The Care Quality Commission
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Archived: Southlands Court Residential Home

Overall: Requires improvement read more about inspection ratings

Bridgerule, Holsworthy, Devon, EX22 7EW (01288) 381631

Provided and run by:
Mr & Mrs V L Goaman

Important: The provider of this service changed. See new profile

All Inspections

5 October 2015

During an inspection looking at part of the service

We carried out an unannounced focused inspection on 5 October 2015.

We last inspected the home in June 2015 and found breaches in six of the regulations we looked at. Following that inspection, the provider sent us an action plan. We did not feel it was sufficiently comprehensive and so requested a second action plan, which was more comprehensive. The June 2015 inspection found there were not effective systems to assess, monitor and mitigate risks and records were not always accurate and complete. We gave the provider until 30 September 2015 to ensure those systems were in place so that people’s health and safety were better promoted. We undertook this focused inspection to check that they had followed their plan and to confirm that they now met that one legal requirement, as this related to the way the home was run. The other breaches will be looked at during a subsequent inspection. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for (location's name) on our website at www.cqc.org.uk

Southlands Court provides accommodation and personal care for up to 25 people. Any nursing needs are met through community nursing services. There were 24 people resident at the time of the inspection.

The service has a registered manager. 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 arrangements for staff training were used more effectively. Staff were receiving the training which the registered manager said was required for them to provide safe care, such as moving people safely.

Staff induction was structured and was now started prior to new staff delivering care to people. A structured supervision of their work was planned to ensure new staff’s practice would be monitored and they would be supported. This structured supervision was then to be rolled out to include all staff members; this had not yet started. People told us, ”On the whole staff know what to do” and “Very good really.”

Risks were being assessed and managed. Staff meetings informed staff of where improvement was needed, such as not propping open fire doors and medicine management. The registered manager was undertaking regular audits, such as the safety of the home environment. Maintenance arrangements were improved and now included work being signed off so it was clear what had been dealt with and what still needed work. On admission risks to people’s health and welfare and a plan of how to deliver their care were in place for staff reference. Policies and procedures had been reviewed in July 2015 as a source of staff reference, although the registered manager expressed the opinion they were of no value.

People using the service, their families and health professionals had their opinion of the service surveyed. Where possible the registered manager had made changes in response to their comments. However, recruitment difficulties were negatively affecting what could be achieved, such as more outings. The registered manager was well known to people and their families and available to hear their views and support staff. She was supported by the provider who visits the home most days.

15 & 17 June 2015

During a routine inspection

We carried out an unannounced comprehensive inspection on 15 and 17 June 2015.

We last inspected the home in June 2013 and found no breaches in the regulations we looked at.

Southlands Court provides accommodation and personal care for up to 25 people. Any nursing needs are met through community nursing services. There were 23 people resident at the time of the inspection.

The service has a registered manager. 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.

Safety was not fully promoted because the arrangements for assessing, monitoring and mitigating risks were not effective. Monitoring and auditing arrangements did not inform the registered manager or provider where action needed to be taken.

The arrangements for staff training did not ensure staff were fully aware of current good practice, such as moving people safely; some staff had not received some training for many years. Actions following environmental risk assessments were not always followed up within the specified timescales and fire doors were propped open and staff did nothing about it.

Medicines were stored securely and people received their medicines as prescribed but records were not always completed and some medicine in stock was out of date.

The registered provider and registered manager were not up to date with their regulatory responsibilities. Whilst people were involved in decisions about their care the staff did not understand how to ensure people’s rights were protected. This had led to at least two people who may be unlawfully deprived of their liberty, one because their movements were being closely monitored and one because a strap was used to restrain them in their wheelchair.

Records were not always accurate and complete. This included positioning and dietary monitoring records.

We have made a recommendation about environmental adaptation to promote the independence of people living with dementia.

Recruitment procedures were in place but one person started working at the home before the checks of their suitability to work in a care home environment was confirmed.

Risks to people’s individual safety were assessed and followed up although not always recorded. People’s care plans provided enough information for staff to understand what person centred care the person required but plans were not always in place within a reasonable timescale. This meant staff might not understand what support one person required, whose behaviour was a challenge.

Staff had sufficient understanding of abuse and how to report any concerns to protect people from abuse. The registered manager understood her responsibilities and how to alert any concerns identified.

Health care professionals had no concerns about the service and felt the standard of care delivered met people’s needs and preferences. They said they were always contacted appropriately and they had a lot of confidence in the registered manager and staff at Southlands Court.

