Care Home: Southwold Nursing Home

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What the care home does well Residents at the home were being cared for and supported well by the acting home manager and her staff. Residents spoken to said the quality of care provided was good. Residents said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included: `the staff always speak to me with respect and in a pleasant way`, `the carers and nurses are all lovely and very patient`, `I get all the help I need and the staff have a lovely manner about them`, `my relative is looked after by very dedicated people who are pleasant and full of good humour`, `I visit regularly and take the view that the residents are looked after by caring and compassionate staff who are respectful to everybody`, `they are really good and I feel that my privacy and dignity is respected her by them all`. Also people spoke positively about being able to make individual choices in their daily life. Comments made included `I am able to make personal choices in daily life her and do so`, `I decide what time I get up in the morning, what I have for my meals`, `how I spend my day and when I go to bed`, `if I want to spend time in my own room I can at ant time`, ` I choose what clothes I wear, what I do during the day and also go out with my family whenever I want to`, `the staff all respect my relative`s views and always try to accommodate their wishes if possible`, `the carers and nurses ask if you are happy with things or if you want to do something else`. What has improved since the last inspection? The owner of the home and the acting home manager have put into place an action plan that seeks to improve the quality of the care and support residents receive. Areas in which changes have been made include how medicines are managed in the home, updates to staff training, and how information is communicated to residents and their relatives. What the care home could do better: To comply with The Care Standards Act 200 an application needs to be submitted to the Care Quality Commission to register the home manager when appointed. They also need to ensure that residents care plans and risk assessments are evaluated at least monthly. Discussion with the acting manager, responses in the AQAA document referred to above, and the outcomes of checks (audits) conducted at the home indicate that areas where improvement can be made are identified and acted upon appropriately. Key inspection report Care homes for older people Name: Address: Southwold Nursing Home Southmoor Road Wythenshawe Manchester M23 9NR     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: Michael Murphy     Date: 0 2 0 2 2 0 1 0 This is a review of quality of outcomes that people experience in this care home. We believe high quality care should • • • • • Be safe Have the right outcomes, including clinical outcomes Be a good experience for the people that use it Help prevent illness, and promote healthy, independent living Be available to those who need it when they need it. The first part of the review gives the overall quality rating for the care home: • • • • 3 2 1 0 stars - excellent stars - good star - adequate star - poor There is also a bar chart that gives a quick way of seeing the quality of care that the home provides under key areas that matter to people. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. that people have said are important to them: They reflect the things This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Care Homes for Older People Page 2 of 24 We review the quality of the service against outcomes from the National Minimum Standards (NMS). Those standards are written by the Department of Health for each type of care service. Copies of the National Minimum Standards – Care Homes for Older People can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The mission of the Care Quality Commission is to make care better for people by: • Regulating health and adult social care services to ensure quality and safety standards, drive improvement and stamp out bad practice • Protecting the rights of people who use services, particularly the most vulnerable and those detained under the Mental Health Act 1983 • Providing accessible, trustworthy information on the quality of care and services so people can make better decisions about their care and so that commissioners and providers of services can improve services. • Providing independent public accountability on how commissioners and providers of services are improving the quality of care and providing value for money. Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report Care Quality Commission General public 0870 240 7535 (telephone order line) Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. www.cqc.org.uk Internet address Care Homes for Older People Page 3 of 24 Information about the care home Name of care home: Address: Southwold Nursing Home Southmoor Road Wythenshawe Manchester M23 9NR 01619456367 01619459002 Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): www.anchor.org.uk Anchor Trust Name of registered manager (if applicable) Type of registration: Number of places registered: care home 41 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 old age, not falling within any other category Additional conditions: The maximum number of service users aged over the age of 60 requiring nursing care shall be 41. Date of last inspection Brief description of the care home Southwold Nursing Home is a home with 41 beds providing personal care with nursing. The Home was purpose built for the specific resident group in the early 1990s, initially to provide a better care setting for people on long stay wards within the NHS. It is built on two floors and has a passenger lift. The home is totally wheelchair accessible. The home is divided into 4 care areas which each have 8 single and one double room, all of which are en suite. Each care area has it own lounge. There is also a central lounge and dining room on the ground floor and a smaller dining room on the first floor. There are two gardens. The home is on the edge of the Wythenshawe Hospital site. The home has its own car Care Homes for Older People Page 4 of 24 Over 65 41 0 Brief description of the care home park at the front of the building. It is close to a major motorway network and public transport provides very frequent services to Manchester, Stockport and Altrincham. These