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Southfield Court Care Home Good

Reports


Inspection carried out on 26 February 2019

During a routine inspection

About the service: Southfield Court Care Home, known to people, their relatives and staff as Southfield Court, is a purpose-built care home providing accommodation and nursing care for up to 50 people. At the time of our inspection there were 24 people living in the home.

People’s experience of using this service: Our observations during this inspection confirmed staff were friendly, kind and compassionate. People were treated with respect and dignity and examples were seen.

Additional detail was required in moving and handling risk assessments, which the regional manager said they would add immediately. Fire safety and key checks on the premises were well managed.

There were sufficient numbers of staff to meet people’s needs. Staff had been recruited using procedures which meant they were safe to work with vulnerable people.

Systems were in place to ensure the safe management of medicines and staff had been assessed as competent to carry out this role.

Lessons were learned when things went wrong. Staff told us these learning opportunities were shared with them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Training completion rates were satisfactory. The remaining gaps in training were being addressed and courses were already booked.

Staff felt confident approaching the management team who they said were supportive. Some gaps in supervision were seen at the end of 2018, although these were being addressed.

People received timely access to healthcare when they needed this support.

People received adequate nutrition and hydration which supported a healthy and balanced diet.

Care plans were easy to follow and contained enough information for staff to provide effective care.

The activities programme was suited to the needs of people living in the home. Group activities took place when external entertainers visited the home. One-to-one support was provided for people who preferred this.

Information on how to complain was on display. Complaints were appropriately investigated and responded to.

People, relatives and staff felt the management team were approachable. They felt listened to and changes were made as needed.

Systems of governance were effective through a series of audits, surveys and meetings for people and staff held in the home.

Rating at last inspection: Requires improvement in January 2018 (published 9 March 2018)

Why we inspected: This was a planned inspection.

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

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

Inspection carried out on 24 January 2018

During a routine inspection

A comprehensive inspection took place on 24 and 26 January 2018 and was unannounced.

Southfield Court Care Home, known to people, their relatives and staff as Southfield Court, is a purpose built care home providing accommodation and nursing care for up to 50 people. It has two floors, with lift access. There are communal bath and shower rooms located on each floor. The home is situated in Almondbury village and is approximately two miles from the town centre of Huddersfield. On both days of our inspection there were 36 people living at Southfield Court Care Home, providing care and support for people with residential needs including people who were living with dementia.

When we completed our previous inspection on 19, 20 and 21 July 2017 we found the registered provider had not taken appropriate steps to ensure staffing levels were sufficient to meet people’s needs, infection control procedures were not robust, care plans did not always contain accurate information, risks to people had not been managed effectively and some audits were ineffective.

Southfield Court was placed into ‘special measures’ and we issued requirement notices and added conditions to the registered provider’s registration regarding Regulation 17 (good governance) and Regulation 18 (staffing). Following the last inspection, we met with the provider to confirm how they were going to make improvements to Southfield Court and what actions there were going to take to improve the key questions of safe, effective, responsive and well-led. We asked the registered provider to complete an action plan to show what they would do and by when to improve the service. The purpose of this inspection was to see if significant improvements had been made and to review the quality of the service currently being provided for people. At this inspection we found the service had met these requirement notices and conditions.

The provider had taken appropriate action and was now meeting legal requirements. While improvements had been made we have not rated this key questions safe and well-led as 'Good'; to improve the rating to ‘Good’ would require a longer term track record of consistent good practice.

Southfield Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of our inspection the home had a registered manager in place who had been registered since 8 July 2016. 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.

People and relatives told us they and their family member felt safe at the home. We found there were appropriate systems in place to protect people from risk of harm.

There were sufficient staff to keep people safe and we observed call bells were answered in a timely manner. Robust recruitment procedures were in place and all staff completed an induction when they started work.

Risk assessments were completed, reviewed and changed with peoples care needs. Staff were aware of individuals’ risks and how to support people. Maintenance checks were carried out in the home to ensure it was safe.

Safe systems were in place to manage medicines so people received their medicines as prescribed.

Staff attended regular supervision and training, although some annual appraisals were overdue.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s needs were fully met with regards to the provision of fo

Inspection carried out on 18 July 2017

During a routine inspection

We inspected Southfield Court Care Home (known as ‘Southfield Court’ to the people who live and work there) on 18, 20 and 21 July 2017. The first day of the inspection was unannounced. This meant the home did not know we were coming.

