Archived: Fenwick House

Updated 19 August 2015

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.

We undertook a focused inspection of Fenwick House on 2 July 2015. This inspection was carried out to check that improvements had been made to meet legal requirements planned by the provider after our inspection on 30 October and 11 November 2014.

The service was only inspected against one of the five questions we ask about services; is the service effective? This is because the service was not meeting legal requirements relating to the effective domain.

The inspection was unannounced and the inspection team consisted of one inspector.

Before our inspection we reviewed the information we held about the service. This included the provider’s action plan, which detailed the action they intended to take to meet legal requirements.

During our inspection we observed how staff interacted with people. We spoke with four people who used the service, two care staff, the deputy manager and the manager.

We reviewed four people care records and records relating to staff training.

Updated 19 August 2015

Fenwick House provides personal care and accommodation for up to 30 people who may have a range of care needs such as older people, dementia, physical disabilities and the misuse of drugs and alcohol. There were 8 people living at the service when we visited. This was because the local authority had identified areas which required improvement during their quality monitoring visit and had imposed a suspension on new admissions.

This unannounced inspection took place on 30 October and 11 November 2014.

The home did not 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.

During our inspection on 3 July 2014, we found that people’s needs were not adequately assessed prior to them moving into the service and support was not planned and delivered in a way that consistently ensured their health and well-being. The medicines recording systems were inadequate and the systems in place to regularly assess and monitor the quality of service were not effective.

After the inspection in July 2014, we asked the provider to make improvements to the care and welfare of people who used services, management of medicines and assessing and monitoring the quality of service provision. Following the inspection the provider sent us an action plan detailing the improvements they were going to make and stated that improvements would be achieved by September 2014.

During this inspection we found that improvements had been made in the safe handling of medicines. The medicines recording systems had improved. People were now protected against the risks associated with the management of medicines.

We found that quality audits were now undertaken. The environmental audits seen, identified areas in the premises that required attention and there were action plans in place; however, they did not provide timescales when the work would be undertaken. Therefore, the quality assurance system was not fully embedded.

Staff were aware of their responsibilities to keep people safe and to report any allegations of abuse. The daily staffing numbers provided were adequate to safeguard the safety and welfare of people who used the service.

Staff said that they had been provided with on-going e-learning training and that their competencies were regularly assessed. They also said that the frequency of supervision had improved; however, we found that their knowledge on the Mental Capacity Act (MCA) 2005 was limited.

There were no Deprivation of Liberty Safeguards (DoLS) applications made to the Statutory Body to deprive people of their liberty in their best interest. You can see what action we told the provider to take at the back of the full version of this report.

People were provided with a balanced diet and their nutritional needs were closely monitored. Those who were at risk of poor nutrition were regularly weighed and provided with high protein food and drinks. People also had access to GP and health care professionals if they were unwell.

We observed good interactions between people and staff. If required staff supported people to obtain the services of an advocate to speak on their behalf.

The provider did not maintain a complaints record. We found the guidance provided by the provider for people to escalate an unresolved complaint was not accurate.

Staff told us that regular staff meetings were now taking place with the provider who was supportive, approachable and listened to suggestions made.

Some improvements had been made in relation to the provider’s quality assurance system. For example, regular audits were now undertaken in relation to the environment, medicines and health and safety. Further improvements were needed to ensure action plans identify timescales when areas requiring attention would be addressed. People’s views on the delivery of care could not be analysed and measured in a balanced and proportionate manner. This was because only two people who used the service and a staff member had responded to the quality assurance questionnaire.