services are situated very close to the entrance to the home. Fees payable at the time of this inspection ranged from a minimum of 471.60 pounds per week to 740.00 pounds per week. Please contact the home manager for further details. Care Homes for Older People Page 5 of 24 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: 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 inspection included an unannounced visit to the home on the 2nd of February 2010. During the visit we talked to residents, relatives staff and the acting home manager. We also looked at documents and records the home have to keep such as residents care records, medicine records, written policies and other records. In the twelve months before this inspection we asked the home to complete a form called an Annual Quality Assurance Assessment (AQAA) to tell us what they felt they did well, and what they needed to do better. This helps us to determine if the management of the home sees the service they provide the same way that we see the service. We felt this form had been completed in sufficient detail and provided useful information. Care Homes for Older People Page 6 of 24 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details on page 4. The report of this inspection is available from our website www.cqc.org.uk. You can get printed copies from enquiries@cqc.org.uk or by telephoning our order line 0870 240 7535. Care Homes for Older People Page 7 of 24 Details of our findings Contents Choice of home (standards 1 - 6) Health and personal care (standards 7 - 11) Daily life and social activities (standards 12 - 15) Complaints and protection (standards 16 - 18) Environment (standards 19 - 26) Staffing (standards 27 - 30) Management and administration (standards 31 - 38) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Older People Page 8 of 24 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them and the support they need. People who stay at the home only for intermediate care, have a clear assessment that includes a plan on what they hope for and want to achieve when they return home. People can decide whether the care home can meet their support and accommodation needs. This is because they, or people close to them, have been able to visit the home and have got full, clear, accurate and up to date information about the home. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between them and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Before being admitted to the home prospective residents have their care and support needs assessed to ensure the home is able to meet their needs. Evidence: All prospective service users undergo a pre-admission assessment before a decision is made about them entering the home. This assessment is conducted by the appropriately qualified and experienced acting manager of the home. The purpose of this assessment is to decide if the home will be able to meet the potential residents care and support needs properly. It also helps prospective residents and their relatives in their decision of how appropriate the home would be for them. A record of the preadmission assessment is kept in each residents care record and identifies what care and support they will need. Other pre-admission assessments conducted by social workers and health care workers were also kept in the care records. Discussion with residents indicated that their views were taken into account before admission to the home. Care Homes for Older People Page 9 of 24 Evidence: Prospective residents are given the opportunity (where possible) to visit the home before they are admitted. Reviews of all new admissions are undertaken around six weeks after admission to determine if the new resident has settled well, is happy at the home and decide if the home is suitably meeting their care and support needs. The home does not provide intermediate care. Care Homes for Older People Page 10 of 24 Health and personal care These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s health, personal and social care needs are met. The home has a plan of care that the person, or someone close to them, has been involved in making. If they take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it, in a safe way. People’s right to privacy is respected and the support they get from staff is given in a way that maintains their dignity. If people are approaching the end of their life, the care home will respect their choices and help them feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were satisfied they were being properly supported to ensure their health and personal care needs were being met appropriately. Evidence: The care records of three residents were looked at on this occasion. These were organized and contained care plans that set out the action that needed to be taken by the nursing and care staff to ensure the health, personal and social care needs of residents are met. Care plans were written in a way that reflected the very specific care and support needs of each resident. The care records also contained risk assessments that identified possible threats to a residents health and safety and described things that needed to be done to keep them safe at the same time as maintaining their freedom and independence. For example risk assessments had been done with regard to residents mobility and nutrition needs and the condition of their skin. However it was noted that care plans and risk assessments had not been formally evaluated for some time. The acting manager confirmed this should be done at least monthly. Arrangements had been made to register all residents with a local GP and their Care Homes for Older People Page 11 of 24 Evidence: healthcare needs were also being addressed through the support of a specialist team (based at the nearby hospital) led by a medical consultant. Information in the care records and discussion with residents, their relatives and staff indicated residents were able to access health care services appropriately. A record of all such access was kept. Residents medicines were being looked after safely and securely. The qualified nurses manage and administer residents medicines. A medicine record was kept in respect of each resident. These had been completed properly. The manager regularly conducted checks (audits) to make sure the way residents medicines were being looked after continued to be safe. Residents and relatives spoken to said staff spoke to them respectfully and maintained their dignity, particularly when personal care was being given. Comments made included the staff always speak to me with respect and in a pleasant way, the carers and nurses are all lovely and very patient, I get all the help I need and the staff have a lovely manner about them, my relative is looked after by very dedicated people who are pleasant and full of good humour, I visit regularly and take the view that the residents are looked after by caring and compassionate staff who are respectful to everybody, they are really good and I feel that my privacy and dignity is respected her by them all. Care Homes for Older People Page 12 of 24 Daily life and social activities These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives. They are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. People have nutritious and attractive meals and snacks, at a time and place to suit them. