• Care Home
  • Care home

Archived: Friary Fields Care Home

Overall: Requires improvement read more about inspection ratings

21 Friary Road, Newark, Nottinghamshire, NG24 1LE (01636) 706105

Provided and run by:
Friary Fields Limited

All Inspections

17 July 2019

During a routine inspection

About the service

Friary Fields is a residential care home providing personal care and support to 22 people aged 50 and over at the time of the inspection. The service can support up to 34 people.

The service accommodates people in one adapted building with people’s bedrooms on two floors. It has shared lounges and dining areas and a conservatory providing access to a garden area with raised flower beds and seating areas. There is an access ramp for people who use a wheelchair.

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

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The environment was poorly maintained, unclean and not furnished to a good standard.

People were not safe. Risks were not assessed and appropriately managed. We found no evidence that people had been harmed however, systems were either not in place or robust enough to demonstrate safety was effectively managed

When significant incidents had occurred, action was not always taken to keep people safe. The registered manager had failed to notify the CQC of significant events.

People did not receive an appropriate food and drinks to meet their specific dietary requirements.

People and relatives said they liked the staff. Staff were kind and caring. People's privacy and dignity was not always maintained.

Records showed that when people became unwell or needed additional support they had access to a range of health and social care professionals in respect of their well-being.

Staff recruitment was safe. Appropriate checks were undertaken to ensure staff employed were suitable to work with vulnerable people. Staff had access to mandatory training to do their job role and received regular supervision from their line manager.

Rating at last inspection

The last rating for this service was Good (published 3 January 2018).

Why we inspected

The inspection was prompted in part by notification of a specific incident. Following which a person using the service was hospitalised. This incident is subject to an ongoing adult’s safeguarding investigation. As a result, this inspection did not examine the circumstances of the incident.

The information CQC received about the incident indicated concerns about the management of people’s safety within the service. We were informed that the service failed to seek prompt medical attention for a person living in the service and the service lacked robust infection control processes. This inspection examined those risks.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to premises and equipment (cleanliness and physical environment), safe care and treatment, the need for consent, lack of person – centred care, and good governance at this inspection.

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

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and 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.

12 September 2019

During an inspection looking at part of the service

About the service

Friary Fields Care Home is a care home that provides personal care and nursing for up to 34 people in one adapted building. At the time of the inspection 21 people lived at the home.

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

People were not safe at Friary Fields. The environment was not safe. People were placed at risk of serious harm due to elevated fire risk and inadequate fire risk management. There was an increased risk of legionella developing in water supply and people were exposed to the risk of sustaining burns due to a failure to manage risks associated with hot water and exposed hot surfaces.

Risks associated with people’s care and support were not managed safely. Measures were not in place to reduce risks associated with falls, health conditions, moving and handling and pressure ulcers. Equipment was not always used safely or effectively. For example, some people were unable to call for help as call bells were not within their reach. These issues placed people at risk of harm.

People were provided with care which was degrading and disregarded their need for care and support. Staff were not deployed effectively to meet people’s needs and ensure their safety. Furthermore, staff worked long shifts, back to back which could have led to exhaustion and compromised people’s safety. Medicines were not managed safely, and some people did not receive their medicines as prescribed. The home was not clean and good food hygiene practices were not followed. This could have had a negative impact upon people’s health.

The home was not well led. The provider did not have the skills, competency or resources to run Friary Fields Care Home. People’s health and safety was at risk due a failure to identify and address issues and poor practices. Although we found that the service worked with partner agencies, feedback from professionals was poor. Information had not always been shared in an open and honest way with people, their families or staff.

Following our inspection the local authority made arrangements for people to be moved to new homes.

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 11 September 2019) and there were multiple breaches of regulation. Following this inspection we served two warning notices on the provider in relation to safe care and treatment and governance.

Why we inspected

The inspection was prompted due to concerns received about safety, quality and leadership. A decision was made for us to inspect and examine those risks.

Enforcement

We have identified three breaches of the legal regulations. These were in relation to safeguarding, safe care and treatment and governance. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will continue to monitor information we receive about the service. 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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

8 December 2017

During a routine inspection

We carried out an unannounced inspection of the service on 8 and 11 December 2017. Friary Fields is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Friary Fields Care Home provides accommodation for up to 34 older people and people living with

dementia. At the time of the inspection 15 people were living at the service.

