Frampton House Residential Care Home

Frampton House is a residential care home providing personal care for up to 30 older people, some of whom

may live with dementia. Accommodation was arranged across three floors and at the time of the inspection

24 people were living in the home.

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

People were exposed to the risk of acquiring infectious diseases including Covid-19 because infection control procedures were not always managed safely.

There had been technical issues with access to electronic systems for the manager that had only recently been resolved.

Quality monitoring systems and management oversight had been significantly reviewed since our last inspection This was particularly noticeable with regard to record keeping and keeping the environment safe.

The new manager and team were also using an electronic care record system to help ensure high standards of care were consistently maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were seen to be treated in a kind and caring manner and staff understood the importance of maintaining their privacy and dignity. They were supported to choose and take part in meaningful activities, and again were seen to be engaging enthusiastically with these. One relative told us.” The variety of activities is brilliant and although I never thought my relative would want to join in, I am pleased to see the photographs on social media.”

People were able to see healthcare professionals when they needed to, and they received their medicines in the ways prescribed for them. They were encouraged to have a balanced diet to help them stay healthy and well hydrated, and one resident said, “the food is just lovely, I often have seconds”.

There were enough staff employed in the home to ensure people's needs, wishes and preferences were met in a timely manner.

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 the service was good (published 4 October 2019)

Why we inspected

We received concerns in relation to infection control and staffing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

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

Enforcement

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.

We will continue to monitor the service and discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to people's safe care and treatment.

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 request an action plan to understand what the provider 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.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Frampton House is a residential care home providing personal care for up to 30 older people, some of whom may live with dementia. Accommodation was arranged across three floors and at the time of the inspection 26 people were living in the home.

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

Quality monitoring systems and management oversight had not always been effective at highlighting shortfalls within the service, for example in some areas of record keeping and keeping the environment safe. Whilst we did not find a direct impact on the quality of people’s care and support, improvements were required to ensure high standards of care were consistently maintained.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were treated in a kind and caring manner and staff understood the importance of maintaining their privacy and dignity. They were supported to choose and take part in meaningful activities.

People were able to see healthcare professionals when they needed to and they received their medicines in the ways that were prescribed for them. They were encouraged to have a balanced diet to help them stay healthy and well hydrated.

Staff understood how to keep people safe and minimise risks to their health safety and welfare. There were enough staff employed in the home to ensure people’s needs, wishes and preferences were met in a timely manner.

The environment was kept clean and staff understood how to reduce the risk of infections occurring. The registered provider had an on-going programme of refurbishment and maintenance in place to promote people’s comfort and safety.

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 Good (published 18 December 2018).

Why we inspected

The inspection was prompted due to concerns we had found at another of the registered provider’s locations. A decision was made for us to inspect Frampton House to assess the quality of care services provided there.

We found evidence that some improvements were needed. Please see the Well-Led key question section of this full report. We were assured that actions would be taken to address the shortfalls we found.

Frampton House Residential Care 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. Frampton House Residential Care Home is registered to accommodate 30 older people, some of whom are living with dementia. At the time of our inspection there were 24 people living in the home.

At our last inspection in May 2016 we rated the service good overall, but we found improvements were required in the implementation of the Mental Capacity Act 2005. At this inspection we found those improvements had been made and the evidence continued to support the overall rating of good. 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.

There was a registered manager in post. 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.

Staff had a good understanding of abuse and the safeguarding procedures that should be followed to report abuse and incidents of concern. Risk assessments were in place to manage potential risks within people’s lives, whilst also promoting their independence.

The staff recruitment procedures ensured that appropriate pre-employment checks were carried out to ensure only suitable staff worked at the service. Good staffing levels were in place. Staffing support matched the level of assessed needs within the service during our inspection.

Staff induction training and on-going training was provided to ensure they had the skills, knowledge and support they needed to perform their roles. Specialist training was provided to make sure that people’s needs were met and they were supported effectively.

Staff were well supported by the registered manager and senior team, and had regular one to one supervisions. The staff we spoke with were all positive about the senior staff and management in place, and were happy with the support they received.

People's consent was gained before any care was provided. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice

Staff treated people with kindness, dignity and respect and spent time getting to know them and their specific needs and wishes. Care plans reflected people’s likes and dislikes, and staff spoke with people in a friendly manner. Our observations during inspection, were of positive and friendly interactions between staff and people.

People were involved in their own care planning and were able to contribute to the way in which they were supported. People and their family were involved in reviewing their care and making any necessary changes.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly and lessons were learned through positive communication.

The provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Frampton House Residential Care Home can provide accommodation and personal care for 30 older people and for people who live with dementia. There were 26 people living in the service at the time of our inspection. The accommodation was a two storey detached house situated in a rural location.

There was registered manager in post. 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.

Staff knew how to respond to any concerns that might arise so that people were kept safe from abuse including financial mistreatment. People had been helped to avoid the risk of accidents and medicines were managed safely. There were enough staff on duty and background checks had been completed before new staff were appointed.

Staff had received training and guidance and they knew how to support people in the right way. People had been assisted to eat and drink enough and they had been supported to receive all of the healthcare assistance they needed.

Staff had ensured that people’s rights were respected by helping them to make decisions for themselves. However, the Care Quality Commission is also required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered manager had not promptly taken all of the necessary steps to ensure that people only received lawful care that respected their rights.

People were treated with kindness and compassion. Staff recognised people’s right to privacy, promoted their dignity and respected confidential information.

People had been consulted about the support they wanted to receive and they had been given all of the assistance they needed including people who could become distressed. People had been helped to enjoy a range of interests and hobbies and there was a system for resolving complaints.

Most of the necessary quality checks had been completed to ensure that people benefited from the facilities and services they needed. Good team work was promoted and staff were supported to speak out if they had any concerns because the service was run in an open and inclusive way. People had benefited from staff acting upon good practice guidance.

We spoke with three people who lived at the home and two visitors. We were not able to speak with some of the other people due to their communication needs. One person said to us, "The staff are very nice; they work very hard." Two people described a variety of Christmas activities they had recently enjoyed. One person said, "It was a lovely Christmas lunch." We observed the care and attention people received from staff. All of the interactions we saw were appropriate, respectful and friendly.

The accommodation was adapted to meet the needs of the people living there, was suited to caring for people with limited mobility and was properly maintained. Risks to people living in the home had been assessed. The home was warm, clean and was personalised to the people who lived there.

We saw that people's support plans and risk assessments reflected their needs and were up to date. Staff we spoke with were aware of the contents of the care plans, which enabled them to deliver safe care in line with those plans. The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines.

Staff recruitment systems were robust. The provider ensured staff were supported and trained to care for the people safely.

We spoke with three members of staff who told us how they would recognise signs of abuse and how they would escalate their concerns to the relevant bodies. One member of staff said, 'I would go straight to the manager or the team leader.'

We spoke to people who told us they felt safe and well looked after. One person said, 'We're all fine here. No problems.'

On this visit we saw the manager now had a robust recruitment process. Staff were not appointed until they had received Criminal Record Bureau clearance and two references.

We spoke with one person who told us, 'The staff all know what they are doing.'

On this visit we saw all care files were stored in a locked office. People who lived in the home and visitors to the home did not have access to the office.