Archived: Southfields Care Homes - Homeleigh

As part of this inspection we spoke with the three people using the service, one relative, two support workers and the registered manager and deputy manager. We also reviewed records relating to the management of the home which included care plans for three people, medication administration records, staff training records, policies, survey results and quality audits.

Below is a summary of what we found. The summary describes what people using the service, a relative and the staff told us, what we observed and the records we looked at.

Is the service safe?

The service was safe. We saw comprehensive needs and risk assessments had taken place before people had gone to live at the home. These included physical and mental health, decision making capacity and social needs. The premises were safe and secure. Renovation and refurbishment of the premises had taken place in the previous year and a maintenance plan was in place. The home was clean and staff understood how to prevent and control any infection. A recent infection control audit had led to an action plan which was being implemented. Medicines were administered safely using an improved system.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. One application had needed to be submitted, and proper policies and procedures were in place. Relevant staff had been trained to understand when an application should be made, who to contact to seek advice and how to submit one.

Is the service effective?

The service was effective. People told us they were happy with the care they received and felt their needs had been met. A person living at the home said, 'I am happy here. I would be sorry to leave.'

A relative said a person living at the home, 'Loves it there,' and that they got, 'all the help they need.' It was clear from what we saw and from speaking with staff they understood people's care and support needs and they knew them well. Multi-disciplinary care planning took place with people's involvement to ensure that people received optimal care and support. People using the service said they would recommend the home to other people. Staff had received enough training that was relevant to the needs of the people living at the home.

Is the service caring?

The service was caring. A person living at the home said the (support workers) were, 'Nice people. They are caring and always there for you.' They said they could talk to all of the support workers and, 'They know what they are doing.' Another person said, 'They are really good when I'm not well.'

A relative told us, 'The staff are lovely.' They told us they had been involved in best interest meetings to make good decisions for a person living at the home.

We spoke with staff who knew people's needs and we observed them interact with different people in a kind and caring way, using humour when appropriate.

Is the service responsive?

The service was responsive to the changing needs of people using the service, to risks to people's safety and comments and suggestions. We saw assessments of people's needs had resulted in care plans which staff read. The care and support plans helped staff to know the needs and the care and support individual people required. Care and support plans were changed if people's needs changed.

A relative of a person who had lived at the home for over five years said that the home had significantly improved in the previous year. They said the home, 'Used to get a lot of complaints,' and it had often been cold and some areas were dirty. They said, and we saw that the home was now clean and fresh smelling and had been recently redecorated. They also said when they had a problem and the manager had helped them to sort it out.

Is the service well led?

The service was very well led by an experienced registered manager who had been in post for seven months when we visited. They were supported by a deputy manager and the provider's locality manager. A person living at the home said they saw the manager nearly every day and they were, 'Brilliant.' They said the manager had a sense of humour but was serious when they needed to be. All of the people we spoke with said the home had improved in many ways since the new manager had been in post. A person said, 'It used to be a bit regimented; now it's more like your home.' Another person said they thought the new manager cared about them and was very nice.

Support staff said that the manager was, 'Nice and very supportive.' Another told us that the manager and deputy worked well together which confirmed the impression that we had from talking to them both. The deputy manager said of the manager, 'If she says she is going to do something, it happens,' and that there was a, 'Really positive attitude amongst the staff.'

The service had an effective system in place to monitor and assess the quality of the service.

Overall we saw that 'significant changes in management of the home' noted by a recent local authority inspection had led to significant improvement in leadership and quality of care and safety for people living at the home.

We found that written records about clinic visits, or healthcare professional advice were on occasion missing, or difficult to find. We have advised the provider of this in order that it can be monitored and addressed through their audits.

However, we saw that people were waiting in a corridor for their medicines to be administered; this could reduce the privacy of people going in to the medicines room. We also found that people's medicines needs were not fully considered when they were away from the home when medicines were usually administered. This meant that doses of medication may be unnecessarily missed.

We carried out this inspection to check that the provider had taken action since our last inspection on 1 May 2013.

We found the provider had addressed our concerns relating to the maintenance of premises. At the time of our inspection the service was undergoing a programme of redecoration and weekly environmental checks were carried out to ensure risks were identified and managed promptly.

Following our inspection on 1 May 2013 we identified moderate concerns because we found care plans contained limited information and did not provide clear guidance to staff on the support people required.

During our inspection on 15 August 2013 we found that some improvements had been made. A new care plan format was in place and staff were due to receive training to enable them to provide person centred care.

Following our inspection on 1 May 2013 we also identified concerns relating to the safe management of medicines. During our inspection on 15 August 2013 we found there were multiple errors in the recording of medicines. Staff were not administering medicines in a safe and consistent way, in line with professional guidance.

The provider had systems in place to obtain and act in accordance with the consent of people who used the service. People's needs were being met by sufficient numbers of appropriately trained staff.

A choice of nutritious food was available, in sufficient quantities to meet people's needs. There were systems in place to provide and maintain a clean environment. However, the provider did not have suitable arrangements in place to ensure premises were adequately maintained.

There were appropriate systems in place for obtaining, storing and disposing of medicines. However, the provider did not have robust systems in place for recording and monitoring the administration of medicines.

Following our last inspection we identified moderate concerns because care plans contained limited information and did not provide clear guidance to staff on the support people required. During our inspection on 1 May 2013 we found that there had been very little improvement in the development of care plans since our previous inspection. Overall this meant people did not experience effective and appropriate care and support which met their needs and ensured their welfare and safety.

'They respect me and give me my own freedom'.

'I can decide what I want to do here'.

'My first day was overwhelming, everybody welcomed me with open arms'.

We found that people living at Homeleigh had their privacy, dignity and independence respected. They were encouraged to express their views and these were taken into consideration in the way the service was provided.

The provider had taken appropriate steps to identify and prevent abuse from occurring. We saw there were sufficient numbers of staff to support the health and welfare needs of people who used the service. There were effective systems in place to regularly assess and monitor the quality of the service provided.

However, we saw that care plans did not include the necessary information to ensure people received effective and appropriate care and support. This meant we judged the provider was not meeting the required standards in this area.