Archived: Southwinds

Updated 16 January 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection visit took place on 4 May 2017 and was unannounced. The inspection team consisted of two inspectors.

We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also received current monitoring information from the local authority and healthcare professionals. We used this information to formulate our inspection plan.

We also had a provider information return (PIR) sent to us. A PIR is a form that asks the provider to give some key information about the service. This includes what the service does well and improvements they plan to make. As part of our planning, we reviewed the information in the PIR.

We spoke with five people who used the service, two members of care staff, the deputy manager and the registered manager. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas. We also spoke with three visiting community professionals.

We looked at the care plans of five people to see if they were accurate and up to date. We also looked at records that related to the management of the service. This included the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 16 January 2018

This inspection was unannounced and took place on 4 May 2017. The service was registered to provide accommodation for up to 25 people. At the time of our inspection, 13 people with learning disabilities were using the service.

At our last comprehensive inspection on 1 December 2016, the provider was placed into special measures by CQC following an inadequate rating. The overall rating for the service remains ‘Inadequate’ and therefore remains in ‘special ‘measures.’ This inspection found that there were not enough improvements to take the provider out of special measures. CQC is now considering the appropriate regulatory response.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last comprehensive inspection, the provider was in breach of seven regulations. Fire safety procedures were not followed; people were living in an environment that had unpleasant odours; people’s health care needs were not responded to in a timely manner; their dignity was not promoted; care was not individual to people; the management was ineffective and they had not notified us about incidents when needed. We took enforcement action against the provider and they sent us an action plan on 4 January 2017 telling us how they would make improvements in these areas.

At this inspection, we found that the provider had completed some of these actions, but others were still outstanding. For example, few improvements had been made in relation to the individual and person centred nature of the support people received. In addition, whilst the audit system in place had been effective in relation to fire safety and the environment, and policies had been updated, the provider did not know what some of the policies were, and was not analysing the information gathered.

At our previous inspection, we also found that improvements were needed in various other aspects of the service. We were not confident that there were enough staff available for people during the night; staff did not have personal protective equipment readily available to them; the provider had not responded to safeguarding concerns as they should have done; risks to individuals were not managed. In addition, the provider did not understand or follow guidance when people were not able to make decisions for themselves; people did not have easy access to drinks and they were not supported to make choices about their meals. We also found that people were not actively involved in making decisions about their care; they had limited involvement with the planning of their support; opportunities to participate in meaningful activities were limited; care records did not contain the information staff needed and these were not accessible when staff needed to look at them.

At this inspection, we found that some improvements had been made, however further were required.

Risks to people were still not effectively assessed, monitored and reviewed. Staff were aware of how to safeguard people, but the provider still had not acted on concerns raised. Some staff were not aware of people’s specific health conditions. The provider had still not followed guidance when people were not able to make decisions for themselves. Risks to people when eating were not managed, and people’s choices and preferences were not considered.

People’s independence was not promoted and they were not enabled to make decisions about their care. People did not receive care that was individual to them or person centred. People’s care plans were being updated, but it was not clear how they had been involved with this. Care plans did not contain all the information that was important to people. When care plans were clear about the support people should receive, this was not always followed by staff.

The provider did not manage the service effectively to ensure that people received high quality care. They did not have effective systems in place to drive continuous improvements. They were unaware of the policies they had introduced. The overall culture of the service did not empower the people living there and the provider had failed to meet their legal obligations when things had gone wrong in the service.

The provider had made improvements to the environment, and fire safety procedures were followed. The provider had considered access to staff during the night, and medicines were administered safely. People received support from healthcare professionals, and their privacy was respected. People were able to maintain family relationships and said they would speak to staff if they had any problems.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC's regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.