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents were supported to enjoy a stimulating lifestyle and access a wide range of social and leisure activities. Residents were encouraged to make as many personal choices in their daily lives as possible, and the general view of food provision was positive. Evidence: The routines of daily living and the social activities available were flexible and varied and were meeting residents expectations, preferences and capacities. Residents were supported to access a wide range of social and leisure activities, entertainments and outings. Information about forthcoming events, activities and entertainments was prominently displayed. Residents said they enjoyed the programme of activities available. Residents were able to follow their own religious practices and as in other areas of life in the home were are able to exercise their own personal choices in respect of this. Residents and relatives spoken to said there were no unreasonable restrictions on visiting at the home. Residents may receive their visitors in the privacy of their own room or quieter area of the home if preferred. Residents also said they were able to exercise choice and independence in their daily lives. Comments made included: I am able to make personal choices in daily life her and do so, I decide what time I get up Care Homes for Older People Page 13 of 24 Evidence: in the morning, what I have for my meals, how I spend my day and when I go to bed, if I want to spend time in my own room I can at ant time, I choose what clothes I wear, what I do during the day and also go out with my family whenever I want to, the staff all respect my relatives views and always try to accommodate their wishes if possible, the carers and nurses ask if you are happy with things or if you want to do something else. Menus were prominently displayed in the home and were varied, balanced and provided choice. Residents said they can always request an alternative from the menu if they wish. Comments regarding the food included: the quality of the meals is really good, there is plenty to eat and it tastes good, I occasionally have a meal when I visit and the food is consistently good. Lunch was observed on the day of inspection. This was a hot and substantial meal. Staff served and assisted residents appropriately and sensitively. The dining area was comfortable, suitably furnished and appropriate for residents to take their meals in. Care Homes for Older People Page 14 of 24 Complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them know how to complain. Any concern is looked into and action taken to put things right. The care home safeguards people from abuse and neglect and takes action to follow up any allegations. People’s legal rights are protected, including being able to vote in elections. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. There is a clear and accessible procedure in place to respond to any complaints. Staff are provided with safeguarding training and there are policies in place that describe how to protect residents and keep them safe. Evidence: Information on how to make a complaint was prominently displayed in the home. This information detailed who to contact and how the complaint would be dealt with. A complaints record is kept by the home. Complaints appeared to have been dealt with properly. Discussion with residents and relatives indicated that the acting manager or senior staff are always available and that any issues raised are dealt with promptly. The home operates safeguarding and whistle-blowing policies (including those developed locally and operated by Manchester social services) that seek to keep residents safe. Staff spoken to were aware of the importance of safeguarding and protecting residents and described their role in doing so. They confirmed they have been provided with safeguarding training. Inspection of training records revealed that safeguarding training has been provided to staff at the home and that this was in the process of being updated. In relation to the Mental Capacity Act the acing manager informed us that no people living at the home were subject to a deprivation of liberty authorisation and that no one living at the home was having their liberty deprived without authorisation. Care Homes for Older People Page 15 of 24 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The home provided a pleasant, comfortable, clean and suitably adapted environment for residents. Evidence: The home appeared to be in a good state of repair and an ongoing programme of maintainence was being operated. The lounge and dining areas were clean, appropriately and adequately heated, comfortably and appropriately furnished and provided a suitable and safe environment for residents to be cared for and supported properly. Lounge areas are available on each unit and there is also a large communal lounge on the ground floor. Televisions, music centres and other leisure equipment were available throughout the home. Suitably adapted bathing and toilet areas were provided. The home has generally been suitably adapted and equipped to meet the needs of residents. For example there is an adequate provision of hoists, grab rails and other equipment. Individual residents specialist needs are met after referral to the appropriate health care worker for assessment. Residents bedrooms that were inspected were clean, suitably furnished and equipped and personalized. Residents and relatives spoke positively about the environment of the home saying it was clean, warm and comfortable. The home was very clean and odour free. Proper arrangements were in place to manage residents laundry needs. Suitable measures were being taken to minimize the Care Homes for Older People Page 16 of 24 Evidence: potential spread of infection within the home such as adequate hand washing facilities and the provision of protective clothing for staff as well as appropriate cleaning practices within the home. Care Homes for Older People Page 17 of 24 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable to care for them. Their needs are met and they are cared for by staff who get the relevant training and support from their managers. