Archived: Southmead Rest Home

Southmead Rest Home is registered to accommodate up to 16 people. At the time of our inspection there were 12 older people living in the home. Accommodation for people is arranged over two floors with stair lifts to assist people to get to the upper floor. The home had a well maintained garden that provided a safe, accessible area for people to enjoy.

At the last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and on going monitoring that demonstrated serious risk or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changes since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated Good.

Is the service safe?

People were protected from potential abuse and avoidable harm by staff who were knowledgeable about recognising and reporting different signs of abuse. There were sufficient numbers of appropriately qualified staff available on each shift to ensure people were cared and supported safely. Risks to people were well managed and medicines were stored appropriately and managed effectively. People were protected by the prevention and control of infection. There was a system in place to review and learn from incidents when things went wrong.

Is the service effective?

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People had access to a variety of health care professionals who gave care and support to people at the home. Staff received quality training which they found effective and useful. Staff were well supported with a clear system of supervision meetings and annual appraisals. People had access to nutritious, home cooked food that they enjoyed and were given choice in their menu selections.

Is the service caring?

People and relatives told us they found the staff to be kind, caring, friendly and patient. Staff spoke knowledgeably about people and showed they knew how people preferred to be given their care and support. People were treated with dignity and respect and supported to make their own choices about how they spent their day. People’s privacy was respected. Relatives told us they were always made to feel very welcome and enjoyed the calm, cheerful atmosphere at the home.

Is the service responsive?

People received person centred care from a team of staff who knew them and their health needs well. People’s needs were re-assessed when their health needs changed and relatives were kept informed and included. Activities formed a key part of people’s daily lives which improved their sense of wellbeing. There was a planned programme of varied and interesting activities for people to take part in if they wished. People knew how to complain if they needed to and there was a clear complaints process available.

Is the service well led?

There was an open, honest, friendly culture and people told us they had confidence in the management team and the staff. People and their relatives were consulted and involved in their care and support. There was a programme of quality checks and audits to ensure the quality of the service was maintained.

Further information is in the detailed findings below.

Southmead Rest Home is a care home for up to 16 older people. There were 14 people living there when we visited. Accommodation is provided in bedrooms on the ground and first floors, with the living and dining rooms on the ground floor. Rooms have washbasins and some rooms have an ensuite toilet. The first floor is accessed via a staircase, with a stairlift in place to both wings of the first floor. There is an attractive garden outside with direct access to the small on-site parking area. On street parking is readily available close to the service.

The service has a long-established registered manager, who is also one of the owners of the service. 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.

The service had a homely, friendly atmosphere. There was an established team of regular staff, who knew people well and were caring and kind towards them. Staff were quick to identify and respond when people required assistance, even if people did not communicate this verbally.

People received individualised care that met their needs, including their nutrition and hydration needs; people were positive about the quality of the food. The registered manager and staff reviewed people’s care regularly and supported people with their healthcare needs, making referrals as necessary and supporting people to attend appointments. They were mindful of people’s preferences for end of life care, ensuring that the necessary support was in place to meet these, particularly if someone’s health had deteriorated. The service had within the past year been reaccredited with the Gold Standards Framework in end of life care, with very positive feedback from the external assessor. The registered manager recognised that this process had improved the quality of care overall, as well as the way the staff team communicated with each other and with healthcare professionals.

Where people had the capacity to consent to their care, their consent was obtained. Where people did not have the capacity to consent to particular aspects of their care, staff followed the requirements of the Mental Capacity Act 2005. Mental capacity assessments and best interests decisions had been recorded where necessary, in relation to particular aspects of people’s care where there were concerns about their ability to give consent. We have made a recommendation regarding developing the confidence of staff to record mental capacity assessments and best interests decisions.

The registered manager understood where the law considered people to have been deprived of their liberty and had applied for deprivations of liberty to be authorised under the Deprivation of Liberty Safeguards.

People felt safe at the service. Risks to their health and wellbeing were assessed and managed. The premises and equipment were maintained in good order. Staff were aware of their responsibilities for reporting accidents, incidents and concerns, including safeguarding adults. Safeguarding adults information, including contact numbers for local statutory agencies concerned with safeguarding adults, was displayed in the hall. Medicines were stored and managed safely and people received their medicines when they needed them. However, instructions for administering topical medicines, such as skin creams, and medicines to be taken as necessary rather than regularly were not always clearly recorded. We have made a recommendation concerning this.

Staff received the training, development and support they needed in order to be able to perform their roles effectively. There were sufficient staff on duty to meet people’s care needs; staff confirmed the registered manager stepped in to cover shortfalls if necessary. Checks such as references and criminal records checks were undertaken to ensure that new staff were suitable to work at the service.

People, their relatives and staff had confidence in the management of the service and their views were sought and used to develop and improve the service. Staff morale was good. The registered manager had close oversight of the service and undertook regular audits, including medicines and health and safety.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. One person we spoke with told us, 'I wouldn't want to live anywhere else, we are treated like human beings' 'I am so happy here'. Another individual said, 'We are well fed and well looked after'. One member of staff said, 'This is their home, and they can do what they want to do'. Another care worker told us, 'It's their home' 'It's very much a family atmosphere'.

People using the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

The provider had an effective system to regularly assess and monitor the quality of service that people received.

People were protected from the risks of unsafe or inappropriate care and treatment because information about them was mainly complete and accurate.

We carried out this inspection because we had received information that some people may not be being cared for appropriately.

We started our inspection by visiting the home in the evening and completed it the next morning. None of the concerns which we were told about were substantiated.

We spent time chatting with people about what it was like to live at Southmead. Everyone was very positive about the home. They told us they were happy with the care they received, that staff were always kind and helpful and that there was always plenty to do or someone to talk to if they wanted this.

We found that each person had a detailed care plan. We saw that staff supported and cared for people in the ways described in their care plans. When we spoke to people living in the home they told us the staff knew how to care for them and they felt safe in their care.

The people living at the home we spoke to told us the staff were friendly, courteous and knew what they were doing. One person told us "they are friendly and bright" another said "I like them, they are all so kind".