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Archived: Reside at Southwood Inadequate

We are carrying out a review of quality at Reside at Southwood. We will publish a report when our review is complete. Find out more about our inspection reports.

Reports


Inspection carried out on 1 May 2018

During a routine inspection

This comprehensive inspection took place on 1, 4, 8 and 11 May 2018. The first day of the inspection was unannounced. We gave the provider short notice of our visits on the other days so that the manager and staff would be available to speak with us, and appropriate records would be available.

Reside at Southwood is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to accommodate a maximum of 38 people who require support with personal care. There were 24 people living in the home at the start of our inspection.

The service comprises three individual houses which have been linked together to form one building. Accommodation is provided in individual bedrooms on the ground, first and second floors. Some rooms have ensuite facilities. There are two lounges and a dining room on the ground floor. The home specialises in providing care to people living with dementia.

The service was led by a new manager who was not registered with the commission but confirmed that they had submitted an application to become registered. 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.

This inspection was brought forward from the planned date because we received information of concern and safeguarding alerts from the local authority. At our last inspection in January 2018, we found shortfalls in a number of areas and the service was rated Inadequate and placed in special measures. At that time we found breaches of the regulations relating to the way people received care and treatment, that people's consent was not always properly obtained and people were not always treated with dignity and respect, the management and administration of medicines, the management of risks to people, premises and equipment that was not safe to use, the recruitment, training and supervision of staff, the service did not act in accordance with the Mental Capacity Act 2005, quality monitoring systems were not effective and record keeping required improvement.

At the last inspection there were nine breaches of the regulations. At this inspection action had been taken to comply with one of the regulations but the other eight breaches of regulations were repeated.

The feedback we received from people and their relatives and visitors was that staff were kind and most people were happy living at Reside at Southwood. We observed that not all of the staff made meaningful connections with people and therefore not everyone received person centred care. This was because many of the staff focussed on completing a task and then moving to the next task.

At the last inspection, systems and procedures to ensure people were safe in the event of an emergency were not effective. At this inspection we found that work was underway to ensure this was addressed but not all staff had received training in the action to take in the event of an emergency. Also, they had not taken part in a fire drill to practice their learning.

We raised concerns about the number of staff on duty at night at the last inspection and at this inspection found that this had been addressed. However, actions to ensure that staff had the necessary skills, training and competence to care for people and meet their needs had not been completed. Failure to complete thorough moving and handling training for staff had continued to place people and staff at continued risk of injury.

We again found that systems to manage the administration of medicines were not robust and meant that people may not always be

Inspection carried out on 16 January 2018

During a routine inspection

This comprehensive inspection took place on 16, 17, 25 and 30 January 2018 and 28 February 2018. The visits on 16 and 30 January and 28 February were unannounced. We let the provider know we would be visiting on 17 and 25 January 2018 so that senior staff would be available to speak with us, and appropriate records would be available. The visit on 30 January 2018 commenced at 6.30am to enable us to meet with night staff.

At our last inspection in September 2015 we found the service was running well and rated it as good.

Reside at Southwood is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to accommodate a maximum of 38 people who require support with personal care. There were 34 people living in the home at the start of our inspection.

The home comprises three individual houses which have been linked together to form one building. Accommodation is provided in individual bedrooms on the ground, first and second floors. Some rooms have ensuite facilities. There are two lounges and a dining room on the ground floor. The home specialises in providing care to people living with dementia.

The service was led by a registered manager. 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. During the course of the inspection, the registered provider advised CQC that the registered manager had ceased working at the home and the operations manager had taken over interim responsibility for the service until a new manager could be recruited.

The feedback we received from people and their relatives and visitors was that staff were kind and they were happy living at Reside at Southwood. Not all of the staff made meaningful connections with people and therefore not everyone received person centred care. This was because many of the staff focussed on completing a task and then moving to the next task.

Systems and procedures to ensure people were safe in the event of an emergency were not effective. Proper drills had not been carried out to allow staff to practice how they would evacuate people and there was not enough equipment to help them do this.

