Enhanced Elderly Care Service - Fellingate Care Centre Limited

We found the following examples of good practice.

¿ Systems and procedures were in place to prevent the spread of infection. Only essential visits could take place at the time of inspection. Visitors were required to undergo a robust screening procedure before they could enter the home.

¿ The service promoted social distancing. Chairs and tables in communal areas were spaced out for people to enable them to share these spaces safely. Staff were provided with separate areas in which they could take their breaks.

¿ The service admitted people safely and in line with best practice guidance. People were required to have a negative COVID-19 test before admission.

¿ The home was well stocked with personal protective equipment (PPE). Staff were trained in how to use PPE safely. Systems were in place to safely dispose of used PPE.

¿ Staff and people were regularly tested for COVID-19 testing in line with government guidance. Best interests decisions were in place for people who lacked capacity to consent testing.

¿ The home was clean, tidy and well ventilated. Additional cleaning of frequently touched areas such as door handles was in place. Anti-bacterial door plates for opening doors were in situ. The provider had purchased equipment to deep clean rooms and communal areas.

¿ The home had supported the wellbeing of people and staff. People were encouraged and assisted to have contact with their relatives using electronic communications. Monthly surveys were carried out to see what people had enjoyed doing to maintain their well-being. The management team supported staff using a variety of means including providing emotional support from external professionals.

Enhanced Elderly Care Service - Fellingate Care Centre provides personal and nursing care for up to 81 people. At the time of our inspection there were 78 people using the service. The home is arranged over four floors, three of which provide accommodation. The administration service, kitchen and the laundry were on the ground floor.

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

Systems were in place to safeguard people from abuse. People told us they felt safe and relatives told us they did not have any concerns.

Health and safety checks were routinely carried out on the building and its contents. Emergency evacuation plans were in place for each person.

Safe recruitment practices were followed, and sufficient staff were deployed. Staff were suitably supported to carry out their roles and were competent in meeting people’s needs.

People were supported to eat and drink to promote their health and well-being. There was an emphasis on people having meal choices and people told us they were well fed. Staff worked in partnership with other professionals and assisted people to access healthcare services.

Staff provided kind care and promoted people’s independence. People received personalised care which reflected their needs and preferences. They were supported to participate in activities to prevent social isolation.

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.

A complaints procedure was in place. People and their relatives knew how to complain. They were confident the registered manager would respond to any concerns they raised.

The provider had arrangements in place to effectively monitor the service. Both the provider and the registered manager were responsive to feedback and immediately implemented changes to the service when concerns were raised.

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 14 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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.

We last inspected Enhanced Elderly Care Services Fellingate Care Centre in August 2015. At that inspection we found the service was not meeting all of the legal requirements in force at the time.

Enhanced Elderly Care Services Fellingate is a purpose built care home that provides personal and nursing care to a maximum of 81 older people, including people who live with dementia. At the time of inspection 74 people were living at the home.

A registered manager was in place. 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.

People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. Staff were aware of the whistle blowing procedure which was in place to report concerns and poor practice. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support.

Due to their health conditions and complex needs not all of the people were able to share their views about the service they received. Other people could tell us they felt safe. People appeared contented and relaxed with the staff who supported them. People and relatives said staff were kind and caring. Staff had more time to interact and engage with people and not just when they carried out tasks.

Risk assessments were in place and they accurately identified current risks to the person as well as ways for staff to minimise or appropriately manage those risks. Staff received opportunities for training to meet peoples’ care needs and in a safe way. A system was in place for staff to receive supervision and appraisal and there were robust recruitment processes being used when staff were employed.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and best interest decision making, when people were unable to make decisions themselves. People were able to make choices where they were able about aspects of their daily lives. People had access to health care professionals to make sure they received appropriate care and treatment. Staff followed advice given by professionals to make sure people received the care they needed. People received their medicines in a safe and timely way.

Staff supported people who required help to eat and drink and special diets were catered for. Some activities and entertainment were available for people and people were being consulted to increase the variety of activities and outings.

