Southfields House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Southfields House is located in Northampton and is registered to provide accommodation and personal care to older people. It provides care for older people and people with a physical disability and accommodates 45 people across six separate units, each of which have separate adapted facilities.

The provider had recently started to provide reablement support to people for up to six weeks following discharge from hospital. When we visited there were 23 people living at the home permanently and nine people temporarily living at the home receiving reablement support.

The reablement support was being provided in two areas, separately to people that lived at the home permanently to minimise any disruption. However, the provider told us that they were planning to increase the number of reablement beds available and extend this to a third unit. The provider was in the process of consulting with people and their relatives regarding this change.

This is Southfield House’s first comprehensive inspection under the current provider. The inspection took place on the 12 November 2018 and was unannounced.

The provider notified us that the registered manager was absent from work. 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. The provider had appointed an acting manager as an interim arrangement.

People were at risk of not receiving a nutritionally balanced meal or adequate nutrition as a menu was not being followed and there were inconsistencies in the kitchen staff. This impacted on the quality and the variety of food available to people.

We found the poor cleanliness of the kitchen and unsafe food storage had not been adequately addressed by the management team, despite this being identified in meeting minutes and audits two months prior to the inspection.

Risk assessments were in place but did not always include enough information to assist staff in identifying a deterioration in people’s health condition.

Some people at the home were prescribed medicines on a when required basis. We found there was no guidance in place to advise staff when and how to give these medicines.

People were at risk of accidents or incidents re-occurring as reports were not immediately reviewed to identify learning. This meant changes were not promptly made to reduce the risk of the incident occurring again.

The quality assurance systems in place identified areas that needed improving. The acting manager had developed an improvement plan to enable the service to prioritise areas for action. Whilst we found the acting manager had implemented improvements that impacted positively on people, further improvements were required and we could not be assured these would be sustained or were embedded in practice.

People were treated with warmth and kindness by the staff and management team, and supported by staff that had taken time to get to know them and enjoyed spending time with them. People's privacy and dignity was protected and promoted always.

People were assisted to maintain relationships with their families, visitors were welcome at any time and were made to feel at home.

People told us they felt safe and staff understood their roles and responsibilities to safeguard people from the risk of harm. There were sufficient staff available to meet people's needs and staff had been safely recruited.

People using the service and their relatives knew how to raise a concern or make a