Southfield Court is a care home registered to provide nursing and residential care for up to 50 people. It consists of one building with two floors accessed by passenger lifts. All rooms are single with ensuite facilities. There were 44 people living at the home at the time of this inspection.

Each floor of the home has lounge areas, a dining area and shared bathrooms and toilets. There is an enclosed garden area to the rear of the building, but it had not been tended for some months prior to this inspection and was therefore not used by people.

Southfield Court was last inspected in December 2016. At that time the home was rated as Requires Improvement overall as it was deemed to be Requires Improvement in the key questions of Safe, Responsive and Well-led, and Good in key questions of Effective and Caring. We served two warning notices after the inspection in relation to continuous breaches of the regulations relating to person-centred care and staffing. We also asked the registered provider to send us an action plan to tell us how they were going to tackle a continuous breach of the regulation relating to good governance.

At this inspection we found some improvements had been made, but identified other concerns. We found continuous breaches of the regulations relating to staffing and good governance, and new breaches of the regulations relating to safe care and treatment, and safeguarding people.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

The home had a registered manager. At the time of this inspection she had been on a period of extended leave since November 2016 and had started working two days a week commencing the week before this inspection, in preparation for returning to work four days a week in August 2017. During the registered manager’s absence the deputy manager had been the acting manager, with support from various staff from the registered provider.

A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Healt

Inspection carried out on 13 December 2016

During a routine inspection

The inspection of Southfield Court Care Home took place on 13 and 14 December 2016. Both visits were unannounced. We previously inspected the service on 9 and 24 March 2016 and at that time we found the provider was not meeting the regulations relating to person centred care, premises safety, safe care and treatment, staffing, keeping accurate records and good governance. The service was placed into special measures and we took enforcement action to require the service to improve. The provider sent us an action plan outlining the improvements they would make. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to 50 older people, some of whom are living with dementia. There were 35 people using the service at the time of this inspection.

The service is required to have 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.

The service had a registered manager in post who had commenced employment with the service in March 2016. The registered manager had commenced maternity leave in November 2016 and at the time of this inspection the deputy manager was managing the service with the support of the regional manager and a CHAP (care home advanced practitioner) on one day of the week.

Our inspection on 9 and 24 March found the registered provider was not meeting the regulations relating to the safety of premises. At this inspection we found improvements had been made and people were protected because the necessary fire safety checks were being regularly completed and maintenance was being completed in a timely manner.

At our inspection on 9 and 24 March we found there were not always enough experienced staff available to respond to people who required assistance in a timely manner. At this inspection we found less agency staff were being used, however we found sufficient staff were not always deployed to meet people’s assessed needs. This was a continuing breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Our previous two inspections found the registered provider was not meeting the regulations relating to the management of medicines. At our inspection on 13 and 14 December 2016 we checked and found improvements had been made and medicines were now managed in a safe way for people.

We also found practice in the prevention and control of infections had improved since our inspection on 9 and 24 March 2016. We found effective measures were now in place to protect people from the spread of infections

Staff had a good understanding about how to safeguard adults from abuse and who to contact if they suspected any abuse.

Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence, although some risk assessments were not up to date.

Our inspection on 9 and 24 March 2016 found the registered provider was not meeting the regulations relating to supporting staff. On this inspection we checked and found improvements had been made and staff received sufficient training and supervision to support them in their role.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were protected.

People told us they enjoyed the food and we observed staff supporting people to eat and drink. People had access to external health professionals as the need arose.

We observed staff interacting with people in a caring, friendly and professional manner. Staff were able to clearly describe the steps they would take to ensure people’s privacy and dignity.

At our inspection on 9 and 24 March 2016

Inspection carried out on 9 March 2016

During a routine inspection

The inspection of Southfield Court Care Home took place on 9 and 24 March 2016. Both visits were unannounced. We previously inspected the service on 8 and 10 August 2015 and at that time we found the provider was not meeting the regulations relating to premises safety, administration of medicines, staff training and supervision and keeping accurate records. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to 50 older people, some of whom are living with dementia. There were 46 people using the service on the first day of our inspection and 39 people on the second day.

