Southover Care Home

About the service

Southover Care Home is a residential care home providing personal care to up to 22 people. The service provides support to older people who may have a physical disability or sensory impairment. At the time of our inspection there were 17 people using the service.

People’s experience of using this service and what we found

People were protected from the risk of abuse as systems were in place and risks were assessed, managed and monitored. People and their relatives told us they were supported by kind staff who knew them well. People received their prescribed medicines safely. We were assured that the provider was supporting people living at the service to minimise the spread of infection. Incidents and accidents were investigated and reviewed by the registered manager and management team.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager understood their responsibility to be open and honest with people and acted appropriately when things went wrong. Quality assurance processes were used to monitor the service effectively which reduced the risk of avoidable harm. Staff worked in partnership with other health and social care professionals to ensure people’s individual needs were met.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was good (published 25 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The provider had ensured there was a plentiful supply of personal protective equipment and we saw staff used this appropriately.

Cleaning and disinfection was seen as a high priority and an ozone steriliser was used to further reduce risks.

Risk assessments had been completed to consider any staff who maybe at higher risk and measures were in place to support them. Staff were supported by regular information and training.

Activities within the service had been personalised and took place in bedrooms which reduced people’s risk of isolation. These had been received well and for some people this had resulted in a reduction in the reliance of medicine.

Most visitors had initially been discouraged there is now a system in place to enable visiting to be completed in a safe way.

Further information is in the detailed findings below.

Southover Care Home accommodates up to 22 people in one adapted building. The service specialises in caring for older people including those with physical disabilities and people living with dementia.

At our previous inspection in July 2017 we rated the service as 'requires improvement'. We found improvements were needed to the premises to ensure people lived in a place that was safe, kept clean and ensure risks were managed to protect people from avoidable harm.

The provider was asked to complete an action plan to tell us what they would do to meet legal requirement for the breach in safe care and treatment.

You can read the report from our last comprehensive inspection and our focused inspection, by selecting the 'all reports' link for Southover Care Home on our website at www.cqc.org.uk

This inspection took place on 8 August 2018 and was unannounced. At the time of our inspection visit 18 people were in residence.

We found the provider had made the required improvements to meet the legal requirements. The overall rating of Southover Care Home has improved to ‘good’.

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.

People were safe using the service. The provider had made improvements to the premises to ensure that people lived in a safe place. The provider had made the necessary improvements to ensure people lived in a safe place. This included new carpets and flooring, installing radiator covers, making appropriate risk assessments. The provider had also begun a programme of decoration.

All areas were clean and tidy. Staff followed the infection control procedures. Regular checks carried out on the premises, equipment used to maintain people's safety and fire safety checks.

People were protected from the risk of harm. The risks to people’s health and wellbeing had been assessed and measures put in place to manage risks to people and promote their safety and independence.

People received their medicines as prescribed. Medicines were stored and managed safely. People’s nutritional needs were met. People had access to a range of health care professionals. Staff monitored people’s health and made referrals when people’s health was of concern.

Staff recruitment procedures reduced the risks of employing staff unsuitable to work in care. There were enough staff to support people. Staff were trained in safeguarding and other relevant safety procedures to ensure people were safe and protected from avoidable harm and abuse. Staff understood their responsibilities to report concerns.

Staff continued to be supported in their role. Systems were in place that ensured staff were trained, supervised and supported in their role. Staff worked in partnership with other health care professionals to enhance people’s quality of life.

Staff gained people's consent before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and their family were involved in the development and review of their care, and changes were made as needed. Care plans were personalised, reviewed regularly and provided staff with guidance about how people wanted to be supported. People had the opportunity express their views about their end of life care, when needed.

People continued to be supported by kind and caring staff. They had developed positive and trusting relationships with the staff team. People’s privacy and dignity was respected and their independence promoted. People’s bedrooms were treated as their own private space. Staff ensured people’s confidential personal information was secure.

People continued to receive care that was responsive and personalised. Staff respected and supported people’s backgrounds, faith and choice of lifestyle. Information was made available in accessible formats to help people understand the care and support agreed.

People made choices about their day to day lives and how they spent their time. People took part in activities, social events that were of interest them and maintain contact with family, friends and links with the wider community. People’s religious and spiritual needs were met. People knew how to make a complaint.

