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Inspection Summary


Overall summary & rating

Good

Updated 25 April 2017

This inspection took place on the 07 April 2017and was unannounced.

Southdowns Nursing Home provides accommodation, personal and nursing care for up to forty eight people living with dementia and mental health problems. There were 47 people living at the home at the time of our inspection. Accommodation is arranged over two floors and each person had their own bedroom. Access to the each floor is gained by a lift, making all areas of the home accessible to people. Southdowns Nursing Home is a large detached house in a residential area of St Leonards on Sea, close to local amenities.

A registered manager was responsible for the day to day management of the home. 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 an inspection in July 2015, Southdowns Nursing Home was rated as inadequate with breaches of regulation. At that time we took appropriate enforcement action. The provider sent us an action plan stating the breaches of regulation would be addressed by 30 December 2015. At our inspection in February 2016, we found our concerns had been addressed, although improvements were required. This inspection was to see if the improvements had been made and sustained. We found that improvements had been made and sustained.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The provider, registered manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. People’s mental capacity was assessed and reviewed regularly to ensure that decisions made were still valid and in their best interest.

The care planning system had been reviewed and records for each person were specific to their needs, with guidance for staff to ensure people received the support and care they needed and wanted. Staff said the care plans had been developed and they were still looking to improve them by introducing a computer based system, which would include risk assessments and graphs to monitor falls and weight loss. Nurses wrote the care plans and all staff recorded the care and support provided and any changes in people’s needs. The registered manager said care staff were being supported to do this and additional training had been arranged for those who required it. Food and fluid charts were completed and showed people were supported to have a nutritious diet.

Visits from healthcare professionals were recorded in the care plans, with information about any changes and guidance for staff to ensure people's needs were met. There were systems in place for the management of medicines and people received their medicines in a safe way.

Staff and relatives felt there were enough staff working in the home and relatives said staff were available to support people when they needed assistance. The provider was actively seeking new staff, nurses and care staff, to ensure there were always sufficient number with the right skills when people moved into the home. The provider had made training and updates mandatory for all staff, including safeguarding people, moving and handling, management of challenging behaviour, pressure area care, falls prevention and dementia care. Staff said the training was very good and helped them to understand people's needs. All new staff received an induction and told us that it was a good introduction to the service and felt supported by the care and management team. All staff received regular supervision from senior staff and felt that this gave them the opportunity to discuss any learning needs.

Pre-employment checks for staff were completed, which meant on

Inspection areas

Safe

Good

Updated 25 April 2017

Southdowns Nursing Home was safe.

Staff had received training on safeguarding adults and were confident they could recognise abuse and knew how to report it. Visitors were confident that their loved ones were safe and supported by the staff.

There were enough staff to meet people’s individual needs. Staffing arrangements were flexible to provide additional cover when needed, for example during staff sickness or when people’s needs increased.

There were systems in place to make sure risks were assessed and measures put in place where possible to reduce or eliminate risks. Medicines were stored and administered safely.

Comprehensive staff recruitment policies and procedures in place.

Effective

Good

Updated 25 April 2017

Southdowns Nursing Home was effective.

Staff had a good understanding of people’s care and mental health needs. Staff had received essential training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS) and demonstrated a sound understanding of the legal requirements.

Staff received training which was appropriate to their job role. This was continually updated so staff had the knowledge to effectively meet people’s needs. They had regular supervisions with their manager, and formal personal development plans, such as annual appraisals.

People were able to make decisions about what they wanted to eat and drink and were supported to stay healthy. They had access to health care professionals for regular check-ups as needed.

Caring

Good

Updated 25 April 2017

Southdowns Nursing Home was caring.

Staff communicated clearly with people in a caring and supportive manner and it was evident that they knew people well and had good relationships with them. We observed that people were treated with respect and dignity.

Care plans were personal to each person and included detailed information about the things that were most important to the individual and how they wanted staff to support them.

Staff were seen to interact positively with people throughout our inspection. It was clear staff had built a rapport with people and they responded well to this.

Responsive

Good

Updated 25 April 2017

Southdowns Nursing Home was responsive.

People had access to the complaints procedure. They were able to tell us who they would talk to if they had any worries or concerns.

People were involved in making decisions with support from their relatives or best interest meetings were organised for people who were not able to make informed choices.

People received care which was personalised to reflect their needs, wishes and aspirations. Care records showed that a detailed assessment had taken place and that people were involved in the initial drawing up of their care plan.

The opportunity for social activity was available should people wish to participate.

Well-led

Good

Updated 25 April 2017

Southdowns Nursing Home was well-led.

Management was visible within the home and staff felt supported within their roles. Systems were in place to obtain the views of people, visitors and healthcare professionals. The manager was committed to making on-going improvements in care delivery within the home, striving for excellence.

There was an open culture, and people and quality care were at the heart of the service.

Staff were well motivated, worked as a team and wanted to make sure they supported people in a caring and person centred way.

There were systems in place to monitor the quality of the service and any areas for improvement identified were dealt with quickly.