This inspection was to follow up on these concerns. We spoke with the manager and staff about how medicines were managed in the home. We found that there had been improvements in the way medicines were managed since our previous inspection.
During our visits we found that concerns about the care and welfare of people living in the home, requirements relating to staff, medication management and record keeping.
We visited the home on four separate occasions, including the 21 January 2013, 13 February 2013, 19 February 2013 and the 28 February 2013. We were told there were 17 people currently living at the home. We spoke with all 17 people over the four days we visited, a relative and staff members. Following our visit we asked the provider for additional information about how the management of the service ensured the quality and safety of the service being provided to people.
Some of the people we spoke with raised concerns about their care and welfare needs not being met.
Some people spoke positively about the staff and said, 'the staff are kind'. Another person said, 'they (the staff) won't let you go out' and another said, 'like a prison in here'.
One relative said, 'The staff are friendly and helpful'.
We saw and heard staff speak to people in a way that demonstrated a good understanding by staff of recognising people's individual choices and preferences. We observed however, that people's privacy and dignity was not always being respected.
We looked at medication systems and we found that the management of prescribed and controlled medication was not managed safely.
Comments included: 'my care needs are always met'; 'I feel involved in my care'; 'I have no complaints. I would speak to staff if I had any concerns'; 'the staff are lovely' and 'the food is very nice and there are always alternatives available.'
Care plans that we saw reflected people's health and social care needs and demonstrated that other health and social care professionals were involved.
Appropriate checks were undertaken before staff began work.
People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.
People's personal records including medical records were accurate and fit for purpose.
On the 20 March we walked around the home, spoke to people that used the service, observed the delivery of care within the operation of the home, and spoke with the staff. On the morning of 21 March we largely considered documents and spoke with the representative of the provider.
After our two days of visits we spoke with social and health care professionals to gain further information about the quality of the service being delivered.
We spoke with a number of people that lived in the home during our visit. They told us that they were satisfied living at the home and said that the staff were respectful and helpful. We saw staff supporting people appropriately.
We found that peoples' needs were generally being met and the service was providing enough adequately trained staff to meet peoples' needs. However some people were not being protected against the risks of receiving inappropriate care or support because their care and support needs had not been adequately assessed and planned.
People that lived at Southview had access to an adequate diet. However they were not offered fresh fruit or fresh vegetables by the service. Also people that were at high risk of malnutrition or dehydration were not having their food or fluid intake recorded in order to monitor their condition and to ensure that these risks were managed.
The systems for managing the administration of people's medication were being adequately managed and people were receiving their medication appropriately.
We looked at the provider's records of some of the recruitment processes that had been carried out for new staff that worked at the home. We found that the provider was not operating effective recruitment procedures that demonstrated that their new employees were of good character before they began work at the home.
We received several comments from people about how conscientious they found the new housekeeper and their rooms were much cleaner.
People told us they are happy with the way they receive their medicines.
Eight people residing at Southview told us about their daily lifestyle in the home. Four of them prefer to stay their own room because it is quieter than the lounge.They all described the lounge as as noisy. They said they sometimes join in activities. They all have family and friends who visit regularly and take them out for short trips. One person told us the home was "boring". "I only go out if someone comes for me". Another person told us "It's lovely here. I am very comfortable." "I sometimes go to the lounge before lunchtime but mostly I stay in my room with my television."