Southlands Nursing Home

Updated 5 March 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 undertaken by two inspectors and an 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 care service.

Service and service type

Southlands Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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. Before the inspection we reviewed information, we had received about the service. This included details about incidents the provider must notify us about, for example, injuries that occur in the service and any allegations of abuse. This information helps support our inspections.

During the inspection

Some people using the service were not able to verbally express their views about the service. Therefore, we spent time observing interactions between staff and people within the communal areas of the home. We spoke with seven people who used the service and six relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, care, nursing and ancillary staff.

We reviewed a range of records. This included seven people’s care records and multiple medication records; three staff files in relation to recruitment and additional staff supervision records; 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 provider to validate evidence found. We looked at training data and quality assurance records.

Updated 5 March 2020

About the service

Southlands Nursing Home is a residential care home providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 30 people.

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

Feedback from people who were supported at Southlands Nursing Home was positive. People spoken with told us they felt safe and well cared for. They did not express any concerns about living at the home.

Staff’s knowledge of the people they supported was good and they were able to tell us about the risks associated with their care and how to minimise these. However, detailed care plans and risk assessments were not always in place to guide staff, especially for new or agency staff members who may not know people well.

Although some comments from people and relatives suggested that their dignity was respected, other comments and some of our observations demonstrated that this could be improved upon. Care planning continued to require improvement as at times these did not contain sufficient guidance to support staff to understand a people’s wants, wishes and preferences.

There was a clear management structure in place and the providers senior management team had been supporting the registered manager. They were open and honest with us about the need to make improvements to the culture of the service and they had developed an action plan to support this. However, the overall rating for the service remained requires improvement and we found a breach of regulation showing appropriate and timely action had not been undertaken to make necessary improvements, following our last inspection.

Enough staff who had been recruited safely were available to meet people’s needs. Where staff were responsible for supporting people with their medicines, suitable arrangements were in place to do this safely and in accordance with best practice guidance. People were supported by staff who had been trained and understood their responsibility to safeguard people. People were protected from the risk of infection because staff used protective equipment. Incidents were used to identify improvements that could be made to people’s care and support.

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. Staff had received appropriate training and support to enable them to carry out their role safely. They received regular supervision to help develop their skills and support them in their role. People’s nutritional needs were met, and they were supported to access health care. Adaptations had been made to the home to meet the needs of people living there.

People knew how to raise concerns and told us how things had changed for the better when they had needed to do so.

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 requires improvement (published 31 January 2019).

The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to person centred care.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.