A registered manager was present during the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

During the home’s previous inspection in July 2016 we identified improvements were required in relation to the management of medicines, safety to the external environment and communication between the staff team. At this inspection we found action had been taken to make these improvements and no further concerns were identified.

People were now protected against the risk of their prescribed medicines not being effectively managed. New audits and checks had been implemented; protocols were in place for people who were prescribed medicines to be taken as and when required. The medicines policy and procedure had been updated. The external environment was found to be safe; any garden equipment was stored and secured appropriately. Communication between staff had improved and staff were found to work together effectively.

People were protected from avoidable risks. Staff were aware of their role and responsibilities to protect people from of any type of abuse. Risks associated to people’s needs, including the environment had been assessed, planned for and were regularly monitored and reviewed.

People were supported by an appropriate number of staff that were deployed effectively. The service was found to be clean and hygienic; the provider was working towards an action plan with the local Clinical Commissioning Group to ensure the prevention and control of infection measures were in place. Incidents and accidents were recorded, monitored and action was taken to reduce further risks.

People were supported by staff who had completed an appropriate induction, ongoing training and opportunities to review and discuss their work and development needs. People received a choice of meals and their dietary, nutritional needs and preferences were known and understood by staff. People’s health needs had been assessed and planned for and the staff worked well with external healthcare professionals to effectively support people’s health needs and outcomes.

The principles of the Mental Capacity Act (2005) were followed when decisions were made about people’s care. Deprivation of Liberty Safeguards were in place for some people where required.

People were supported by staff who demonstrated a good understanding of their needs and were found to be caring and kind, showing empathy and compassionate in their approach. Staff were aware of the importance of respecting people’s privacy and dignity and they maintained high standards of this. People’s diverse needs were known and understood by staff and they were encouraged as fully as possible, to be involved in discussions and decisions about their care and support.

People were provided with information about how they could access independent advocates. The environment met people’s physical needs and those living with dementia. There were no restrictions of when people’s friends or relatives could visit them.

Staff supported and encouraged people to participate in daily activities. Staff had information to support them to provide a person centred approach in the delivery of care and support. Care records were found to be up to date and responsive to people’s needs.

People were treated equally, without discrimination and systems were in place to support people who had communication needs. People had access to the provider’s complaint procedure that was provided in an appropriate format to support people’s communication needs. Plans were in place to support people who were approaching the end of their life.

The home was well led by a dedicated and caring registered manager. Staff were aware of the provider’s aims and values and were observed to adhere to these at all times. The registered manager was supported by the provider and plans were in place to continually improve the service. Staff enjoyed working at the service. The registered manager continually looked to improve the service provided and expanded their knowledge by attending locally run forums with registered managers of other services. Quality assurance processes were in place and these were effective.

18 July 2016

During a routine inspection

This inspection took place on 18 July 2016 and was unannounced.

Friary Fields Care Home provides accommodation for up to 34 older people and people living with dementia. 20 people were living at the service at the time of the inspection.

Friary Fields Care Home is required to have 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. A registered manager was in place.

Improvements in the systems and processes to check the management of medicines were required. Protocols to advise staff about the administration of prescribed medicines to be taken as and when required were not available. Information about people’s preferences of how they took their medicines was not available for every person.

Staff were aware of their responsibilities to protect people from abuse and avoidable harm. Staff had received adult safeguarding training and had available the provider’s safeguarding policy and procedure.

Risks to people's individual needs and the environment had been assessed. Staff had information available about how to meet people’s needs, including action required to reduce and manage known risks. These were reviewed on regular basis. Accidents and incidents were recorded and appropriate action had been taken to reduce further risks. The internal environment was safe but action was required to ensure the external building was kept safe at all times.

Safe recruitment practices meant as far as possible only suitable staff were employed. Staff received an induction, training and appropriate support. There were sufficient experienced, skilled and trained staff available to meet people's individual needs.

People's healthcare needs had been assessed and were regularly monitored. The provider worked with healthcare professionals to ensure they provided an effective and responsive service. However, for one person staff had not followed recommendations from a healthcare professional and this had impacted on the person’s health.

People received sufficient to eat and drink and their nutritional needs had been assessed and planned for. People received a choice of meals and independence was promoted.

