was undertaken, such as infection control and health and safety. Care staff had completed manual handling, infection control and fire safety. Fire records were well managed, all drills, training, equipment checks were up to date. There was a fire risk assessment in place. Records looked at, including maintenance and servicing certificates, showed that regular maintenance was undertaken on all equipment, such as hoists and lift, and gas & electrical systems. Care Homes for Older People Page 22 of 25 Are there any outstanding requirements from the last inspection? Yes R 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 1 29 19 The registered person shall 28/03/2009 not allow a person to work at the care home until she has obtained the documents in respect of that person as required by the regulations in order to protect residents from potential harm. 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 1 29 19 The registered person shall not allow a person to work at the care home until she has obtained the documents in respect of that person as required by the regulations. This will keep people safe from harm. 31/01/2010 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 2 26 27 The laundry floor should be improved so that it can be cleaned properly. Staff should be available by night, to provide a sustainable service and ensure continued safety of people living at the home. Feedback should be sought from visiting professionals about the service provided by the home so that they can continually improve and keep up to date with good practice. 3 33 Care Homes for Older People Page 24 of 25 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. 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