Southwell Court Care Home

Southwell Court is a residential care home providing the regulated activity of personal care to up to 82 people. The service provides support to older adults some of whom were living with advanced dementia. At the time of our inspection there were 52 people using the service.

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

Systems in place protected people from the risk of abuse and neglect. 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 senior 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, deputy manager and all staff worked hard to ensure the culture was open, inclusive, and person-centred. 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 details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 26 July 2019).

Why we inspected

We received concerns in relation to the management of medicines and risks relating to people’s care and support needs. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Southwell Court Care Home on our website at www.cqc.org.uk.

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.

Visiting procedures were robust to reduce the risk of COVID-19. All visitors were required to show a negative COVID-19 test and their temperature was taken to ensure they showed no symptoms of COVID-19. Professional visitors were also required to show their COVID-19 vaccination passport.

The service welcomed visitors. We saw a number of visitors coming and going throughout our inspection. There were robust processes for ensuring visits were staggered to allow cleaning and disinfection of people’s bedrooms before and after each visit.

The premises were clean. Staff completed enhanced cleaning of frequently touched surfaces to reduce the risk of the spread of infection.

A programme of regular COVID-19 testing for people in the service, staff, and visitors had been implemented.

The provider ensured there was enough PPE available for staff at all times. Staff were observed wearing, regularly changing and disposing of personal protective equipment (PPE) correctly to reduce the risk of infection.

We found the following examples of good practice.

The service had managed an outbreak of COVID-19 well. People who tested positive for COVID-19 were requested to self-isolate. Some people were unable to self-isolate, these people were closely monitored by staff to ensure they were not coming into close contact with others.

Regular testing for COVID-19 was in place. The registered manager had supported both staff and people living at the home in the roll out of the COVID-19 vaccination programme.

The home was very clean and housekeeping staff kept records to demonstrate the high level of cleaning throughout the home. The home implemented deep cleaning of areas where people who had previously tested positive for COVID-19, had been cared for. The service had invested in equipment to strengthen cleaning processes to minimise the risk of possible transmission of COVID-19.

People were encouraged to maintain communication with their loved ones through the use of technology. The service had created a safe visiting space for when visits were deemed to be safe. Robust measures were in place to keep people safe during visits.

Southwell Court Care Home is a residential care home providing personal and nursing care for up to 82 people. At the time of the inspection there were 68 people residing at the home. The accommodation was in a large purpose built home over three floors with one floor for people with severe dementia.

We found the following examples of good practice.

¿ All visitors had to wear appropriate personal protective equipment (PPE), and complete a health declaration prior to entering the home. The provider implemented a booking system to make sure visits were staggered to minimise the number of visitors at any one time. Due to the recent nationwide lockdown visits were temporarily postponed, however people were able to see their relatives through ground floor windows.

¿ People were encouraged and supported to maintain contact with their relatives by using phone and video calls, as well as social media applications.

¿ The premises were clean and well maintained. The house keeping team had ensured enhanced cleaning methods were used. Hand sanitiser was readily available on the premises.

¿ Staff had received training in infection control and prevention. On the day of the visit staff were seen to be following correct practice in this area. There were areas of the home set aside for staff to change their PPE.

¿ Regular testing for COVID-19 was being undertaken. Staff were tested weekly and people using the service were tested monthly. There were procedures in place informing staff on what actions staff need to take should someone test positive for COVID-19 or displayed signs or symptoms of infections.

Further information is in the detailed findings below.

Southwell Court Care Home is a residential care home providing personal and nursing care for up to 82 people. At the time of the inspection there were 63 people aged 65 and over, residing at the home. The accommodation was in a large purpose built home over three floors with one floor for people with severe dementia. There was a spacious garden.

People’s experience of using this service

There was a friendly atmosphere at the home. The registered manager worked in a person-centred way and staff had a good understanding of people’s needs. People received safe care. Staff were aware of their responsibility to keep people safe. Risks were assessed and managed to reflect people’s current needs. The environment was clean and well maintained.

Safe recruitment procedures were followed to ensure staff employed were suitable to care for people.

Staff received appropriate training and well support from the registered manager. People and relatives were positive about the staff and management team.

People received good care that was effective for their needs. People were supported to eat and drink enough by staff who were knowledgeable about their needs.

Peoples health needs were monitored to ensure their requirements were met. Staff supported people to remain as independent as possible.

Care was person-centred, and staff were caring and compassionate. Staff knew people well and treated them with dignity and respect.

