Southwold House

Updated 29 October 2019

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 This inspection was carried out by one inspector.

Service and service type: Southwold House 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: We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our inspection.

During the inspection: We spoke with one person who received a service and two people's relatives. We observed the care to understand the experiences of people who could not talk with us. We spoke with the registered manager and three staff working in the service.

We looked at a range of records. This included two people's care records, and records relating to two members of staff. We also looked at the provider's arrangements for managing medicines, supporting staff, managing complaints, and monitoring and assessing the quality of the services provided.

Updated 29 October 2019

Southwold House is a residential care home providing personal care for up to 12 people.

The service was bigger than most domestic style properties, and at the time of the inspection, ten people were using the service. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size, and the development of four separate flats. There were deliberately no identifying signs, intercom, cameras, industrial bins, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

People were encouraged to live as full a life as possible and achieve the best possible outcomes. Registering the right support principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

The recruitment and retention of staff had been challenging. However, at the time of inspection there were enough staff on shift to meet people’s needs. People living at the service had complex behaviours, and registered manager had systems in place to assess and monitor risk.

At the time of the inspection, people's medicines were being administered safely. Previously, the local authority had investigated a concern relating to medicine management, and the registered manager had made changes as a result. An air conditioning system needed to be installed to the medicine room to ensure the correct temperature to store medicines was maintained. The provider confirmed there were plans to carry this out.

Plans were in place to carry out remedial work to the environment. People’s health and emotional needs were assessed, and monitored so that they could live well. The service worked closely with relevant health care professionals and people received the support they needed to have a healthy diet that met their individual needs.

People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights.

The care and support people received was individualised. 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.

End of life care planning had not been offered to people, and staff had not been trained in end of life care. We have made a recommendation about end of life care. Complaints were dealt with effectively.

Systems were in place to drive improvement and audits were carried out on a regular basis, which looked at the quality of the service people received. The registered manager had a clear oversight of the service.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.