Southview Lodge Residential Care Home

Updated 20 August 2019

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 undertaken by two inspectors and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service.

Service and service type

Southview Lodge is a care ‘home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided and both were looked at during this inspection.

The service has 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.

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. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and four relatives about their experience of the care provided. We spoke with ten members of staff including the owner, nominated individual, registered manager, deputy manager, senior care workers, care workers, activity coordinator and the chef. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included five people’s care records and multiple medicines 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 continued to seek clarification from the nominated individual to validate evidence found. We spoke with three professionals who regularly visit the service.

Updated 20 August 2019

About the service

Southview Lodge is a residential care home providing personal care and accommodation., At the time of the inspection 27 people were living at the home. The service can support up to 30 people . All bedrooms and communal areas are accessible on the ground floor. There is a large secure garden with an outdoor seating area and ample car parking.

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

People and their relatives felt the home was safe. Staff had received safeguarding training and were able to identify types of abuse and they knew how to raise concerns. However, we found environmental risk assessments were not robust enough to monitor areas of potential risk. The registered manager had not carried out regular health and safety audits. People’s care plans and risk assessment had been considered, however they had not always been updated when needs had changed, such as following a hospital discharge. Accidents and incidents had been recorded and people had received medical attention where required. However, there was no accident and incident audit to identify themes and trends to assist in lessons learnt.

Medicines were not always managed safely, this included inconsistences to medicines administration records (MARs). Some of the records we reviewed had not been signed to show whether people had received their medicines. We found some concerns around the safe storage of medicines . There were no protocols for ‘as required ’ medicines and there were no risk assessments in place for people who were self-administering creams.

The provider did not have effective recruitment procedures to ensure suitable staff were employed in the home. Employment references had not always been obtained and staff had started work before the Disclosure and Barring Service clearance. The Disclosure and Barring Service helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable groups.

The registered manager was open and transparent during the inspection process and the home had visions and values displayed. Staff said the registered manager was very supportive. However, the governance system at the home was not robust. The system did not proactively monitor areas where the care delivered was not safe or meeting standards. The registered manager was not always aware of shortfalls in the home, due to a lack of robust audits and quality assurance systems. Regular audits had not been undertaken in several areas including medicines, health and safety, care records, accident and incidents. The policies and procedures were not up to date with current legislation and best practice guidance.

Records related to consent for care were completed for people with capacity and people told us they were always offered choice and control over the care they received. The provider had systems and procedures for seeking DoLS authorisations. However, these were not consistently followed.

Staff had received an induction and ongoing training, supervision and appraisals. People were supported to eat nutritionally balanced diets and their choices and preferences were considered. The registered manager and the provider had maintained the premises to a high standard and there was adequate space inside and outside the home. People had prompt access to professionals when required.

People told us they were treated kindly and with respect. We saw caring interactions between staff and people. Staff were aware of peoples’ needs. Privacy and dignity were observed during personal interactions.

People were supported with meaningful activities. People were aware of how they could raise a concern or complaint if they needed to. While the complaints policy was not readily available on display a suggestion box was provided for people to raise concerns. No complaints had been received.

No one was receiving end of life care. Improvements were required to the systems for supporting people to plan for end of life care. End of life care records were not robust. Following the inspection, the registered manager and provider gave us assurance that they would introduce robust systems for monitoring the home and to improve their policy and procedures.

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 3 February 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements. Please see the relevant key questions sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We have identified breaches in relation to seeking consent, safe care and treatment, good governance and fit and proper persons employed at this inspection. Please see the actions we have told the provider to take at the end of the report.

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.