Staff numbers and skills were not always adequate to meet people’s needs. We raised concerns about the number of staff on duty at night and found that not all staff had completed basic training that is recommended before they care for people unsupervised.

Systems to manage the administration of medicines were not robust and meant that people may not always be receiving their medicines as prescribed. We could not be sure that people always received all of the food and fluids they needed to maintain good health.

Systems to manage risk and ensure people were cared for in a safe way were ineffective. Risk assessments were not always fully completed or regularly reviewed. Some risks had not been identified and therefore no action had been taken to reduce or manage the risk. For example, a person had an accident involving a piece of furniture. No action was taken to prevent it recurring and the person later sustained a serious injury in another accident with the same piece of furniture. The service had not carried out risk assessments to ensure that the equipment was fitted correctly and worked safely. This meant that people’s safety and well-being was not always protected.

People did not always have their rights protected because the service did not operate in accordance with the Mental Capacity Act. For example, people did not have free access to their bedrooms whenever they wished to

Inspection carried out on To Be Confirmed

During a routine inspection

This was an unannounced comprehensive inspection carried out by one Care Quality Commission Inspector on 23 and 24 September 2015. Our previous inspection of the home completed in October 2013 found the provider was compliant with the regulations.

Reside at Southwood provides accommodation and personal care for up to 38 people living with dementia care needs. At the time of the inspection 36 people were living at the home.

Overall, a safe service was provided to people. Staff had been trained in safeguarding adults and there were policies and procedures in place for staff to follow.

The premises and delivery of care had been risk assessed with appropriate action taken to minimise any identified hazards and implement ways to provide safer care.

Incidents and accidents were recorded and monitored to identify if further action could be taken to reduce likelihood of recurrence.

People had personal evacuation plans in place and these were being developed further to make sure staff could respond appropriately in an emergency.

There were suitable staffing levels maintained to meet people’s needs and robust recruitment procedures followed to make sure suitable and competent staff were employed to work at the home.

Medicines were managed safely in the home.

Although people’s consent was sought appropriately, care planning could be improved to reflect where ‘best interest’ decisions were being made on behalf of people.

Generally, the home provided a good standard of food. People also received appropriate support with dietary requirements.

Staff received appropriate training so that they could meet people’s needs.

Arrangements were in place to ensure staff were supported through supervision and an annual appraisal.

People had access to appropriate health care professionals, ensuring that their healthcare needs were met.

People were cared for by a motivated and caring staff team.

People’s dignity and privacy were respected.

The home was working with the local authority to improve care planning. Part of this was to develop care plan summaries to assist staff in providing consistent responsive care.

There was a system in place to make sure complaints were responded and the complaints procedure was well publicised.

There was a positive and supportive culture in the home with a registered manager in post, who people said was approachable and provided good leadership.

There were systems in place to monitor the quality of service provided to people.

Inspection carried out on 5 September 2013

During a routine inspection

Throughout this inspection we were assisted by the manager and the operations manager for the organisation . We spoke with four members of staff, three people who lived at the home who were able to tell us about their experiences, two relatives and a district nurse who were visiting the home that day. We also spoke with a number of other residents, but owing to a diagnosis of dementia they were not able to tell us about living at the home.

People we spoke with told us they were treated with respect and their privacy and dignity were respected. Throughout the day we observed staff being respectful and supportive with people who lived at the home.

People able to tell us about their experience of the home said that their consent was always sought about how they were cared for. For those people who did not have the capacity to be involved in their care, we saw that mental capacity assessments had been completed. These provided guidance for staff and meant that best interest decisions could be made on people’s behalf.

People’s care and support needs had been assessed and there were up to date care plans in place.

We found there were appropriate arrangements in place with regards to managing people’s medicines.

The provider had systems in place to monitor and assess the quality of service provided.