The service is required to have a registered manager. There had been no registered manager at the home since 8 April 2015. 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.

A temporary peripatetic manager had been managing the service until August 2015, when a new permanent manager came into post. This manager left the service in January 2016 and since that time three peripatetic managers had managed the service. At the time of inspection a new manager had been appointed and was in post on the second day of our inspection.

People who used the service we spoke with were unable to tell us if they felt safe due to cognitive or sensory impairment, however the visitors we spoke with told us they felt their relative was safe at Southfield Court.

Our inspection on 8 and 10 August 2015 found the registered provider was not meeting the regulations relating to the safety of premises. The provider sent us an action plan outlining the improvements they would make. At this inspection we found people were still not protected against the risks of unsafe or unsuitable premises because the necessary safety checks were not being regularly completed and we found the service was still not meeting this requirement. This was a breach of regulation 12 (2) (d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Relatives we spoke with told us they were unhappy with the number of different agency staff at the service, leading to a lack of consistent care for their relative. We found there were not always enough experienced staff available to respond to people who required assistance in a timely manner. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Our inspection on 8 and 10 August 2015 found the registered provider was not meeting the regulations relating to the management of medicines. On this inspection we checked and found improvements had not been made. This was a breach of regulation 12 (2)(g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe management of medicines

We found poor practice in the prevention and control of infections. This was a breach of Regulation 12 (2) (h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

Our inspection on 8 and 10 August 2015 found the registered provider was not meeting the regulations relating to supporting staff. On this inspection we checked and found improvements had not been made. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were pr

Inspection carried out on 12 and 13 August 2015

During a routine inspection

The inspection of Southfield Court Care Home took place on 12 and 13 August 2015. The visit on 12 August was unannounced and the visit on 13 August was announced. We previously inspected the service on 28 May 2014 and at that time we found the provider was not meeting the regulations relating to management of medicines and assessing and monitoring the quality of the service. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to fifty older people, some of whom are living with dementia. The home is situated in Almondbury village and is approximately two miles from the town of Huddersfield.

The service is required to have 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.

There had been no registered manager at the home since 8 April 2015. A temporary peripatetic manager had been managing the service since that time. A new manager had been in post for three weeks at the time of our inspection. They had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

People who used the service we spoke with told us that they felt safe and the visitors we spoke with told us they felt confident that their relative was safe at Southfield Court.

People who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises because the service had not carried out the necessary safety checks and addressed issues noted by the local fire safety office which ensured people were kept safe. This was a breach of regulation 12 (2)(d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, premises safety

Our inspection on 28 May 2014 found the registered provider was not meeting the regulations relating to the management of medicines. On this visit we checked and found the recording of the receipt and administration of people’s medicines was not always clear. This meant people who used the service were not always protected against the risks associated with the recording, receipt and administration of medicines because the provider did not have appropriate arrangements in place. This was a breach of regulation 12 (2)(g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe management of medicines

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

There were not always enough staff available to respond to people who required assistance in a timely manner

Staff were not always provided with training and support to ensure they were able to meet people’s needs effectively. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were protected when decisions needed to be made.

People told us they enjoyed the food. Staff supported people to eat and drink in a kind, caring way.

Accurate records were not always maintained in relation to care that was being delivered. This was a breach of Regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Throughout our inspection we observed staff interacting with people in a caring, friendly, professional manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported.

People had access to external health professionals as the need arose

The home employed an activities organiser to organise and enable people to participate in activities however; there was a lack of meaningful activities for a number of people who lived at the home.

People were able to make choices about their care. Peoples care plans detailed the care and support they required and included information about peoples likes and dislikes

People told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

People we spoke with felt that consistent management had not been in place in recent months, although they spoke highly of the peripatetic manager and the new manager

The peripatetic manager had held occasional meetings with staff, and the relatives of people who lived at the home to gain feedback about the service provided to people.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard, however this system had not picked up the problems we found with premises safety, supporting staff and keeping accurate records

You can see what action we told the provider to take in relation to the breeches in the regulations at the back of the full version of the report.

The inspection of Southfield Court Care Home took place on 12 and 13 August 2015. The visit on 12 August was unannounced and the visit on 13 August was announced. We previously inspected the service on 28 May 2014 and at that time we found the provider was not meeting the regulations relating to management of medicines and assessing and monitoring the quality of the service. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to fifty older people, some of whom are living with dementia. The home is situated in Almondbury village and is approximately two miles from the town of Huddersfield.

