Southlands Place

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Staff told us that the registered manager and their colleagues helped them learn and improve practice when things went wrong. They spoke of a learning culture where staff could raise and discuss issues and concerns during supervision and staff meetings, enabling staff to reflect and share ideas of how to improve things further. The registered manager showed us how they analysed incidents, accidents and complaints to identify any common themes and patterns and how these were used to create action plans to evidence lessons learnt. Action was then taken this included reviewing people’s care needs and staff knowledge and training. Processes for investigating, analysing, and responding to accidents, incidents, complaints, and safeguarding alerts were in place, with systems for families, people and staff to raise concerns or share their views. There was a service improvement plan in place which detailed plans for ongoing improvements.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. People told us “I wasn’t able to visit before coming to live here but my family did, they made a good choice, it’s very nice here, I have all my appointments made, I get my hair and feet done, nothing is forgotten and I feel lucky,” “I made the decision to move in, it was warm and welcoming when I visited, they have a lovely reception area, so I made the decision and I don’t have any regrets,” and “I came here from hospital, but I was given choices, but I wanted to stay in Bexhill, they arranged with the hospital, everything was very organised, I felt it was done well, I didn’t have to worry, because it was all done.” Families told us "They ensure everything was in place before my relative arrived, they had equipment for lifting and for keeping them safe, they also assessed them, and did a health check.” The service provided long term, short term and respite stays. These were coordinated so that there was continuity of care for people from hospital or their home. The management team advised that all people were assessed before admission to ensure their needs could be safely met. The manager communicated with other services, assessed, and reviewed people’s needs and ensured smooth transitions between healthcare services. Each person had a hospital passport which was reviewed and updated regularly. The hospital passport was printed off and accompanied the person which ensured a smooth transition to hospital should the need arise. People’s care plans included reminders for staff of what to do if a person’s physical or mental health needs changed and who should be involved in the ongoing care. Staff and leaders demonstrated good knowledge of referring to external professionals when needed.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. There were systems in place for recording safeguarding concerns. Training records showed staff had completed safeguarding training. Staff were aware of the signs of abuse and how to report safeguarding concerns. Staff were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Staff received training in the principles of the MCA and understood their role and responsibility in upholding those principles. The manager kept an overview of all DoLS, applications and those hat are completed, pending and those that were refused. People were asked for their consent and were involved in day-to-day choices and decisions. We discussed the importance of all DoLS approvals being submitted to the CQC as there had been a delay in sending them. This was actioned immediately.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff were able to tell us about people and the risks associated with their care. They told us how they supported them safely. This included pressure area management, safe mobility and what to do when people become distressed. Staff told us, “We know people from supporting them and we can refer to care plans for guidance.” We discussed with staff, certain people who had either bruising or dressings on and they were able to discuss their treatment plans and any potential risks. Staff told us that additional checks were in place for people at risk of falls. These included sensor mats, location checks, appropriate footwear checks, and if necessary 1-1 support. We spent time with people and staff both in communal areas and in peoples' bedrooms. People who were at risk from pressure damage had air flow mattresses and these were set correctly as per manufacturers guidance against peoples’ weight. Staff recorded these checks on the persons’ care documentation. People who were at risk from falls, had sensor mats that alerted staff the person was up and at risk. These people also had low level beds. Call bells were in peoples' rooms, and there were risk assessments in place for those who couldn't use a call bell and we saw that staff checked them regularly. Systems and procedures were in place for unusual events, such as fire, loss of power, and other emergencies. Staff received training in areas of potential risk such as moving and handling, first aid and health and safety. Personal Emergency Evacuation Plans (PEEPS) had been completed for each person. PEEPS give staff or the emergency services detailed instructions about the level of support a person would require in an emergency such as a fire evacuation.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Not everyone was able to talk to us, but those that could, told us, “I’m very lucky, I have a lovely room, and it’s got everything I need.” Staff received training, in health and safety, fire, first aid and moving and handling, and fire evacuations. They told us that as soon as they report a problem, it was fixed. The environment was safe and well cared for. There was a dedicated maintenance team who took responsibility for the day-to-day maintenance of the building and checking of equipment. This included arranging fire drills. Care equipment was in good working order and documentation to support regular servicing was seen. The premises and gardens were accessible for people with mobility needs and safe for those who walked with purpose. Processes ensured the environment was safe and well kept. Health and safety checks had been undertaken to ensure safe management of utilities, food hygiene, hazardous substances, moving and handling equipment, staff safety and welfare. There was a business continuity plan which instructed staff on what to do in the event of the service not being able to function normally, such as a loss of power or evacuation of the property. There were detailed fire risk assessments, which covered all areas in the home. Premises risk assessments and health and safety assessments were reviewed on an annual basis, which included gas, electrical safety, legionella and fire equipment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. Comments from people and relatives included, ”We are always welcomed, staff seem busy, but I’ve not had cause to grumble,” and “I think more staff would benefit everybody as staff sometimes seem rushed.” Staff told us, “To be honest, staffing can be tight, sometimes we need more staff if people are poorly or more confused, but we manage," and "We do discuss staffing levels, because it can be busy, we all think it would be good to have more, to answer call bells when we are assisting people or be with poorly people. Our observations showed that people mostly received timely care, call bells were answered promptly. However, for those who were unwell or approaching end of life, staff were not able to just sit and be with them to offer comfort holistically. This was fully discussed and the management team acknowledged that present staffing levels did not incorporate flexibility to meet the differing needs of people living in the home, especially for those that were approaching the end of their life. The area manager confirmed this would be reviewed immediately. We looked at staff rotas and the staffing levels were consistent supported by relief staff to cover sickness and holidays. Staff were recruited safely. The provider undertook checks on new staff before they started work. This included checking their identity, their eligibility to work in the UK, obtaining at least two references from previous employers and Disclosure and Barring Service (DBS) checks. The DBS helps employers make safer recruitment decisions and prevent unsuitable people from working with vulnerable people. Registered nurses have a unique registration code called a PIN. This tells the provider that they are fit to practice as nurses. Before employment, checks were made to ensure the PIN was current with no restrictions.

People and their relatives did not share any concerns about the cleanliness of the environment. One person said, “It’s always lovey and clean, they are spot on,” “Marvelous, never smells and is sparkling clean,” and “They pay special attention to our bedrooms, they clean and even polish my pictures.” A relative said, “I visit all the time, always clean and tidy, we spend time in the communal areas and its always smells nice and looks clean.” Staff told us that the provider followed best practice guidelines regarding the prevention and control of infection which was updated as guidance changed and confirmed that they had completed infection control and food hygiene training. We saw that cleaning schedules had been completed and regular audits were carried out.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. People and relatives said, “Staff keep us informed of any changes, let us know what the doctor says. I trust them totally and get informed of changes. I have no concerns,” and “I get my medicines on time and never missed.” Staff told us they had completed training before administering medicines and then had to pass a regular competency assessment. One senior care staff said, “We all receive really good training and support from the registered nurse, when we need it.” Staff who gave medicines had the relevant knowledge, training and competency that ensured medicines were handled safely. We observed staff giving medicines safely and were recorded accurately. Risk assessments were in place for certain medicines. All discrepancies and medicine errors were recorded and investigated and action taken as required. Daily and monthly audits were carried out, and any shortfalls were addressed. Protocols for 'as required' (PRN) medicines such as pain relief medicines were in place. We have asked the provider to look at the PRN charts as to what the outcome of the medication administration was, for example had it reduced agitation. All queries regarding medicine documentation during the assessment were taken forward immediately and have been reflected under the well-led question.