Archived: OSJCT Southfield

OSJCT Southfield is a residential care home. It can provide personal care to a total of 36 people aged 65 and over. At the time of the inspection 28 people were receiving support. People are accommodated in one adapted building.

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

People were at risk of not receiving their medicines as prescribed as good medicine practices in relation to recording were not always followed. Some action was taken during the inspection to address these shortfalls.

Risks relating to all other areas of health and environmental safety had been identified and reduced. People were protected from potential abuse and discrimination.

The home was experiencing staffing pressures due to several staffing vacancies. Although a staff recruitment drive was underway, how the staffing needs of the home were being managed in the meantime was impacting on people and staff. Opportunities for social interaction and activities for people had been limited and staff morale was low. Some action was taken during the inspection to cover necessary staff shifts.

Although the provider had quality monitoring systems in place, these had not always led to action being taken to address shortfalls identified during this inspection. We have made a recommendation about the provider’s on-going quality monitoring and support arrangements.

People’s care was delivered by staff who received relevant training and guidance. People had access to healthcare support and staff worked together with other agencies to facilitate timely and effective support for people.

People received help to maintain their nutritional wellbeing.

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 were caring and committed to the wellbeing of those they looked after. Staff knew people well and were aware of people’s preferences and wishes in relation to their protected characteristics. Policies and procedures ensured the principles of the Equality Act 2010 were met.

The Accessible Information Standards were met; people received information and were communicated with in a way which met their needs.

People were involved in planning and reviewing their care according to their preferences and individual diverse needs. Relatives and representatives were able to speak on behalf of people where appropriate. Information about people’s care was kept up to date to reduce the risk of people receiving unsafe or inappropriate care.

People’s end of life wishes were explored with them and a dignified and comfortable death was supported.

People had opportunities to take part in social activities, although, these at times had been curtailed when the needs of the home had taken priority.

People and their relatives had opportunities to feedback their views.

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 (report published 15 November 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

We have found evidence that the provider needed to make improvements to the quality of the service. Please see the ‘Is the service safe?’ and ‘Is the service well-led?’ key questions of the full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for OSJCT Southfield on our website at www.cqc.org.uk.

Follow up:

We will ask the provider for an action plan telling us how they intend to improve the key questions ‘Is the service safe?’ and ‘Is the service well-led?’ to at least ‘Good’.

Southfield provides residential and respite care for up to 34 older people. At the time of our inspection 31 people were living there. There was a manager who had applied to CQC to become 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. There were no breaches of legal requirements at the last inspection in June 2013.

People had their medicines on time and generally they were safely managed. Care needed to be taken when staff administered topical creams. Not all staff training was up to date but the manager knew about this and training was planned. People told us they felt safe in the home. Staff knew how to keep people safe and were trained to report any concerns. People were supported by staff that were trained and had access to training to develop their knowledge.

People were provided with personalised care and were supported to make their own choices and decisions where possible. Staff knew what they valued and how they liked to be supported. Peoples care was regularly reviewed. Healthcare professionals supported people and there was good care and support for people nearing the end of their life.

People were treated with kindness and compassion and they told us staff were very good when they supported them with their care. Relatives were welcomed in the home and they supported the home to provide activities. They told us the staff were kind and understanding.

People told us the food was good and there was a choice of meals. When people required assistance with their food staff supported them and gave them time to enjoy their meal. People had activities to choose from which included quiz games, exercise classes, arts and crafts, musical afternoons and ball games. There were links with the local community and trips out were organised.

The area operations manager and the manager monitored the quality of the service with regular checks and when necessary action was taken. People and their relative’s views were taken seriously. They contributed in meetings and regular reviews of the service and improvements were made. Staff felt well supported by the manager and head of care who were available to speak to people, their relatives and staff. Staff meetings were held and staff were able to contribute to the running of the home.

When we returned to the home we found that significant improvements had been made. Staff had received training in the MCA. For those people who lacked capacity there was evidence that decisions had been taken on their behalf in their best interests. Care records were accurate and up to date and demonstrated that people received the care and support they needed.

We looked to see whether people were supported to have adequate nutrition and hydration and to see whether the provider had effective recruitment and selection processes in place. People told us they had enough to eat and drink and they enjoyed a variety of nutritious food. People were appropriately supported to eat and drink. There were effective recruitment processes in place to ensure that people received care from suitable staff.

We looked at processes in place to ensure that people were able to give informed consent to their care, and where they lacked capacity, that staff complied with legal requirements. We found that many staff had not received relevant training and documentation was incomplete.

We observed that the home was clean and tidy and we saw staff taking appropriate steps to minimise the risk and spread of infection.

The home was fully staffed, although some of the staff we spoke to felt that at times staffing levels were not adequate to meet people's needs.

The home had an effective complaints system which was well publicised. There was evidence that they took complaints seriously and investigated and responded appropriately to concerns.

We found that the standard of record keeping was generally poor. There was insufficient documentary evidence that people's care needs were kept under review and consistently met. The provider was aware of shortcomings in this area and was taking action to address this.