The service is required to have 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.

There had been no registered manager at the home since 8 April 2015. A temporary peripatetic manager had been managing the service since that time. A new manager had been in post for three weeks at the time of our inspection. They had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

People who used the service we spoke with told us that they felt safe and the visitors we spoke with told us they felt confident that their relative was safe at Southfield Court.

People who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises because the service had not carried out the necessary safety checks and addressed issues noted by the local fire safety office which ensured people were kept safe. This was a breach of regulation 12 (2)(d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, premises safety

Our inspection on 28 May 2014 found the registered provider was not meeting the regulations relating to the management of medicines. On this visit we checked and found the recording of the receipt and administration of people’s medicines was not always clear. This meant people who used the service were not always protected against the risks associated with the recording, receipt and administration of medicines because the provider did not have appropriate arrangements in place. This was a breach of regulation 12 (2)(g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe management of medicines

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

There were not always enough staff available to respond to people who required assistance in a timely manner

Staff were not always provided with training and support to ensure they were able to meet people’s needs effectively. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were protected when decisions needed to be made.

People told us they enjoyed the food. Staff supported people to eat and drink in a kind, caring way.

Accurate records were not always maintained in relation to care that was being delivered. This was a breach of Regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Throughout our inspection we observed staff interacting with people in a caring, friendly, professional manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported.

People had access to external health professionals as the need arose

The home employed an activities organiser to organise and enable people to participate in activities however; there was a lack of meaningful activities for a number of people who lived at the home.

People were able to make choices about their care. Peoples care plans detailed the care and support they required and included information about peoples likes and dislikes

People told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

People we spoke with felt that consistent management had not been in place in recent months, although they spoke highly of the peripatetic manager and the new manager

The peripatetic manager had held occasional meetings with staff, and the relatives of people who lived at the home to gain feedback about the service provided to people.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard, however this system had not picked up the problems we found with premises safety, supporting staff and keeping accurate records

You can see what action we told the provider to take in relation to the breeches in the regulations at the back of the full version of the report.

The inspection of Southfield Court Care Home took place on 12 and 13 August 2015. The visit on 12 August was unannounced and the visit on 13 August was announced. We previously inspected the service on 28 May 2014 and at that time we found the provider was not meeting the regulations relating to management of medicines and assessing and monitoring the quality of the service. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to fifty older people, some of whom are living with dementia. The home is situated in Almondbury village and is approximately two miles from the town of Huddersfield.

The service is required to have 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.

There had been no registered manager at the home since 8 April 2015. A temporary peripatetic manager had been managing the service since that time. A new manager had been in post for three weeks at the time of our inspection. They had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

People who used the service we spoke with told us that they felt safe and the visitors we spoke with told us they felt confident that their relative was safe at Southfield Court.

People who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises because the service had not carried out the necessary safety checks and addressed issues noted by the local fire safety office which ensured people were kept safe. This was a breach of regulation 12 (2)(d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, premises safety

Our inspection on 28 May 2014 found the registered provider was not meeting the regulations relating to the management of medicines. On this visit we checked and found the recording of the receipt and administration of people’s medicines was not always clear. This meant people who used the service were not always protected against the risks associated with the recording, receipt and administration of medicines because the provider did not have appropriate arrangements in place. This was a breach of regulation 12 (2)(g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe management of medicines

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

There were not always enough staff available to respond to people who required assistance in a timely manner

Staff were not always provided with training and support to ensure they were able to meet people’s needs effectively. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were protected when decisions needed to be made.

People told us they enjoyed the food. Staff supported people to eat and drink in a kind, caring way.

Accurate records were not always maintained in relation to care that was being delivered. This was a breach of Regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Throughout our inspection we observed staff interacting with people in a caring, friendly, professional manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported.

People had access to external health professionals as the need arose

The home employed an activities organiser to organise and enable people to participate in activities however; there was a lack of meaningful activities for a number of people who lived at the home.

