Frome Care Village

Updated 2 September 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by 3 inspectors, a medicines inspector and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Frome Care Village is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Frome Care Village Care home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been appointed at the last inspection but has not yet registered with the Care Quality Commission.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service and the service provider. We looked at notifications and any safeguarding alerts we had received for this service. Notifications are information about important events the service is required to send us by law. We sought feedback from the local authority.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

We used all this information to plan our inspection.

During the inspection

We met most of the people who lived at the service and spoke with 19 of them about their experience of the care provided. We also spoke with 9 family members to get their view of the service. We met with one visiting professional. We observed people and staff in the communal areas throughout the day.

We spoke with 20 members of staff including the manager, care and nursing staff, maintenance person, cook and housekeeper. The nominated individual for the service was remotely present during the inspection and attended the feedback sessions. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 17 people's care records and a number of medication records. We looked at two staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures, maintenance records, cleaning schedules, staff rota's, monitoring charts, fire documents and external servicing records were reviewed.

We asked the manager to email a Care Quality Commission inspection poster to all relatives and staff, inviting them to share their experiences either through our website or by phone. We received no feedback.

Following the site visits, we requested feedback from professionals

Updated 2 September 2023

About the service

Frome Care Village provides care and accommodation for up to 60 older people in two separate buildings. Woodlands provides nursing care in a purpose-built building and The Parsonage is an adapted building for people living with dementia. At the time of the inspection there were 51 people living at the service.

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

Quality assurance systems in place were not always effective at identifying concerns or areas for improvement. The provider had failed to implement and sustain improvements. This is the 3rd consecutive time the overall rating for the service has been rated less than good.

There were not always enough staff on duty and staff were not always appropriately deployed to support people in a timely and person-centred way on the Woodlands unit. This impacted on waiting times, daily routines, including mealtime experiences, activities, and attention to personal care needs.

There were mixed views about staff's skills, competency, and training. Staff training was overdue according to the provider’s records. The Provider had invested in a bespoke in-person training programme but some staff acting in clinical roles had not completed training in line with their policy. There was 1 qualified registered nurse on duty for 41 people with assessed nursing needs. We did not find evidence that people's clinical needs had been negatively impacted by this.

We were not assured the provider was promoting safety through the layout and hygiene practices of the premises. Some areas of the premises were not clean. Cleanliness had improved by the second day of the inspection.

People received their medicines in a safe way. However, some improvements were needed to the way people’s medicines were managed and recorded.

Some routines were not person centred. We have recommended that daily routines are reviewed to ensure person-centred care and support is consistently delivered to people living at the service.

People spoke positively of the culture of the service, which was described as calm, and friendly or jolly. Most people expressed satisfaction with their care.

The manager was open, and willing to listen and act on any concerns.

The service worked in partnership with other professionals. Work was underway to improve working relationships and communication with some external professionals.

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.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence, and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 04 July 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last 3 consecutive inspections.

Why we inspected

We received concerns in relation to the management of the service and staff competencies. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. 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.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of the full report.

The provider has taken action to mitigate some risks identified.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Frome Care Village on our website at www.cqc.org.uk

Enforcement and Recommendations

We have identified breaches in relation to staffing levels and staff training, and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.