Inspection carried out on 19 February 2013

During an inspection in response to concerns

We conducted this unannounced inspection visit because we received information of concern about; staffing levels within the home and the support and care provided to people who lived there. We looked at these areas as part of our inspection. We did not find any evidence during our inspection to indicate that these issues were ongoing.

At this inspection we spoke with the operations manager, three members of staff, four people who lived in the home and one of their relatives.

The majority of the people who lived at Reside were not able to give an account of what it was like to live at the home because of their mental frailty. However, we spoke with four people who were able to tell us what it was like to live there.

Because people with dementia and/or complex needs were not always able to reliably tell us about their experiences, we spent a majority of the visit observing people and looking at records. We observed how people interacted with staff members, other people who lived in the home and their environment.

The relative we spoke with said they were “Happy” with the care provided to their relative and said the staff were “Friendly and caring”.

People were protected from the risks of inadequate nutrition and hydration. One person we spoke with told us the food was, “Lovely”.

People were supported by staff that had been recruited in a safe manner and people said there was enough staff available to make sure they received the care they needed.

Inspection carried out on 5 November 2012

During an inspection to make sure that the improvements required had been made

We conducted a follow up inspection of Reside at Southwood to check concerns with the water availability within the home. At this inspection we spoke with the operations manager and a care worker and checked bedrooms and bathrooms to see if the water was available and at the correct temperature.

The staff we spoke with confirmed hot water was available in all the bedrooms and our checks on the day confirmed this to be the case.

Inspection carried out on 7 August 2012

During an inspection in response to concerns

We brought forward a planned inspection of Reside at Southwood because we had received information of concern. At this unannounced inspection we spoke with five members of staff including the operations manager, manager, permanent staff and one agency member of staff. We also spoke with four visiting relatives of people who lived at the home to obtain their views about the service.

The majority of people who live at Southwood Lodge were not able to talk to us about their experiences at the home due to their mental frailty, however we were able to talk to four of their relatives.

During our visit we observed how relaxed and calm the atmosphere in the home was and how people were being given their personal care in a friendly and respectful way.

Staff told us the home had seen many improvements over the last year and staff moral was good. Staff told us they felt well supported by the management team and they receive one to one supervision meetings each month.

One relative we spoke to said the care at Southwood Lodge was “very good”. They told us their relative was “very settled and happy and was always clean and shaved”.

Another relative told us that the home had improved considerably over the last year and the staff were kind and knowledgeable. They told us the staff arranged for the doctor to visit whenever they felt their relative needed further professional support and this gave the relative considerable peace of mind.

Staff told us there was an ongoing problem with water pressure in the home that affected the hot water system, the manager told us the water board were investigating the problem.

People were supported by staff who had been recruited in a safe manner and people said there was always enough staff available to make sure they received the care they needed.

Inspection carried out on 10 November 2011

During an inspection in response to concerns

We carried out a joint inspection of Southwood Lodge with a member of Bournemouth Social Services safeguarding team following receipt of two separate concerns brought to our attention before the inspection. The inspection took place between 7am and 1.30pm.

At this inspection we spoke with six members of staff; both day staff and night staff, as well as fulltime and agency members of staff. We also spoke with the registered provider, the newly appointed operational manager and other members of the management team. We observed the care and interactions between the staff and people living at the home.

We were told that the home was kept warm and that the heating system was adequate, although there was a problem with the heating system in one part of the home. Staff told us that the needs of people living at Southwood Lodge were being met and that increased staffing at peak times of the day had improved things. They told us that they received adequate training in moving and handling and generally things were improving at the home.

Inspection carried out on 5 July 2011

During an inspection in response to concerns

The majority of people who live at Southwood Lodge were not able to give an account of what it was like to live at the home because of their mental frailty; however, we spoke with three people who were able to tell us what it was like to live there. They told us that generally their care needs were met by a kind and respectful staff team. They had no concerns about how their medication was managed and administered. They told us that there was a good standard of food provided. They told us they had no concerns about how the home was managed.

Reports under our old system of regulation (including those from before CQC was created)