The registered manager applied the principles of the Mental Capacity Act 2005 (MCA) and Deprivations of Liberty Safeguards (DoLS), so that people's rights were protected. Where people lacked mental capacity to consent to specific decisions about their care and support, appropriate assessments and best interest decisions had been made in line with this legislation. However, these lacked specific details in places and had not been reviewed. Where there were concerns about restrictions on people’s freedom and liberty, the registered manager had appropriately applied to the supervisory body for further assessment.

Staff were kind, caring and respectful towards the people they supported. They had a person centred approach and a clear understanding of people's individual needs, routines and what was important to them.

The provider enabled people who used the service and their relatives or representatives to share their experience about the service provided.

People were involved as fully as possible in their care and support. There was a complaints policy and procedure available and people were confident to report any concerns or complaints to the registered manager. People had some information about external services that could provide support. The registered manager had information leaflets about independent advocacy services that they were going to make available for people.

People were supported to participate in activities, interests and hobbies of their choice. Staff promoted people’s independence.

The provider had checks in place that monitored the quality and safety of the service. These included daily, weekly and monthly audits.

2 December 2013

During an inspection looking at part of the service

This inspection was carried out to follow up on our previous inspection in July 2013, where we found the provider was not compliant with two outcomes.

Prior to our visit we reviewed all the information we had received from the provider, including an action plan detailing how they would comply with the compliance action we set at the previous inspection. During the visit we spoke with a relative and asked them for their views. We also spoke with the registered manager, a senior care worker, two care workers and a housekeeper.

We looked at the prevention and control of infections policy and procedures and other records within the service, including three people's care files. We also did a tour of the communal bathrooms and toilets.

A relative spoke highly of the care and support their relative had received whilst residing at the home.They told us the manager had responded very quickly to the request for a short term placement. Comments included, "I've been so impressed with the home, in my opinion the manager is really on the ball, they came to the hospital to do an assessment but not just about medical needs, they took the time and trouble to get to know my father as a person." And, "All the staff have been smashing in supporting my father, they are kind and caring. The care has been excellent."

We found the provider had made the required improvements to become compliant with these outcomes.

31 July 2013

During a routine inspection

Prior to our inspection we reviewed all the information we had received from the provider. During the inspection we used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We spoke with two relatives for their views and spoke with four members of staff this included care staff and the cook. The registered manager was not available on the day of our inspection but we spoke with the provider (owner).

We also looked at service information, care plan files for four people and did a tour of the building.

The relatives we spoke with told us they felt communication was good with the registered manager and staff. They said they were consulted and involved in decisions about their relative's needs. Comments included, 'The manager is very approachable, and they listen to what you have to say, I feel involved in my husband's care.'

We observed people being served their lunch and drinks throughout the day. We saw people were offered choices and the menu provided nutritional and well balanced meals.

We saw improvements had been made to the cleanliness of the home but we found further work was still required.

We observed staff who interacted with people constantly during the day. Staff appeared very knowledgeable, competent and experienced in supporting people with a dementia type illness.

We found some of the records used were not up to date or reflective of people's needs.

25 February 2013

During a routine inspection

Prior to our visit we reviewed all the information we had received from the provider. We used observation to help us understand the experiences of people using the service, because due to the communication needs of some people who used the service, they were not able to tell us their experiences.

We spoke with two people who used the service, three relatives and a visiting professional. We also spoke with the registered manager, four members of staff and looked at service information, records and carried out a tour of the building.

People told us they were treated with dignity and respect and their care needs were well met. One person told us, 'I like living here; they (staff) are very good at their job.' Another person said, 'I feel the staff involve me and listen to me.'

Relatives we spoke with told us they felt they were involved in their relatives care and treatment. Comments included, 'Communication is very good, they (staff) are straight on the phone if they need to tell me something. I have the upmost respect for the staff.'

Relatives and a visiting professional we spoke with described the home as homely, warm and welcoming. They said staff were competent, experienced and knowledgeable. One person told us, 'The staff are very friendly; they make me feel my mum is special. I know she (mum) is safe and well cared for.' Other comments included, 'Whenever I visit there are always activities happening, staff interact really well with the residents.'

6 March 2012

During a routine inspection

Some people living at Friary Fields Care Home had limited verbal communication and were not able to tell us about their experience of the service. Other people living at Friary Fields Care Home did not want to talk to us about their experience of the service. We therefore observed care, inspected care plans and the premises to evaluate the quality of support provided to people living at Friary Fields Care Home.