Southgarth Care Home offers accommodation with care and support for up to 25 older people. There were 20 people using the service at the time of the inspection. At the last inspection November 2015, we gave the service an overall rating of ‘Good’. However we rated the ‘safe’ domain as requires improvement because we found a breach of regulations. This was because the provider had not ensured the premises were safe for people using the service. At this inspection we checked that they had followed their action plan and to confirm that they now met legal requirements. We found improvements had been made and risks to people were being safely managed. At this inspection we found the service remained good.
Why the service is rated good.
Individual risks to people’s safety had been assessed and care plans written to show how these were being addressed. At the last inspection we had identified people were not protected by an effective system to assess and monitor the health and safety risks at the home. This was in relation to vulnerable people having access to hot taps in sinks which exceeded the Health and Safety Executive (HSE) recommended temperatures. At this inspection all communal baths and wash basins had thermostatic mixing valves (TMVs) in place. An assessment of risk had been undertaken for each person regarding hot water outlets in their rooms. Where a risk had been identified a TMV had been fitted. This meant people were kept safe from the risk of scalds from hot water outlets
Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. Care plans were person centred and where able people and their families had been involved in their development and ongoing reviews. Staff were very good at ensuring people where able were involved in making decisions and planning their own care on a day to day basis. People were referred promptly to health care services when required and received on-going healthcare support.
Medicines were safely managed and procedures were in place to ensure people received their medicines as prescribed.
People were supported by staff who had the required recruitment checks in place. Staff received an induction and were knowledgeable about the signs of abuse and how to report concerns. Staff had received training and developed skills and knowledge to meet people’s needs.
There were adequate staffing levels to meet people’s needs. The registered manager and deputy manager undertook a lot of shifts and stepped in to fill staffing gaps. They were working with the provider’s area manager to actively recruit where they had vacancies.
People received person centred care. Staff knew people well, understood their needs and cared for them as individuals. People were relaxed and comfortable with staff that supported them. Staff were discreet when supporting people with personal care, respected people’s choices and acted in accordance with the person’s wishes.
Staff relationships with people were caring and supportive. They delivered care that was kind and compassionate. People said staff treated them with dignity and respect at all times in a caring and compassionate way.
People’s views and suggestions were taken into account to improve the service. Health and social care professionals were regularly involved in people’s care to ensure they received the care and treatment which was right for them. They fed back to us that the service escalated concerns appropriately and in a timely manner.
Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. They had made appropriate applications for people they had assessed that required to be deprived of their liberty to the local authority DoLS team.
People were supported to follow their interests and take part in social activities. A program of activities was available for people to attend as they chose. The provider was looking at ways of improving activity provision further at the service.
People were supported to eat and drink enough and maintain a balanced diet. People and relatives were very positive about the food at the service. People were seen to be enjoying the food they received during the inspection.
The provider had a range of quality monitoring systems in place which were used to continually review and improve the service. There had been one complaints received at the service since our last inspection. This had been responded to in line with the provider’s policy. The registered manager undertook regular duties and dealt with niggles or concerns as they occurred.
The premises were well managed to keep people safe. The home was clean and homely with a welcoming atmosphere. Systems were used to ensure the environment was kept clean and safe with audits being completed on all aspects of the building and equipment. There were emergency plans in place to protect people in the event of a fire or emergency.
Further information is in the detailed findings below.