The service was well led. Complaints, concerns, accidents and incidents were recorded and investigated with lessons learnt and action taken appropriately. Quality assurance systems effectively monitored the service. The manager responded positively to change and was proactive in improving the service. The registered manager was well supported by the provider to deliver a good service.

People received their medicines as prescribed.

The service was working within the principles of the Mental Capacity Act (MCA). People were supported to have choice and control of their lives and staff supported them in the least restrictive way.

There was a registered manager in post who 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 person’s’. Registered persons have legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Rating at last inspection

The service was last inspected on 27 April 2016 (published 14 June 2016) and was rated Good.

Why we inspected

The inspection on 21 May 2019, was an unannounced, planned comprehensive inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

The service had a registered manager in place at the time of our 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 our last inspection on 22 and 23 April 2014 we asked the provider to take action to ensure that suitable arrangements were in place to obtain the consent of people in relation to the care and treatment provided for them. During this inspection, we found that the provider had taken appropriate action and improvements had been made. People were encouraged to make independent decisions and legislation to protect people who lacked capacity was being adhered to.

At our last inspection we also asked the provider to take action to ensure that they acted upon information which would improve the service people received. During this inspection, we found that the provider had taken appropriate action and improvements had been made. We found that quality monitoring systems were being used effectively to monitor the service and respond to any issues.

People were protected from the risk of abuse and staff had a good understanding of their roles and responsibilities if they suspected abuse was happening and appropriate action had been taken when required.

Staff were knowledgeable about how risks to people’s safety could be reduced and potential risks were identified and responded to.

People were supported by sufficient numbers of staff and they received their medicines as prescribed and these were managed safely.

People were supported by staff who received an induction and training relevant to their role. Staff felt improvements were being made to how they were supported by the management team.

People were protected from the risks of inadequate nutrition and specialist diets were provided if needed. Referrals were made to health care professionals for additional support or guidance if people’s health changed and their advice was acted upon.

People were treated with dignity and respect and had their choices acted on. We saw staff were kind and caring when supporting people.

People were supported to maintain their interests and were mostly either proactively or responsively engaged with by staff. A wide range of activities took place within the service which was well staffed and resourced.

People, relatives and staff were given opportunities to feedback their views on the running of the service and there was evidence that action had been taken in response to people’s views.

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people who used the service, their relatives and the staff told us. If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

Staff knew how to respond to any allegation of abuse and we found they were effective at ensuring people were safeguarded. A relative told us, 'I do not worry about their safety.' A person who used the service told us, 'I have an emergency button if anything goes wrong. I have had to use it several times, someone comes to see me quickly.'

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. One application had been made and the correct documentation was available for this. Proper policies and procedures were in place. The manager told us the management team have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We found the provider did not have effective systems to involve people in planning their care and obtaining people's consent for this to be provided. A staff member told us they did not involve people when they reviewed their care plans.

We found the provider could be more effective at assessing and monitoring the quality of the services provided. Audits were not completed as frequently as expected and they did not contain the information needed to show their outcomes.

We found the provider could be more effective at identifying, assessing and managing risks related to the health, welfare and safety of people who used the service. Information in audits was not used to manage risks related to people who used the service. Concerns about the temperature in part of the home had not been risk assessed. A staff member told us, 'It can be very, very hot on the top floor.' A person who used the service told us, 'It gets hot, it can get very hot.'

We found the provider did not have an effective system designed to have regard to the complaints and comments made by people who used the service and those acting on their behalf.

Is the service caring?

We found the care and welfare needs of people who used the service were met in a sensitive and caring manner. One person told us, 'We enjoy a bit of banter.'

During the SOFI observations we saw positive changes in people's mood when staff interacted with them. We saw staff interacted positively with each person on a regular basis throughout the observation. We did not see any interactions we viewed as poor.

Is the service responsive?

We found care workers responded appropriately when people had the capacity to make decisions about their care and welfare. A person who used the service told us, 'I feel able to make choices.'

There were sufficient staff to respond to people's health and welfare needs and we saw staff respond appropriately to these. During the SOFI observations we saw staff were able to respond to people in a timely manner.

We found there was some reluctance amongst staff to work on floors other than the one they normally worked upon.

Is the service well-led?

We found the provider did not protect the rights of people who did not have the capacity to consent, because they did not act in accordance with the legal requirements of the Mental Capacity Act (2005).

We found people's care and support was planned and delivered in a way that ensured their safety and welfare. The manager said they had put in an 'incredible effort' to ensure all the care plans were reviewed and up to date.

Staff support and supervision did not take place as intended. A senior care worker said, 'I like to think I am doing a good job, but it would be nice to be told so in supervision.' Some staff said they did not feel comfortable to raise things with the management team.