Frenchay House

Frenchay House is a care home providing accommodation for people who require nursing or personal care. The service provides support to older people, including those who are living with dementia. Up to 30 people can live at Frenchay House. At the time of our inspection there were 28 people using the service.

Frenchay House is located in a large, listed building in a village location. There are communal areas, and some people live in flats with individual lounges and bathrooms.

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

We highlighted some gaps in medicines records to the provider. Additional information and assurances were given after the inspection with actions taken to meet all standards. Staff were trained to support people with medicines in a way that met their needs.

Governance processes were effective overall, although the most recent medicine audit had not highlighted all of the shortfalls we identified during the inspection. These were identified at the subsequent medicines audit and actions taken as necessary. Audits supported the service to identify, monitor and address performance and risks.

People we spoke with, and their relatives all told us they felt safe living at Frenchay House. People and their relatives spoke positively about the service and staff team. We observed others looking comfortable and relaxed around staff.

Staff received training and knew what they should do to safeguard people from abuse or harm. Specific risks to people were assessed before admission, monitored and reviewed regularly. Staff knew about risks for different individuals.

Staff managed the safety of the living environment and equipment in it through regular checks. Fire safety was monitored, and actions taken as required to manage risks.

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.

There were enough appropriately skilled and experienced staff to meet people’s needs. This was regularly reviewed. Staff were recruited safely by the provider, and there was a consistent staff team. The team worked with other health and social care services to promote good outcomes for people and keep them safe.

Staff were motivated and committed to providing high quality care to people and ensuring their needs continued to be met. Staff told us they enjoyed working at the service and felt well supported by the management team and their colleagues.

The management team were experienced and played an active role in the service. Staff told us managers were visible and approachable. There was a culture of continuous improvement and staff at all levels were encouraged to follow interests and take up training and new opportunities.

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 02 August 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service and the time since our last inspection. We only reviewed the safe and well led key questions at this inspection. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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 COVID-19 and other infection outbreaks effectively.

The overall rating for the service has remained good based on the findings of this inspection.

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

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

We carried out an unannounced inspection of the service on 28 June 2017.

At our last inspection in October 2015, we found a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because the provider had not always fully assessed the risks to the health and safety of people using the service. At this inspection, we saw the provider had taken the action they had identified in their action plan. As a result, improvements had been made and the service was no longer in breach of this regulation.

At the last inspection, the service was rated overall as Good.

As a result of this inspection, we have rated the service Good.

Why the service is rated good.

We did not find any breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 during this inspection.

There was a registered manager in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. 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.

Frenchay House was described by people, relatives and staff as homely. The atmosphere at the home was calm and relaxed. People were treated as individuals and received safe, high quality care.

The registered manager and staff understood their role and responsibilities to keep people safe from harm. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work with people to assess their suitability. Medicines were well managed and people received their medicines as prescribed.

The service was effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see healthcare professionals including a GP when they needed to do so. The service complied with the requirements of the Mental Capacity Act 2005 (MCA).

People received a service that was caring. They were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People’s views were actively sought and they were involved in making decisions about their care and support. Information was provided in ways that were easy to understand.

The service was responsive to people’s needs. People received person centred care and support. They were offered a range of activities. People were encouraged to make their views known and the service responded by making changes.

The service was well led. The registered manager and deputy provided good leadership and management and were supported by the quality and training manager and the provider. A comprehensive quality assurance system was in place. This meant the quality of service people received was monitored on a regular basis and where shortfalls were identified, they were acted upon.

We saw some people being given their medicines in a safe and respectful way. We spoke to three people about their medicines. They told us staff looked after their medicines well. Medicines training had been provided for staff. This meant more staff were able to give people their medicines. Staff told us people received their medicines more quickly because there were usually two members of staff giving people their morning and lunchtime medicines. Medicines administration records showed that people were given their medicines as prescribed for them.

The provider sent us an action plan that detailed how they would achieve compliance. During our inspection we found that the actions the provider told us they were planning to take, had been implemented within the service.

During our inspection we looked at records held within the home that included people's individual care plans. We spoke with people that lived in Frenchay House, visiting friends and relatives and staff that were on duty. Comments we received were positive and people we spoke with felt there had been improvements in the service provision since our last inspection.

Comments from people that used the service included; 'it's lovely here now, things are more relaxed'. 'I am very happy here they are nice girls here'. A member of staff told us 'it has improved here, we have more time to sit and talk to residents. That's all we ever wanted as residents love to chat'. Comments from people that used the service included; 'it's lovely here now, things are more relaxed'.

We were supported on this inspection by an expert-by-experience. This is a person who had personal experience of using or caring for someone who used this type of care service. This person gained the views and experiences of people living in the home.

Not all people were able to verbally tell us about the care they received or if they were happy. This was because some people were living with a form of dementia. Therefore we observed how staff interacted and supported people in communal areas and crossed referenced this with their individual care plans. This enabled us to make a judgement on how their needs were being met.

Overall people we spoke with who used the service were happy with the care they received. Comments included; 'I am very lucky to be here, everyone is very kind and very generous, I have nothing but praise for it'. 'I have the highest regard for the staff this is a wonderful place to live. The food we get is good, especially the porridge with honey at breakfast. We don't join in the activities, we prefer to be together'.

We found the provider had systems in place to effectively monitor the service provided.