You are here

Archived: Southfields House Requires improvement

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 7 November 2017

This inspection took place on 18 September 2017 and was unannounced. The service provides accommodation for up to 46 older people who require support with their personal care. At the time of our inspection there were 40 people living at the service. We carried out this comprehensive inspection due to concerns we had received about the service in the two months prior to this inspection.

There was a registered manager in post at the time of our inspection. 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.

At this inspection we found breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The breaches we identified were in relation to medicines management, risk assessing, nutritional monitoring and support, safeguarding people against abuse and in relation to how the service was being run. At our last inspection the service was rated as 'Requires Improvement.' You can see the action we have asked the provider to take at the end of this report.

People's risk assessments and care plans did not always reflect their current needs. Risks to people had not always been accurately calculated and this put people at risk of receiving unsafe care and support.

Medicines were not being safely managed, stored or administered at the service and although an action plan was in place to improve medicines and how they were being managed, some of the issues we identified had not been identified by the registered manager. There had been eight substantiated safeguarding investigations into people who had not received their medicines as required over the period of two months.

People were not being adequately supported with their nutritional needs and there was confusion within the service about how people's meals were fortified. This was not always happening as required. People had not always been referred to the dietitian where this may have been required. There was not an adequate number of staff to support people as they needed at mealtimes.

Staff felt supported and were trained to deliver safe care to people. This training was monitored and refreshed when needed. However, there was a training gap in relation to managing behaviour which may have been challenging for staff.

Although there were mental capacity assessments carried out at the service, there were no best interest meetings held or documented to consider decisions made in relation to how people were cared for. There was not adequate monitoring and oversight of Deprivation of Liberty Safeguards at the service.

Incidents and complaints had not always been appropriately recorded or responded to and some safeguarding incidents had not been recognised as such by the registered manager. We have made a recommendation about the management of complaints. Some of the safeguarding concerns we looked at had not been responded to as they should have been in order to protect people from the risk of abuse.

There was a lack of management oversight across the service which meant that people's risks were not being monitored and improvements were not made as needed. Quality assurance systems were not effective as information was not being monitored by the registered manager.

People were cared for by kind and compassionate staff who knew people well. People's privacy was respected and their dignity maintained and care records detailed people's personal histories and their preferences in relation to their care.

People were encouraged to remain independent wherever possible and there were activities within the service that people could choose to get involved with.

Most staff felt supported by the registered manager and there were regular meetings held to obtain

Inspection areas

Safe

Requires improvement

Updated 7 November 2017

The service was not safe.

People's risks were not always accurately assessed and planned for.

Medicines were not managed, stored or administered safely.

There were not sufficient numbers of staff to support people as needed at mealtimes.

Some safeguarding concerns had not been recognised as such or reported as needed. Incidents had not always been reported as they should have been.

Staff were safely recruited.

Effective

Requires improvement

Updated 7 November 2017

The service was not consistently effective.

People's dietary needs were not being met and people were not being supported to eat and drink as they required.

Staff had an induction into the service and training was delivered and refreshed. However, there was a training gap in relation to managing behaviour which may have been challenging for staff to manage.

People's mental capacity had been assessed when needed but no best interest meetings had been held to consider any restrictions placed on people or decisions relating to how they were being cared for.

Referrals to health professionals had not always been made when needed.

Consent was sought from people prior to them receiving care.

Caring

Good

Updated 7 November 2017

The service was caring.

People were supported and cared for by staff who knew them well and who treated them in a caring and compassionate manner.

People's dignity was maintained and their privacy respected.

People were treated as individuals and were able to spend their time as they wished.

Responsive

Requires improvement

Updated 7 November 2017

The service was not consistently responsive.

Complaints had not been managed well at the service or in line with the complaints policy in place.

Risk assessments were not always accurate and did not always reflect people's current needs.

People were not involved in on-going reviews of their care.

People were encouraged to remain independent wherever possible.

Well-led

Requires improvement

Updated 7 November 2017

The service was not well-led.

The registered manager did not have oversight across the service as a whole and was not aware of risks across the service.

The registered manager was not clear on the needs of people using the service and quality assurance systems were not being managed effectively.

Incidents and complaints had not always been managed well and reported as they should have been.

Staff felt supported in their roles and felt that these were clearly defined.