This inspection took place on 31 March 2017 and was unannounced. Southfields Residential Care provides accommodation and personal care for up to nine people with a learning disability or autistic spectrum disorder. There were nine people living at the home on the day of our inspection. The home is set over two floors with a large open plan lounge/dining area and secure back garden.

At the last inspection in October 2014, the service was rated Good. At this inspection we found the service remained Good.

People received individualised care which reflected their personal preferences, wishes and routines. People were supported to have maximum choice and control of their lives. Staff support them in the least restrictive way possible; the policies and systems in the service supported this practice.

People’s care records were kept up to date with their changing needs. By closely working with health care professionals the risks to people’s health and well-being were reduced. People were supported to eat and drink. They were encouraged to make choices about their care and support and to be as independent as possible. People were treated with dignity, respect and kindness.

People were supported by staff who had access to training and support to acquire and maintain the skills and knowledge they needed to meet their needs. Staff were supported to develop in their roles through individual and staff meetings.

People’s views were sought as part of the quality assurance process to drive through improvements to the service. A range of quality assurance systems monitored the standards of care provided. The registered manager valued the feedback from people, their relatives and staff and acted on their suggestions.

Further information is in the detailed findings below.

We carried out an unannounced comprehensive inspection of this service on 16 and 17 October 2014. A breach of the legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to Regulation 12, Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. 

We undertook this  focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements.  You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Southfields Residential Care on our website at www.cqc.org.uk.

We undertook an unannounced focused inspection on 5 January 2015. We found the wet rooms and connecting corridor had been completely refurbished and people’s shower equipment had been replaced. The wet rooms and equipment could now be effectively cleaned which protected people from the risk of infection. The service now met the legal requirements relating to cleanliness and infection control.

We were not able to speak to anyone who used the service because of their complex communication needs. We spoke to staff about people's needs and considered feedback comments that we saw within surveys carried out in 2013. We also looked at other documents held by the provider. The staff knew each person very well and knew how each person communicated. This information was reflected in the people’s care plans. As an example, one person used signs to express their wishes and staff were familiar with what each sign meant. We looked at the care files for four of the people who used the service. Three people had up to date care plans and risk assessments that reflected their individual needs.

We looked at how the provider supported people to manage their finances. The provider had introduced a new system since our last inspection. This made it clearer to identify what people had spent so that all their money was accounted for.

We looked at the satisfaction survey results for the summer of 2013. The surveys we saw had been completed by people who used the service, their relatives and other health professionals that visited the home. We noted that all of the feedback we saw was very positive about the home.

We carried out a planned inspection on the 18 October 2012 and found non-compliance in one outcome. We asked the provider to develop an action plan to resolve the concerns. The provider had then confirmed they were compliant with the outcome and we carried out a follow-up inspection to check compliance.

During our visit in October 2012 we identified a number of concerns about the way staff recorded financial transactions. We had concerns regarding receipts were not always present and money not accounted for. Where receipts were in place they did not always match what the staff had documented.

The provider had implemented a new procedure and we found this to be working. We reviewed the action plan submitted by the provider. During our visit we looked at the financial records for all the people using the service. We also saw minutes of a staff meeting that had been held to specifically discuss finances and the new procedures. We found that each person's money was checked by two staff three times a day. These checks had been consistently carried out and documented. Money had been accounted for with appropriate receipts and these had been documented accurately by staff.

During our visit we observed staff offering people who used the service choice about what to have for breakfast. People were also involved in the activities they wanted to do and trips they wanted to take. One person wanted a day trip to a nearby city for their birthday and the staff supported the person to achieve this.

We looked at three peoples care files which had evidence that they had been involved in devising their care plans. Each person had an 'about me' section which was person centred and specific to their individual needs. We also looked at the way the provider managed people's money. Further details about this can be found in outcome 7. We observed staff interacting with people and found this to be friendly, reassuring and respectful. One member of staff was seen to be supporting a person with their eating. The member of staff explained what they were doing and supported the person to eat at their own pace.

This inspection took place on 16 and 17 October 2014 and was unannounced.  Southfields Residential Care provides accommodation and personal care for up to nine people with a learning disability or autistic spectrum disorder. Nine people were living in the home at the time of our inspection.

A registered manager was in place as required by their conditions of registration. 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 and associated Regulations about how the service is run. The registered manager was not available during our inspection so we spoke with the deputy manager who was in charge of the service and assisted us with the inspection.

People were at risk of infection as the wet rooms had not been adequately maintained and could not be effectively cleaned to reduce the risk of infection.

Staff and the registered manager understood their role and responsibilities to protect people from harm and abuse. People’s personal support needs and risks had been assessed and discussed with them. Staff were given guidance on how to best support people when they were upset or at risk of harm. People’s medicines were ordered, stored and administered in a safe way.

People’s health, emotional and social needs were assessed and reviewed. Their care was focused around their needs and wishes. People told us they enjoyed the food and meals served to them. They were supported to eat and drink sufficient amounts and maintain a balanced diet. Their dietary needs and preferences were considered when planning the weekly menu. Alternative food was available if people did not like the meal options.

People were supported by staff who were suitably trained and recruited to carry out their role. There were sufficient numbers of skilled staff to meet the needs of the people they supported. Staff were supported and could raise any concerns with the team and registered manager.

There  were a wide range of individual and group activities in the home and throughout the community offered to people. People were provided with information about the activity to help them decide if they wanted to participate.

People and their relatives spoke highly of the staff and the registered manager. People told us that staff were caring and gave them the support they needed. People were given information about their and daily activities so they could make an informed decision. Relatives told us that any day to day concerns which they had raised were always dealt with immediately. Complaints were managed effectively and actions were put in place to prevent the concern reoccurring.

Monitoring systems were in place to ensure the quality of the service. Internal and external audits were carried out to continually monitor the service provided. The registered manager was knowledgeable in supporting people to ensure they were protected and safeguarded from harm.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.