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Archived: Fieldgate Nursing Home

Overall: Inadequate read more about inspection ratings

153 Portsmouth Road, Horndean, Waterlooville, Hampshire, PO8 9LG (023) 9259 3352

Provided and run by:
Extraservice Limited

Latest inspection summary

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Background to this inspection

Updated 16 September 2020

The inspection

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

Five inspectors and an Expert by Experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fieldgate Nursing Home 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.

The service did not have a manager registered with the Care Quality Commission. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The provider had sought the support from a consultancy company in the absence of a registered manager. Two members of this company were acting as interim managers at the time of our inspection.

Notice of inspection

We gave a short period notice of the inspection because of the Covid-19 pandemic. Inspection activity started on 7 July 2020 and ended on 14 July 2020. We visited Fieldgate Nursing Home on 9 July 2020.

What we did before inspection

Before the inspection we reviewed information we had received about the service, including previous inspection reports, action plans and notifications. Notifications are information about specific important events the service is legally required to send to us. We received feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We spoke with four people who used the service and 11 relatives about their experience of the care provided. We spoke with 19 members of staff including the provider, an interim manager, nurses, care workers and the maintenance person.

We observed the care being provided and reviewed a range of records. This included six people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Overall inspection

Inadequate

Updated 16 September 2020

About the service

Fieldgate Nursing Home is a residential home providing personal and nursing care for up to 39 people aged 65 and over. At the time of the inspection the service was supporting 20 people.

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

People did not always receive a service that ensured their safety.

Risks to people's health and wellbeing had not been effectively assessed, monitored or mitigated. Risks associated with the environment had not always been safely managed.

The provider had not established an effective system to ensure people were protected from the risk of abuse. Lessons had not been learnt when things went wrong.

Medicines were not always managed safely. Staff were not deployed effectively to ensure people received support in a timely way that met their needs and preferences.

The service was not well led.

There had been a lack of effective oversight of the service by the provider, caused by inconsistent management and inadequate governance processes.

The service was highly disorganised and records were not always complete. People were not always given the opportunity to feedback about their care. The lack of robust quality assurance meant people were at risk of receiving poor quality care.

When things had gone wrong, the provider had not acted in line with the requirements of the duty of candour.

The provider was aware of the need to make significant improvements in the service and had engaged the support of other partner organisations to enable this to happen. Following the inspection, we were provided with evidence that demonstrated improvements were taking place.

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

Rating at last inspection (and update)

The last rating for this service was requires improvement (published 18 December 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection the service had deteriorated, and the provider was in breach of multiple regulations.

Why we inspected

We received concerns in relation to the management of people’s nursing care needs, how people were protected from the risk of harm and abuse and a lack of leadership at Fieldgate Nursing Home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

We have found evidence that the provider needs to make improvements. The overall rating for the service has changed from requires improvement to inadequate. This is based on the findings at this inspection. Please see the safe 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 Fieldgate Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to safe care and treatment, safeguarding people from abuse or harm, staffing, governance systems, being honest and open when things went wrong and reporting to CQC.

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

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

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.

Conditions of registration are already in place at Fieldgate Nursing Home and these remain relevant. We have requested an action plan and continuous improvement plan from the provider to understand what they will do to improve the standards of quality and safety. We are regularly meeting with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our inspection programme. If we receive any concerning information we may inspect sooner.