Archived: Southfields Residential Care

Southfields Residential Care is a residential care home providing personal care up to nine people aged 18 and over. There were nine people being supported at the home at the time of the inspection.

The service did not always reflect the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

Parts of the provider’s governance systems were not consistently reliable or effective. Systems used to monitor the safety of the home had failed to identify and ensure that people’s bathrooms and the home’s flooring had been suitably maintained. This meant people were at risk of harm or the spread of infection as parts of the home could not be effectively cleaned. Control measures had not been implemented to reduce the risk to people while the maintenance issues were being addressed.

People were supported with their nutritional needs and medication and were appropriately referred to health care services as required. The management of people’s risks were managed well and recorded in their care plans for staff to follow such as the risk and management of people who experience epilepsy or risk of choking.

The audits used to monitor people’s care records and health needs were not comprehensively completed to identify gaps in people’s care records. For example, the risk management plans for some people who were at risk of pressure ulcers or had specific mouth care requirements needed to be clearer. People’s care plans did not always reflect changes in their support requirements after an incident had occurred such as the breakdown of their skin.

The registered manager was not available during the inspection, however we found that the deputy manager had a good understanding of people’s needs and the running of the home. The deputy manager took immediate action to address our concerns and implement improvements.

Staff told us they felt supported by the management team and were suitably trained to carry out their role.

People were supported by a stable staff team who knew them well. People and their relatives told us they felt people were cared for by staff who were kind and compassionate. We observed staff engaging with people with kindness, respect and dignity. People’s independence and access to the community and engaging in recreational activities was promoted and encouraged.

Staff regularly sought people views through key worker and house meetings. Staff treated people equally and respected their decisions and choices. 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.

The service didn’t always consistently apply the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people did not fully reflect the principles and values of Registering the Right Support for the following reasons. People could not be assured that the provider had taken all reasonable steps to maintain a safe environment and mitigate risks to people. Effective systems had not been continually used to manage risks to people when concerns had been identified to driving improvements.

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 10 May 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to people’s safety and monitoring of the quality of the service at this inspection.

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

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection in October 2014, the service was rated Good. At this inspection we found the service remained Good.

People received individualised care which reflected their personal preferences, wishes and routines. People were supported to have maximum choice and control of their lives. Staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care records were kept up to date with their changing needs. By closely working with health care professionals the risks to people’s health and well-being were reduced. People were supported to eat and drink. They were encouraged to make choices about their care and support and to be as independent as possible. People were treated with dignity, respect and kindness.

People were supported by staff who had access to training and support to acquire and maintain the skills and knowledge they needed to meet their needs. Staff were supported to develop in their roles through individual and staff meetings.

People’s views were sought as part of the quality assurance process to drive through improvements to the service. A range of quality assurance systems monitored the standards of care provided. The registered manager valued the feedback from people, their relatives and staff and acted on their suggestions.

Further information is in the detailed findings below.

We looked at how the provider supported people to manage their finances. The provider had introduced a new system since our last inspection. This made it clearer to identify what people had spent so that all their money was accounted for.

We looked at the satisfaction survey results for the summer of 2013. The surveys we saw had been completed by people who used the service, their relatives and other health professionals that visited the home. We noted that all of the feedback we saw was very positive about the home.

During our visit in October 2012 we identified a number of concerns about the way staff recorded financial transactions. We had concerns regarding receipts were not always present and money not accounted for. Where receipts were in place they did not always match what the staff had documented.

The provider had implemented a new procedure and we found this to be working. We reviewed the action plan submitted by the provider. During our visit we looked at the financial records for all the people using the service. We also saw minutes of a staff meeting that had been held to specifically discuss finances and the new procedures. We found that each person's money was checked by two staff three times a day. These checks had been consistently carried out and documented. Money had been accounted for with appropriate receipts and these had been documented accurately by staff.

We looked at three peoples care files which had evidence that they had been involved in devising their care plans. Each person had an 'about me' section which was person centred and specific to their individual needs. We also looked at the way the provider managed people's money. Further details about this can be found in outcome 7. We observed staff interacting with people and found this to be friendly, reassuring and respectful. One member of staff was seen to be supporting a person with their eating. The member of staff explained what they were doing and supported the person to eat at their own pace.