We carried out a review of the data available to us about Southwold House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Southwold House, you can give feedback on this service.
The service was bigger than most domestic style properties, and at the time of the inspection, ten people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size, and the development of four separate flats. There were deliberately no identifying signs, intercom, cameras, industrial bins, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People were encouraged to live as full a life as possible and achieve the best possible outcomes. Registering the right support 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
The recruitment and retention of staff had been challenging. However, at the time of inspection there were enough staff on shift to meet people’s needs. People living at the service had complex behaviours, and registered manager had systems in place to assess and monitor risk.
At the time of the inspection, people's medicines were being administered safely. Previously, the local authority had investigated a concern relating to medicine management, and the registered manager had made changes as a result. An air conditioning system needed to be installed to the medicine room to ensure the correct temperature to store medicines was maintained. The provider confirmed there were plans to carry this out.
Plans were in place to carry out remedial work to the environment. People’s health and emotional needs were assessed, and monitored so that they could live well. The service worked closely with relevant health care professionals and people received the support they needed to have a healthy diet that met their individual needs.
People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.
The care and support people received was individualised. 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.
End of life care planning had not been offered to people, and staff had not been trained in end of life care. We have made a recommendation about end of life care. Complaints were dealt with effectively.
Systems were in place to drive improvement and audits were carried out on a regular basis, which looked at the quality of the service people received. The registered manager had a clear oversight of the service.
The service applied 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 using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
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 this service was rated Good. At this inspection we found the service remained Good.
Staff were knowledgeable about identifying abuse and how to report it to safeguard people. Recruitment procedures were thorough. Risk management plans were in place to support people to have as much independence as possible while also supporting their safety. There were also processes in place to manage any risks in relation to the running of the service.
Medicines were safely stored, recorded and administered in line with current guidance to ensure people received their prescribed medicines to meet their needs. People had support to access healthcare professionals and services. People had choices of food and drinks that supported their nutritional or health care needs and their personal preferences.
People were supported by skilled staff who knew them well and were available in sufficient numbers to meet people's needs effectively. People’s dignity and privacy was respected and staff were friendly and caring. People were supported to participate in social activities including community based events.
Staff used their training effectively to support people. The registered manager understood and complied with the requirements of the Mental Capacity Act 2005 (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Staff were aware of their role in relation to MCA and DoLS and how to support people so not to place them at risk of being deprived of their liberty. People were supported to have 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.
Care records were regularly reviewed and included people’s preferences and individual needs so that staff had clear information on how to give people the support that they needed. Relatives confirmed that people received the care they required.
The service was well led; relatives and staff knew the registered manager and found them to be approachable and available in the home. People’s relatives had the opportunity to say how they felt about the home and the service it provided. Their views were listened to and actions were taken in response. The provider and registered manager had systems in place to check on the quality and safety of the service provided and to put actions plans in place where needed.
Further information is in the detailed findings below.
We inspected Southwold House on the 3 November 2014.
The service provides accommodation and support for up to 12 people with learning disabilities. There were five people living at the service at the time of our inspection. Due to their complex needs people found it difficult to communicate with us verbally. However people were able to communicate with sounds and gestures. To help us gather views we also spoke with people’s relatives.
The service has not had a registered manager in post for the past 12 months; however a newly appointed manager started in August 2014 and was going through the process to become a registered manager with the Care Quality Commission 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.
People were cared for by staff that had been recruited and employed after appropriate checks were completed. There were enough staff available to support people.
Records were regularly updated and staff were provided with the information they needed to meet people’s needs. People's care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare.
Staff and the manager were able to explain to us what they would do to keep people safe and how they would protect their rights. Staff had been provided with training in safeguarding adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find.
People were relaxed in the company of staff. Staff were able to demonstrate they knew people well. Staff were attentive to people's needs and treated people with dignity and respect.
People who used the service were provided with the opportunity to participate in activities which interested them, these activities were diverse to meet people’s social needs.
The service worked well with other professionals to ensure that people's health needs were met. Where appropriate, support and guidance was sought from health care professionals, including a doctor and speech and language therapist.
Relatives knew how to raise a concern or make a complaint, any complaints were resolved efficiently and quickly.
The manager had a number of ways of gathering views on the service including holding meetings with staff and talking with relatives.
The manager carried out a number of quality monitoring audits to ensure the service was running effectively. These included audits on care files, medication management and the environment.
We carried out a desk top review in January 2013 and from the information that we had received from both the local authority and the provider showed that the service was compliant.
During our visit in May 2013 we found that there was good information available about safeguarding adults. People who use the service had limited communication. All people spoken with on the day of our visit either said or indicated that they were happy and we found them to be relaxed and smiling.
The environment had been greatly improved and the garden had been cleared and was neat and tidy.
We looked at the staff training records and they showed that staff had received training in a range of subjects. Training was delivered by way of e-learning and workshops. We saw that new staff had received a full induction.
Regular management inspections had taken place and the manager and deputy manager had carried out a range of audits to check the quality of the service. People told us that they were happy living in Southwold House.
We found that the home now displayed clear information about safeguarding adults and that staff had been trained in the subject. More staff had been recruited and they had received regular supervision and training. Improvements had been made to the environment both inside and out.
The services improvement plan showed that a lot of the planned improvements had taken place. The manager told us that records have been improved and that regular checks were now carried out to ensure the improvement was maintained.
The manager told us that they now hold all of the required safety certificate.
Although many of the people that we talked with did not respond verbally to the questions that we asked, they did respond in a positive way and they appeared relaxed and happy in staffs presence.