People and relatives all spoke positively about the staff team, management and the quality of care. People had a range of methods to express their views about the service. The registered manager used feedback and complaints to bring about changes to the service.

The registered manager understood their legal responsibilities. They provided good leadership and support to staff and people who used the service. Accidents and incidents were recorded; analysed and action taken. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service. Quality assurance system had been used effectively to identify shortfalls and make improvements.

Southover Care Home provides accommodation for up to 22 people. The service is designed to meet the needs of older people living with or without dementia. At the time of our inspection there were 21 people using the service.

At the last inspection, the service was rated good.

A registered manager was in post and was available throughout the inspection. 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 this inspection, the service remained good overall. However, we found improvements were needed to the premises to ensure people lived in a place that was safe, kept clean and people’s dignity was protected. Environmental risks were not assessed or managed to protect people from avoidable harm without compromising their independence.

People were supported by staff who knew how to keep people safe, recognise abuse and how to respond to concerns. Risks in relation to people’s care and support needs were assessed. People were involved in the development of care plans to ensure care was personalised, and their safety, independence and wellbeing was promoted. Care plans were regularly monitored and reviewed.

People mostly received their medicines safely. People’s dietary needs were met. People had access to a range of healthcare services and attended routine health checks.

People’s safety was protected because staff were recruited through safe recruitment practices. We found there were sufficient numbers of staff to provide care and support when people needed it. Staff received an appropriate induction, training, supervision and appraisal.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

People’s privacy and dignity was respected. Staff’s approach was caring and they knew people well. People were involved in the review of their care plans which helped to ensure they received personalised care that was responsive to their needs. People maintained contact with family and friends and took part in social events, activities that were of interest to them and supported people with their religious needs.

People’s views about the quality of the service were sought in a range of ways and their comments showed that they were satisfied with the care provided. People and their relatives felt confident to raise concerns with the registered manager. A complaint process was available and advocacy support was made available to people.

The provider was meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

We saw care plans were well written and person centred. The care plans covered people's individual needs and included the wishes of the person for how they would like to be cared for as well as detailed guidance for staff carrying out the care. People were involved in updating their care plans. Improvements had been made in the recording of the administration of medication.

We saw appropriate checks were undertaken before staff began work. Staff told us there were enough staff on duty to meet people's needs. One person we spoke with confirmed this.

We saw audits of care plans and medication records had been carried out, as well as health and safety audits.

People who used the service were generally complementary about staff who worked at the home, however, we found that the people using the service could not be assured staff employed to care for them were suitably qualified, skilled and experienced.

We found that the provider had failed to ensure that there were always enough qualified, skilled and experienced staff to meet people’s needs.

Although the provider had some systems in place to identify risks relating to the health, welfare and safety of people using the service, we found that these were not effective in identifying and managing risks. The provider did not always take action to ensure the safety of people using the service.

We found that there were not always enough staff available to meet people's needs. Three of the six people we spoke with told us that they often had to 'wait around for someone to come'. Staff supported this telling us 'we could do with more staff, people's needs have changed and we don't always have enough staff to manage'.

We found that the provider had put systems and processes in place to ensure that risks to peoples' health and wellbeing were identified and managed. These included systems to ensure staff were recruited safely.

We found that staff had a clear understanding of when and how to undertake capacity assessments to ensure that people could be assured that if decisions were made on their behalf, that they were always in their best interest. However, we found that the provider was not protecting people from receiving treatment that was inappropriate.

People had in place nutritional risk assessments which accurately reflected their current needs and nutritional requirements. Staff told us that they felt confident in assessing people's nutritional needs.

We found that the homes general environment and quality of food provided to people had improved since our inspection in March. However there were still some improvements needed. The provider was not fully protecting people from the risks of inadequate nutrition.

Whilst the provider had in place some systems and processes to assess and monitor the quality of service provision, we found that they did not always act on concerns raised.

Additionally, a lack of staff knowledge in regards to capacity assessments meant that people could not be assured that their rights were protected. We also found that the provider did not have in place evidence of effective recruitment and selection processes which would ensure that people were suitably qualified, skilled, experienced and fit to work in social care.