Southway

Southway is a residential care home providing personal care for up to 42 people. The service provides support to older people most of whom were living with different types of dementia. At the time of our inspection there were 40 people using the service.

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

We found there were shortfalls with how the managers and provider responded to accidents and injuries. Investigations were not thorough with safeguarding referrals made to promote people’s safety. Actions were not considered and taken to try and reduce the risk of the injury happening again. Risk assessments lacked details and staff did not always have clear plans to follow. There was also a lack of care planning around some people’s medicines to ensure staff had all the relevant information at hand to guide their actions.

There were shortfalls with plans and drills related to fire safety. We were not confident at times there was enough staff or staff had the right support to spend time with people, talking with them and responding to them when they needed support. Parts of the home and people’s rooms needed decorating, but there was no plan in place to do this.

The registered manager and provider were not carrying regular audits and checks on the quality of the care people experienced. Audits were not effective or not taking place to see what was happening in key areas and consider if changes needed to happen.

People were not always supported to have maximum choice and control of their lives. Staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

People felt happy living at the home. One person said, “No washing up, no ironing, a life of comfort. No one has upset me so far.” Another person said, “Staff are nice here, its ok.”

People’s relatives were confident their loved ones were safe, and staff had got to know them. Relatives spoke of being made to feel welcomed by staff.

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 1 February 2020). At this inspection we found the service had deteriorated.

Why we inspected

We undertook this inspection as part of a random selection of services which have had a recent Direct Monitoring Approach (DMA) assessment where no further action was needed to seek assurance about this decision and to identify learning about the DMA process.

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.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to promoting people’s safety and the managers quality checks on the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. 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.

A room has been allocated for the exclusive use of visitors which can only be accessed from an external door. The room has been laid out to enable safe social distancing at all times. Visits were scheduled for 20-minute periods and were cleaned in between visits by staff.The registered manager had also purchased head phones for use by people when making telephone and video calls enhancing their ability to hear and have private conversations.

The provider was participating in the whzan programme which enabled staff to complete observations of temperature, blood pressure and oxygen saturations and interpret these to identify where people's health conditions were deteriorating so early medical intervention could be sought, which in some cases could help avoid unnecessary hospital admissions.

Further information is in the detailed findings below.

Southway is a residential care home providing personal and respite care to people. At the time of the inspection there were 39 people living at the service and two people staying at the service on respite care. Respite care is when a person requires temporary support and stays in a home short term.

The care home can accommodate up to 42 people in one adapted building across two floors. The building has been designed to meet the needs of people living with dementia by in mind. The design enabled people to freely access all areas safely should they choose to. The home was split into five smaller units each with their own kitchen, lounge and dining area. This gave the home a personal feel while still enabling access to the other areas without restriction. There was a shared garden, hairdressing salon and activities room.

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

People were very happy about living at this service and told us they felt safe and were treated with respect. On person gave written feedback and wrote, 'The staff are my friends. The food is lovely. I like everything and want to stay here forever.'

People were supported by staff who understood how to protect them from harm and how to report any concerns. Risks were well managed and medicines administered safely and in consultation with people. There were always plenty of staff on duty to meet the needs of people.

People were encouraged to take their time in order to do what they could for themselves. Staff were patient and kind. People and their relatives told us the management team were also very good and communication between staff and relatives was very good.

The environment had been updated and refurbished to meet people’s needs and people spoke very positively about their rooms, the home and the colours. The environment was clean and staff understood how to prevent the spread of infection.

People were supported to become involved in activities that promoted good health. Professionals told us the staff team and registered manager were always very efficient in addressing people’s health concerns and updating their care plans as their needs changed.

People were offered a variety of activities both inside the home and within the local community. The registered manager encouraged community links and supported people to maintain friendships. Relatives told us they were fully involved in reviews of people’s care needs and encouraged to give feedback regularly.

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; policies and systems in the service supported this practice.

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 28 September 2017).

Why we inspected

This was a planned 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.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good.

People using the service felt safe. Staff had received training to enable them to recognise signs and symptoms of abuse and felt confident in how to report them.

People had risk assessments in place to enable them to be as independent as they could be in a safe manner. Staff knew how to manage risks to promote people’s safety, and balanced these against people’s rights to take risks and remain independent.

There were sufficient staff, with the correct skill mix, on duty to support people with their needs. Effective recruitment processes were in place and followed by the service. Staff were not offered employment until satisfactory checks had been completed. Staff received an induction process and on-going training. They had attended a variety of training to ensure they were able to provide care based on current practice when supporting people. They were supported with regular supervisions.

Medicines were managed safely. The processes in place ensured that the administration and handling of medicines was suitable for the people who used the service.

People were supported to make decisions about all aspects of their life; this was underpinned by the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Staff were knowledgeable of this guidance and correct processes were in place to protect people. Staff gained consent before supporting people.

People were able to make choices about the food and drink they had, and staff gave support when required to enable people to access a balanced diet. There was access to drinks and snacks throughout the day.

People were supported to access a variety of health professionals when required, including opticians and doctors, to make sure they received continuing healthcare to meet their needs.

Staff provided care and support in a caring and meaningful way. They knew the people who used the service well. People and relatives, where appropriate, were involved in the planning of their care and support.

People’s privacy and dignity was maintained at all times.

People were supported to follow their interests and join in activities.

People knew how to complain. There was a complaints procedure in place and accessible to all. Complaint had been responded to appropriately.

Quality monitoring systems were in place. A variety of audits were carried out and used to drive improvement.

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.

Further information is in the detailed findings below