Background to this inspection
Updated
21 February 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Southfield Residential Care is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The registered manager was not available during the inspection, however the deputy manager supported us with the inspection.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with two people who used the service about their experience of the care provided and observed how staff interacted with people. We spoke with three members of staff and the deputy manager.
We reviewed a range of records and the premises. This included three people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We spoke to two relatives and continued to seek clarification from the provider to validate evidence found. We received feedback from three professionals who regularly visit the service.
Updated
21 February 2020
About the service
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.