A complaints procedure was available. People told us they felt confident to speak to staff about any concerns if they needed to. Staff and people who used the service said the registered manager was supportive and approachable. People had the opportunity to give their views about the service. Feedback was acted upon in order to ensure improvements were made to the service when required. The provider undertook a range of audits to check on the quality of care provided. Records had been updated and they were regularly reviewed to reflect peoples’ care and support requirements.

.Is the service safe?

.Is the service effective?

.Is the service caring?

.Is the service responsive?

.Is the service well-led?

This is the summary of what we found.

Is the service safe?

Risk assessments were in place. Audits were carried out to look at accidents and incidents and the necessary action was taken to keep people safe.

Information was available to show that the service worked with other agencies to help ensure people's health needs were met and to prevent admissions to hospital wherever possible.

The necessary checks were carried out to ensure the building was safe and fit for purpose.

People who used the service said they felt safe.

Is the service effective?

We saw the service provided care to some older people with dementia and cognitive impairment. The service was quite well-equipped to meet these specialist needs.

People commented how helpful and friendly staff were. Relatives told us the service kept them up to date with what was happening with their relative's care and they felt able to ask any questions. Several people we spoke with commented how pleased they were with the care provided by staff at the home. We observed staff were patient and supportive as they worked with people.

Is the service caring?

We observed the interaction and noted the kind and caring way staff supported people, especially people with dementia. One relative commented. "The lasses are great." and; "Staff are all very caring." Another commented. "The care is excellent." Staff were helpful and offered people information and support about their care. We observed staff interacted well with people. It was evident that staff had developed a good understanding of people's communication needs and how best to communicate with them.

Is the service responsive?

Information was collected by the service with regard to the person's ability and level of independence before they moved into the service. Various assessments were completed by the manager of the service with the person and/or their family to help make sure staff could meet their needs. Regular reviews were carried out with the person who used the service and their representative to make sure people's support plans were kept up to date. This helped ensure staff provided the correct amount of care and support.

Referrals for specialist advice were made when staff needed guidance to ensure the health needs of people were met.

People's individual needs were taken into account and they, or their representative if they were not able, were involved in decision making with regard to their care. They were kept informed and given some information to help them understand the care and choices available to them, this was developed to include and involve people with dementia.

Information collected by the service gave staff some insight into the interests and areas of importance to the person. Activity provision was developed to help ensure activities reflected people's interests and provided stimulation to people with dementia, if they wished to become involved.

Regular meetings took place with staff and people who used the service and their relatives to discuss the running of the service and to ensure the service was responsive in meeting the changing needs of people.

Is the service well-led?

Staff we spoke with were enthusiastic about their role working with people and they were knowledgeable about the support needs of people. Staff said they felt supported by the manager and advice and support was available from the management team.

We saw there was a focus from management on the provision of individual care and support to people who used the service. There was an emphasis about individualised care and support to people. One person said; "They are respectful. I can get up and go to bed when I like, I decide. I do go along with what it said but if there was anything that I was not happy about then I would say so."

We saw people had the opportunity to comment on the quality of the service and that they felt able to speak to the manager and staff about any issues. Comments included; "The care is excellent." Another person commented; "The staff are very kind and friendly." And; "We are well looked after."

The people we talked with were happy with their care and spoke highly of the manager and staff. Our observations confirmed that people experienced appropriate and personalised support in meeting their needs.

We found the improved recording of medicines meant they were now accurate and showed people received their medication safely.

Proper systems were in place to make sure only suitable staff were employed to care for people in the home.

Systems were also in place to check the quality of the service provided, and to make any necessary improvements.

Care and other records in the home were kept in a professional way, and were informative and accessible.

We found that care was delivered by skilled staff who had planned how they would meet individual needs and manage risks to personal safety. However the recording of medicines was not fully accurate and did not demonstrate that people were always given their medication safely.

People told us they were happy at the home and felt able to report any concerns they might have. They said, 'I haven't had any problems', and, 'I definitely have no complaints'.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.