Staff were caring, kind and treated people with respect and dignity, taking their views into account. All interactions between staff and people using the service were unhurried and put the person as the priority. There was friendly banter and gestures of affection.

People liked the food and people’s dietary intake was monitored and followed up as required for their well-being. Activities were organised but there was no evidence that they took into account people’s personal interests or hobbies. However, no person mentioned a lack of activities and the homely atmosphere and friendly interactions with staff gave people lots of opportunity for social interaction.

People said when they called for assistance it arrived quickly. There were sufficient staff to meet people’s needs in a timely way.

We found breaches of the regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

7 June 2013

During a routine inspection

On the day of our visit we were told that there were 23 people living at Southlands Court. We spoke with ten people living at the home, six staff members, looked at four people's care files and reviewed six employee records.

People we spoke with told us that they were very happy with the care and support they received and the staff were polite and easy to communicate with.

People said that their care and welfare needs were being well met. Comments included: 'My needs are met by the staff when I need help'; 'Southlands could never replace my home, but it is lovely here, the staff are helpful and I feel safe and well cared for' and 'It's nice and airy here. I like sitting outside when the weather is nice.'

People we saw and spoke with confirmed that they felt safe and supported by staff at Southlands Court and had no concerns about the ability of staff to respond to safeguarding concerns.

Staff confirmed that all relevant checks had been completed before they started working at the home, which included references being obtained and Criminal Record Bureau (CRB) checks.

People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw evidence of questionnaires being completed in September 2012 with issues raised discussed at the home's yearly residents meeting.

31 October 2012

During a routine inspection

We carried out an unannounced inspection on 31 October 2012. On the day of our visit we were told that there were 22 people living at Southlands Court. We spoke with six people living at the home, two relatives/friends, four staff members and looked at three people's care files.

People we spoke with told us that they were very happy with the care and support they received and the staff were polite and easy to communicate with. Comments included: 'I couldn't imagine living anywhere else'; "The staff are kind' and 'Thoughtful staff.'

Staff had knowledge of privacy, dignity, independence and human rights. For example, they knew how to maintain privacy and dignity when assisting with personal care.

Care plans that we saw reflected people's health and social care needs and demonstrated that other health and social care professionals were involved. This showed that expert advice was sought and people's health was promoted.

We spoke with staff about their understanding of what constituted abuse and how to raise concerns. They demonstrated a good understanding of what kinds of things might constitute abuse and knew who within the home they should go to report any suspicions they may have. However, staff were less familiar with the multiagency procedure to be followed if abuse was alleged, such as contacting the local authority safeguarding team.

18 October 2011

During a routine inspection

We the Care Quality Commission (CQC) carried out this planned inspection on 18 October 2011. The inspection was carried out by one inspector who spoke with seven people living at the home. The inspector observed interactions between staff and people living here. We spoke with the manager, owner, two care staff and with housekeeping staff. We received feedback from two healthcare professionals who visited the home frequently. We left our contact details in the reception area asking people to contact us if they wanted to provide feedback. We did not receive any calls.

People told us that they received the care they need, in the way they liked it from 'excellent' staff who were skilled at striking the balance between supporting people to make their own decisions and helping to promote their safety. This was confirmed by a healthcare professional. Care records did not always demonstrate the extent to which staff were achieving best practice.

People said that staff were respectful of them and of their privacy and treated them as individuals. Staff demonstrated a good understanding of, and commitment to, person centred care (putting people first) and understood their responsibilities in relation to protecting people from abuse. The manager also demonstrated a good understanding of this. However, she was not completely familiar with the multiagency procedure to follow if abuse were alleged.

Records showed that people saw health care professionals when they needed to and visiting professionals were confident that people were receiving appropriate care. Risk assessment and management plans were in place. No one living at the home had a pressure sore and people were being supported to maintain a healthy weight.

Some people living at Southlands Court had dementia. Staff showed excellent management of one person who was anxious. They showed understanding, warmth and were relaxed and accepting of this person. They received training relevant to the needs of people they were caring for, including caring for people with dementia, and received regular supervision.

This home had both informal and formal processes in place to gain feedback and comments from people. They sent out questionnaires asking for feedback and for suggestions for improvement. Suggestions were acted upon. Residents meetings were held, and these were well attended. Staff meetings were also held. These are were not so well attended, and the manager said this is probably because staff were happy. We spoke with staff who told us they enjoyed working at Southlands Court and felt well supported. The rate of staff turnover was very low. One healthcare professional described the home as 'a positive' place, and we found the atmosphere to be welcoming and upbeat.