People were able to make choices about their care. Peoples care plans detailed the care and support they required and included information about peoples likes and dislikes

People told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

People we spoke with felt that consistent management had not been in place in recent months, although they spoke highly of the peripatetic manager and the new manager

The peripatetic manager had held occasional meetings with staff, and the relatives of people who lived at the home to gain feedback about the service provided to people.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard, however this system had not picked up the problems we found with premises safety, supporting staff and keeping accurate records

You can see what action we told the provider to take in relation to the breeches in the regulations at the back of the full version of the report.

The inspection of Southfield Court Care Home took place on 12 and 13 August 2015. The visit on 12 August was unannounced and the visit on 13 August was announced. We previously inspected the service on 28 May 2014 and at that time we found the provider was not meeting the regulations relating to management of medicines and assessing and monitoring the quality of the service. We asked the registered provider to make improvements. On this visit we checked to see if improvements had been made.

Southfield Court is a purpose built care home providing accommodation and nursing care for up to fifty older people, some of whom are living with dementia. The home is situated in Almondbury village and is approximately two miles from the town of Huddersfield.

The service is required to have 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.

There had been no registered manager at the home since 8 April 2015. A temporary peripatetic manager had been managing the service since that time. A new manager had been in post for three weeks at the time of our inspection. They had submitted their application to commence registration with CQC. At the time of our inspection this was not finalised.

People who used the service we spoke with told us that they felt safe and the visitors we spoke with told us they felt confident that their relative was safe at Southfield Court.

People who used the service, staff and visitors were not always protected against the risks of unsafe or unsuitable premises because the service had not carried out the necessary safety checks and addressed issues noted by the local fire safety office which ensured people were kept safe. This was a breach of regulation 12 (2)(d) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, premises safety

Our inspection on 28 May 2014 found the registered provider was not meeting the regulations relating to the management of medicines. On this visit we checked and found the recording of the receipt and administration of people’s medicines was not always clear. This meant people who used the service were not always protected against the risks associated with the recording, receipt and administration of medicines because the provider did not have appropriate arrangements in place. This was a breach of regulation 12 (2)(g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, safe management of medicines

Staff had a good understanding about safeguarding adults from abuse and who to contact if they suspected any abuse. Risks assessments were individual to people’s needs and minimised risk whilst promoting people’s independence.

There were not always enough staff available to respond to people who required assistance in a timely manner

Staff were not always provided with training and support to ensure they were able to meet people’s needs effectively. This was a breach of regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People’s capacity was considered when decisions needed to be made. This helped ensure people’s rights were protected when decisions needed to be made.

People told us they enjoyed the food. Staff supported people to eat and drink in a kind, caring way.

Accurate records were not always maintained in relation to care that was being delivered. This was a breach of Regulation 17of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Throughout our inspection we observed staff interacting with people in a caring, friendly, professional manner. Staff were able to clearly describe the steps they would take to ensure the privacy and dignity of the people they cared for and supported.

People had access to external health professionals as the need arose

The home employed an activities organiser to organise and enable people to participate in activities however; there was a lack of meaningful activities for a number of people who lived at the home.

People were able to make choices about their care. Peoples care plans detailed the care and support they required and included information about peoples likes and dislikes

People told us they knew how to complain and told us staff were always approachable. Comments and complaints people made were responded to appropriately.

People we spoke with felt that consistent management had not been in place in recent months, although they spoke highly of the peripatetic manager and the new manager

The peripatetic manager had held occasional meetings with staff, and the relatives of people who lived at the home to gain feedback about the service provided to people.

The registered provider had an overview of the service. They audited and monitored the service to ensure the needs of the people were met and that the service provided was to a high standard, however this system had not picked up the problems we found with premises safety, supporting staff and keeping accurate records

You can see what action we told the provider to take in relation to the breeches in the regulations at the back of the full version of the report.

Inspection carried out on 28 May 2014

During a routine inspection

The inspection visit was carried out by two inspectors and a specialist advisor. During the inspection we spoke with the deputy manager, regional manager, four care assistants, three people who lived at the home, six relatives of people who lived at the home and one person�s friend, who told us they were a regular visitor. We looked around the premises, observed staff interactions with people who lived at the home, observed lunchtime and looked at records. There were 49 people living at the home on the day of the visit.

The regional manager and deputy manager told us the home manager had been in post for two months and was applying to become the registered manager for the home. The home manager was on leave on the day of the inspection.

