Southerndown

Southerndown is a care home registered to provide personal and nursing care to older people, including people living with dementia. The service comprises of two separate units, including one which specialised in providing care to people living with dementia. There were 77 people living at the service at the time of our inspection.

People’s experience of using this service:

People benefitted from being supported by enthusiastic, motivated and compassionate staff. The entire team at the service demonstrated a visible person-centred culture enabling people to feel they were really cared for and mattered. Staff had developed very positive and meaningful, caring relationships with people. The care provided was sensitive to people's diverse needs.

People were respected, included in decisions and their privacy and independence maintained to a high standard. People’s independence was promoted, and the provider sought new ways of working, such as a dementia accreditation programme, that had a positive impact on people’s well-being. The provider employed a dementia care specialist nurse who provided additional support to people living with dementia and their families.

People's healthcare and nutritional needs were met. 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. People benefitted from suitably trained, competent and skilled staff.

People were supported to take their medicines as prescribed and other risks to their health and wellbeing were managed safely. The provider had good systems to manage safeguarding concerns, accidents, infection control and environmental safety.

The provider’s quality assurance systems remained effective. There was a new registered manager who was well supported by the provider and by a robust team of staff who all had clearly set out roles and responsibilities. There was an open, transparent and positive culture at the service. External professionals were complimentary about how the service worked in partnership with them.

Rating at last inspection:

Good (report published 24 November 2016).

Why we inspected:

This was our scheduled, planned inspection based on previous rating.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

There was a registered manager in post. A registered manager is a person who has registered with the CQC 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 in August 2015 we found people were not always protected from the risk of infection. Staff used the same body sling to assist two people with transfers and we found the sluice rooms on each floor of the home were not being kept clean. This was a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. At this inspection we found the provider had implemented the improvements required and all previous issues with regard to the infection control had been addressed.

People’s risk assessments and support plans were detailed and contained clear information for staff. People’s care records were reviewed every month or when the person's care needs had changed. Where people had pressure reliving mattresses in place, there was no recorded guidance in relation to settings required for an individual. There was no evidence that regular checks of the settings of mattresses took place to ensure these were set appropriately for people. This meant people could be at risk of developing pressure sores. The registered manager immediately organised for these to be reviewed and updated.

Accidents and incidents were recorded and investigated. The registered manager had a system to monitor the accidents to identify any trends or patterns. People received their medicines as prescribed and in line with the organisation’s medicines policy. We observed that medicines were given to people in a professional and safe manner.

There were sufficient staff on duty to meet people’s needs. People were assisted promptly and with no unnecessary delay. There was a safe recruitment system in place that helped the management ensure people were cared for by suitable staff. People were supported by staff that were knowledgeable about their responsibilities and had the relevant skills and experience. Staff told us they were well supported and records confirmed they received regular supervision sessions.

Staff demonstrated knowledge of principles and their responsibilities of the Mental Capacity Act 2005. Mental capacity assessments were completed where required and we saw the evidence on people's files. Where people were at risk of having their liberty deprived appropriate applications were sent to the local authority for authorisation.

People were supported to maintain a balanced and nutritious diet. People at risk of malnutrition had appropriate assessments and we saw the detailed records were kept of their food and fluid intake. People were supported to access a range of healthcare professionals and their input was incorporated into people’s care plans. People’s needs were assessed before they came to live at the service. People’s care plans contained information about people’s individual health and social care needs, their wishes and preferences.

People were cared for by staff that respected their privacy and dignity and promoted people’s independence. Staff spoke about people in a warm and professional manner and they were enthusiastic about working at the service. People we spoke with told us they were happy with the care and complimented the staff.

People knew how to make complaints and provider had a complaints policy and procedure in place. The registered manager ensured when a complaint had been raised it had been investigated promptly and in a timely manner. People’s feedback was obtained through satisfaction surveys and residents meetings we saw feedback was actioned as appropriate.

The staff and the registered manager promoted an open, honest and transparent culture. The registered manager provided strong leadership to the team, there was a clear staff structure and the staff knew their roles and responsibilities. The provider had effective systems in place to monitor the quality of the service. The audits included various aspect of service delivery. Any issues identified during audits were compiled into an ongoing action plan with clearly planned dates for completion.

We spoke with nine care workers who told us they were happy working at Southerndown and felt supported. One said "definitely good, lots of help and support". All the care workers we spoke with told us they received induction training and felt well prepared to carry out their jobs. They also told us they felt there was sufficient staff on duty. We saw care workers administering care to people and saw this was done in a respectful, involved and caring way.

We looked at eight care plans and found them to be person centred, up to date and well maintained. All risks had been adequately assessed and any control measures required were in place.

We found that people's food and fluid intake was being monitored and people were being checked regularly to ensure their health needs were being met. A visiting GP told us "Staff are well supervised and the home is good at wound management". Staff we spoke with told us they had received relevant training for their role and where new clinical skills were required to care for people, this training was readily available.

We found that some people living in the home were not getting up and going to bed at a time of their choosing and were not asked what their preferred time might be. One person told us "They tell me when to get up, I can't choose'. Also some people did not have their privacy, dignity and independence respected because they were either left partially dressed or sitting on commodes when staff were not available to help. Another person told us 'They leave me on the commode to go to someone else".

The numbers of staff on duty and the way in which staff were organised and allocated to work with people meant that people living in the home were not having their needs met. We also found that there were some omissions and inconsistencies in record keeping that needed to be improved.