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Southfields House Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 11 November 2019

During a routine inspection

About the service

Southfields House is a residential care home providing personal care to 33 people with a physical disability, sensory impairment, dementia and mental health needs at the time of the inspection.

The service can support up to 45 people across six separate units, each of which have separate adapted facilities. 19 people lived at the home permanently and 14 people were temporarily staying at the home to receive reablement support at the time of inspection.

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

The service had a registered manager. However, they had been absent since July 2018. The provider had appointed an acting manager who was responsible for monitoring the quality of the service and ensuring the regulatory requirements were met. Quality assurance systems and processes identified where improvements were needed. However, we found action was not always taken quickly enough to resolve issues found.

Decision specific mental capacity assessments and best interest decisions had not been undertaken for all people that lacked capacity to make decisions about their care. However, we found 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.

Staff knew how to recognise, and report suspected abuse. They had been safely recruited and had access to the training they needed to meet people’s individual care needs. Staff had a good knowledge of infection control requirements and had access to personal protective equipment. Staff felt well supported by the management team.

There had been an increase in medicines errors and there were no protocols in place to instruct staff to administer medicines people were prescribed ‘as required’. Following our inspection, the service implemented protocols for ‘as required’ medicines and met with the GP surgery and pharmacy to develop a new system for ordering and stock control of medicines. People told us they received their medicines on time.

People told us they were happy with the food available and were able to choose what they wanted to eat and drink. Staff contacted health professionals as needed and had received specific training to meet people’s individual needs.

People were supported by staff that were kind and caring. Staff respected people’s privacy and dignity and involved them in decisions about their care. Staff knew people’s hobbies, interests, preferences and wishes and we observed staff talking with people about these. Activities such as crosswords, newspapers and jigsaw puzzles were available for people to use.

Complaints were managed in line with the providers complaints policy. People and relatives told us, they felt confident action would be taken should they complain.

The service understood their requirements in relation to duty of candour and were open and honest with us during our inspection. They worked with partner agencies such as commissioners and healthcare professionals to meet the needs of the people living at the service.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 29 December 2018)

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection enough, improvement had not been sustained and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified a breach in relation to the governance of 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 continue to monitor information we receive about the service until we return to visit as per our r

Inspection carried out on 12 November 2018

During a routine inspection

Southfields House 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.

Southfields House is located in Northampton and is registered to provide accommodation and personal care to older people. It provides care for older people and people with a physical disability and accommodates 45 people across six separate units, each of which have separate adapted facilities.

The provider had recently started to provide reablement support to people for up to six weeks following discharge from hospital. When we visited there were 23 people living at the home permanently and nine people temporarily living at the home receiving reablement support.

The reablement support was being provided in two areas, separately to people that lived at the home permanently to minimise any disruption. However, the provider told us that they were planning to increase the number of reablement beds available and extend this to a third unit. The provider was in the process of consulting with people and their relatives regarding this change.

This is Southfield House’s first comprehensive inspection under the current provider. The inspection took place on the 12 November 2018 and was unannounced.

The provider notified us that the registered manager was absent from work. 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 provider had appointed an acting manager as an interim arrangement.

People were at risk of not receiving a nutritionally balanced meal or adequate nutrition as a menu was not being followed and there were inconsistencies in the kitchen staff. This impacted on the quality and the variety of food available to people.

We found the poor cleanliness of the kitchen and unsafe food storage had not been adequately addressed by the management team, despite this being identified in meeting minutes and audits two months prior to the inspection.

Risk assessments were in place but did not always include enough information to assist staff in identifying a deterioration in people’s health condition.

Some people at the home were prescribed medicines on a when required basis. We found there was no guidance in place to advise staff when and how to give these medicines.

People were at risk of accidents or incidents re-occurring as reports were not immediately reviewed to identify learning. This meant changes were not promptly made to reduce the risk of the incident occurring again.

The quality assurance systems in place identified areas that needed improving. The acting manager had developed an improvement plan to enable the service to prioritise areas for action. Whilst we found the acting manager had implemented improvements that impacted positively on people, further improvements were required and we could not be assured these would be sustained or were embedded in practice.

People were treated with warmth and kindness by the staff and management team, and supported by staff that had taken time to get to know them and enjoyed spending time with them. People's privacy and dignity was protected and promoted always.

People were assisted to maintain relationships with their families, visitors were welcome at any time and were made to feel at home.

People told us they felt safe and staff understood their roles and responsibilities to safeguard people from the risk of harm. There were sufficient staff available to meet people's needs and staff had been safely recruited.

People using the service and their relatives knew how to raise a concern or make a