When we visited Southfield Court in January 2014 we found the social needs of people who lived at the home were not being met, due to the lack of regular social activities. We asked the provider to make improvements. We went back on this visit to check whether improvements had been made.

Before this visit we had received information of concern about infection control and cleanliness, staff training and medicines management at the home. We looked at these areas during our visit and found no evidence to support this information, with the exception of the management of medicines, where we have asked the provider to make improvements.

We considered all the evidence we had gathered under the outcomes we inspected.

We used the information to answer the five key questions we always ask;

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found. The summary describes what we observed, the records we looked at and what people using 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?

People were protected from abuse and avoidable harm.

Staff were suitably qualified and had the knowledge and experience needed to carry out their role. Staff we spoke with knew how to recognise and report abuse or allegations of abuse.

People were cared for in an environment that was safe, secure, clean and hygienic. We saw some parts of the building were not well maintained. The deputy manager told us there were ongoing refurbishment plans in place at the home. We saw evidence which confirmed this. For example new furniture was being delivered on the day of our visit for a downstairs lounge which had recently been redecorated and re-carpeted.

There were sufficient numbers of suitably qualified staff to meet the care needs of the people who lived at the home.

We found several small issues with medications, mainly around safe storage.

Is the service effective?

From our observations and from speaking with staff, people who lived at the home and relatives we found staff knew people well and were aware of peoples care and support needs.

We found staff had received appropriate training to meet the needs of the people who lived at the home.

We spoke with people, relatives and their visitors who all told us they were happy with the care provided at the home. They confirmed people�s care, treatment and support needs were being met. One relative told us their mother had been in hospital prior to moving in to the home and her weight had dropped to 6 stones. They said, �Since mum has been here she�s been putting weight back on. We�re really pleased. She was also on oxygen 24 hours a day when she was in hospital, now she only needs it at night.�

This showed us people�s care treatment and support at the home achieved good outcomes.

Is the service caring?

People who lived at the home were supported by kind and attentive staff. Care assistants were patient and encouraging when they were supporting people.

We observed staff interactions with people in two of the lounges during the morning and we observed lunchtime in the two dining rooms. We saw that staff were caring, patient and encouraging when they spoke with people. At lunchtime we saw several staff helped people to eat their meals, this was not rushed and people were allowed to go at their own pace.

One of the relatives we spoke with told us, �Mum�s been here for about six weeks. The staff are very, very kind and always pleasant. The management are absolutely lovely.� This person�s mother said to us, �I couldn�t have come to a better place. The food�s good and you get a choice. It gets a bit lonely at times but that�s no different to when I was at home.� This confirmed what we observed during the visit. Care staff encouraged people to be independent as possible. This showed us staff treated people with compassion, kindness, dignity and respect.

Is the service responsive?

Since our inspection in January 2014, dedicated activity hours had been increased from one person working 22 hours a week to two people working 30 hours a week between them. However, we did not observe many activities going on through the day. The regional manager told us there were plans for care workers to receive training in delivering activities and engaging more with people. They also told us they would look into getting more dedicated activity hours at the home.

People were supported to maintain relationships with their friends and relatives. Some people told us there were not a lot of activities at the home; other people said they had seen activities happen fairly regularly. One friend told us they regularly took the person who lived at the home out. The friend told us, �They (the people living at the home) are not getting much stimulation. She goes to bed early because there�s nothing else to do.�

Care and support was provided in accordance with peoples� wishes. We saw from the care records and daily records that people�s preferences, interests and diverse needs were taken into consideration.

This meant the home was well-organised so that it met peoples� care needs. However some improvements were required in order to meet everyone�s social and emotional needs in the form of meaningful activities.

Is the service well-led?

The leadership and governance of the home assured the delivery of high quality care for the people who lived there.

We saw the home had quality assurance processes and systems in place to monitor the care provided to people. For example we saw evidence of consultation with people, their relatives and care staff.

The home manager had been in post since February 2014. The regional manager told us they would be applying to be the home�s registered manager as soon as possible.

Most people we spoke with confirmed they had been listened to and, as a result changes had been made. However, one person told us they had been asking for their friends� pictures to be put up on the wall for a couple of weeks, following a change of bedroom. They said nothing had happened and the pictures were of great sentimental value. When we pointed this out to the two managers they asked the handyman to do it straight away. As a result the handyman spoke with the person concerned to see how they would like their pictures. The pictures were in place before we left the home.

