Fornham House Residential Home

Updated 5 December 2018

‘We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.’

This comprehensive inspection was carried out on 6 and 7 November 2018. The first day of the inspection was unannounced; the inspection team consisted of two inspectors, and an expert by experience. An expert by experience is a person who has experience of using, or caring for someone using, this type of service. The second day of the inspection was announced and completed by one inspector.

We reviewed all information the Care Quality Commission (CQC) held about the service before the inspection. This included all contacts about the home, previous inspection reports and notifications sent to us. A notification is information about important events which the service is required to tell us about by law.

We reviewed the Provider Information Return. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

During the inspection we spoke with eight people living the service. We spoke with four relatives. We also spoke with the regional director, registered manager, the deputy manager, head of care, chef, four members of staff and one health care professional.

We also reviewed five care plans, three recruitment files, the complaints and compliments log, 15 medicine records and quality assurance documents completed by the service.

Updated 5 December 2018

This was a comprehensive inspection carried out on 6 and 7 November 2018. The inspection was unannounced on the first day and announced on the second.

Fornham House is a 'care home'. People in care homes receive accommodation and personal care as a single package under one contractual agreement. We regulate both the premises and the care provided, and both were looked at during this inspection. The service is registered to accommodate up to 73 people who require personal care. At the time of the inspection 60 people were living at the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At our last inspection on 12 October 2016, we rated the service good overall and good in the questions of Effective, Caring, Responsive and Well-Led. We rated the service required improvement in the key question of Safe.

At this inspection we found the evidence continued to support the overall rating of good and the service had improved to good regarding the question of Safe. The other key questions continued to be good.

At our last inspection we were concerned regarding how the service staff cared for people needing support with pressure area care, The management of medicines when people were away from the service on trips and the time it took to answer call bells.

At this inspection we found action had been taken to improve the safety of the service on all three of the above issues. We saw risk assessments which identified how to support people with their skin integrity. Medicines were carefully managed including recording medicines that were booked into and out of the service. The registered manager monitored call bell response times and investigated if any call were not answered within a set time frame. We found there were justifiable reasons for the few calls that were not answered within the set parameters.

There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the home. 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 home is run.

Staff continued to understand safeguarding procedures and said they would not hesitate to report any concerns. Risks assessments about people’s well-being were carried out and updated regularly.

There was a robust recruitment procedure in place and staff were employed in sufficient numbers to meet people’s needs. The staff team had received training to care for people at the service and were further supported through supervision and appraisals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People continued to enjoy a choice of food and were supported to maintain a healthy diet and fluid intake. People had access to health professionals as needed to promote their health and well-being. Health professionals expressed their confidence in the staff team’s ability to recognise people’s

People were treated in a kind and caring way by the staff team. Their privacy and dignity was respected. Staff interacted with people in a caring, respectful and professional manner. Staff had developed good relationships with people and were attentive to their needs. Health care professionals expressed their confidence in the staff team’s ability to care for people.

People’s care plans identify what support they required and how they would like this to be provided. People had opportunities to take part in activities which they enjoyed and which met their abilities and interests. The service had a complaints system and people were confident that any concerns raised would be dealt with. The service had worked with other organisations to develop skills to care for people in the last stages of their lives.

The service was well led and provided strong leadership which promoted a positive, caring culture which was focused on the needs of people who used the service.

There were effective quality assurance arrangements in place to monitor people’s care and plan ongoing improvements. People's views about the management of the service were sought regularly and changes and improvements took account of people’s suggestions.

Further information is in the detailed findings below.