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The staffing provision, staff recruitment procedure and the staff training provided at the home seek to ensure residents are cared for and supported safely and appropriately. Evidence: Staffing arrangements at the home were supporting residents ensuring their needs were met. Discussion with residents and relatives revealed they were generally of the view sufficient staff were available to make sure residents were being properly looked after. Though comments were made about residents sometimes having to wait a little longer for support from staff in the evening when staff numbers were not as high as earlier in the day. This was discussed with the acting home manager on the day of inspection when it was recommended that staffing levels during this period are reviwed to ensure residents care and support needs continue to be met at all times. There were appropriate arrangements in place to ensure there were sufficient staff in respect of the management/administration, catering, laundry, maintainence and housekeeping functions of the home. There was a proper process in place in respect of recruiting staff. This is important to ensure residents are being cared for and supported by suitable people. The recruitment process included making police checks and another check regarding the suitability of the applicant working with vulnerable people. The arrangements for training staff seeks to ensure that residents care and support needs are being met by Care Homes for Older People Page 18 of 24 Evidence: competent staff. Discussion with the acting manager, staff and inspection of training records revealed that a training programme is in place in respect of all staff employed at the home. The homes training plan and training records were in the process of being updated by the acting manager at the time of this inspection. 52 of the care staff have obtained a level 2 national qualification in care. The remaining carers were undergoing this type of training or are expected to do so in the near future. Care Homes for Older People Page 19 of 24 Management and administration These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is led and managed appropriately. People control their own money and choose how they spend it. If they or someone close to them cannot manage their money, it is managed by the care home in their best interests. The environment is safe for people and staff because appropriate health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately with an open approach that makes them feel valued and respected. The people staying at the home are safeguarded because it follows clear financial and accounting procedures, keeps records appropriately and ensures their staff understand the way things should be done. They get the right care because the staff are supervised and supported by their managers. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The interim arrangements to manage the home until a home manager is recruited were satisfactory. Residents, their relatives and staff were confident the home is run in the best interests of the residents. Evidence: The position of home manager was vacant at the time of this inspection and the service provider was actively seeking to recruit somebody for the post. The home was being managed, at the time of our visit, by the the homes care manager. This person is a qualified nurse who holds an appropriate management qualification and is very experienced in providing nursing care and support for the elderly. Discussion with residents, their relatives and staff revealed that the acting manager created a positive, inclusive and open atmosphere at the home. There was also a comitment to ensure the quality of the service provided to residents is of a high standard and that the home is run in their best interests. The acting manager and provider representative (who supports the acting manager) regularly obtain the views of residents, relatives and staff in respect of this. Discussion with Care Homes for Older People Page 20 of 24 Evidence: these groups of people showed that the manager and provider listen to any issues/suggestions raised and take any neccessary action. The acting manager also conducts checks (audits) on how well the home is run. For example regular checks are made in respect of residents medicines, how care records are maintained and the state of the environment. The arrangements to support residents with their money (personal allowances only) were secure and appropriately documented. The arrangements for the health and safety of residents (and others) in the home were adequate and appropriate. Staff are provided with regular training in respect of moving and handling, fire safety, food hygiene and the prevention of infection. Hazardous substances were being securely stored and gas and electrical systems had been checked/certificated regularly, we were informed hot water temperatures in resident areas are appropriately controlled. Procedures were in place for the appropriate reporting of accidents, illnesses and injuries. Care Homes for Older People Page 21 of 24 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 22 of 24 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 7 15 That all residents care plans and risk assessments are evaluated at least monthly. To ensure the care and support needs of residents face are being met appropriately through regular review. 31/03/2010 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 Care Homes for Older People Page 23 of 24 Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 24 of 24 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. 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