Staff told us they were clear about their responsibilities and felt well supported by the manager. They told us they had regular staff meetings and their views were taken into consideration.

This showed us the home supported learning and innovation and the managers promoted an open and fair culture.

Inspection carried out on 9 January 2014

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

As part of our inspection we spoke with nine staff members: the manager, deputy manager, a nurse, two care staff, a housekeeper, two domestics, and the activities person. We spoke with several people living at the home; however, due to their complex care needs, not everyone was able to comment on the service they received.

There were enough qualified, skilled and experienced staff to meet people's needs. However, the social needs of people were not being met. This was because there were insufficient dedicated activity hours to meet the social needs of people receiving the service.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Inspection carried out on 8 April 2013

During a routine inspection

Many of the people who use this service could not tell us directly about their experiences as they had dementia, however, we saw staff treated people with respect and supported them to maintain their privacy and independence.

At lunch time people were offered a choice of what to drink and eat. For those people who could not make up their mind what to eat, the staff brought samples of the dishes on offer to the table and this assisted people to choose what they would like whilst maintaining their independence.

People visiting the service told us they were pleased to see the permanent staff who had been absent from work, now returning. Although there had been concerns about the use of agency staff, the visitors told us their relatives were well looked after.

Inspection carried out on 10 January 2013

During an inspection in response to concerns

We spoke with a number of people living at the home, however, due to them having complex care needs,they were unable to directly comment on the service they received.

We spoke with three relatives and these are some of the things they told us:

�I am kept informed about my relatives wellbeing, when I was away staff phoned me everyday to let me know everything was alright. We have relatives meetings once a month at the last meeting the acting deputy manager came to the last part of the meeting to answer any questions. They were very professional and we were impressed and reassured by them.�

�I am involved in my relatives care plan and kept informed about any changes. Food is very important to my relative and staff make sure it is served in the way they prefer. The activities are very limited it�s a long time since we had a proper activities person. I wouldn�t want my relative to be anywhere else.�

�We spoke with 10 members of staff. They told us that they enjoyed working at the home but felt staff were stressed and morale was low. Most of the staff we spoke with thought they needed more carers on duty to meet people�s needs.

Inspection carried out on 4 September 2012

During a routine inspection

Many of the people who use this service could not tell us directly about their experiences as they had dementia, however, we saw staff treated people with respect and supported them to maintain their privacy and independence.

We spoke with three visitors and their comments included,

'Southfield Court is as close to perfect as a home can be for a care environment.'

'Staff always give individualised and personal care to all residents.'

'My husband is now smiling again, and other residents always seem so happy.'

One person told us the staff encouraged their relative to maintain their independence. They spoke of how their relative was an active sports person and the importance of them keeping active. They told us they were able to enjoy walks together in the grounds of the home.

We observed at lunch time people could choose where they would like to sit and have their meal. For example, one person told us they had chosen to eat their meal in the dining room but other days might choose to have their meal in their room.

At lunch time people were offered a choice of what to drink and eat. For those people who could not make up their mind what to eat, the staff brought samples of the dishes on offer to the table and this assisted people to choose what they would like whilst maintaining their independence.

We spent a significant amount of our time in one of the lounges observing care practice and saw staff frequently entering and offering support to people. They did this in an unhurried manner and were competent in their care tasks.

A relative told us, �Staff always provide care in pairs, and any requests for care, either verbal or from call buttons are answered immediately.�

Inspection carried out on 19 July 2011

During a routine inspection

Many of the people who use this service could not tell us directly about their experiences due to a variety of complex needs, however, staff observed had good relationships with these people and they were seen to have their privacy, dignity and independence respected.

We observed genuine warmth between people living at the home and staff who supported them. A relative who we spoke to said, �The staff and care are very good. I can visit at any time and am always notified immediately about any incidents or changes�. The relative spoke in glowing terms about one particular member of staff who was on duty at the time of the visit. They described the staff member as �Excellent� and added �He is a calming influence on everyone�. This was observed throughout the visit.

Another relative said that whether they visited early in the morning or late in the evening the staff were always polite, there were always sufficient staff about to assist people, and the staff appeared to be knowledgeable.

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