• Care Home
  • Care home

Fremington Manor Nursing and Residential Home

Overall: Good read more about inspection ratings

Fremington Manor, Fremington, Barnstaple, EX31 2NX (01271) 377990

Provided and run by:
Care South

Important: The provider of this service changed. See old profile

Latest inspection summary

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Background to this inspection

Updated 4 September 2021

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 Care Act 2014.

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

The inspection team consisted of three inspectors and a member of the medicines team.

Service and service type

Fremington Manor 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.

Notice of inspection

The first day of the inspection was unannounced. Prior to the second and third days we gave short notice and the fourth day of the inspection was spent completing telephone calls to relatives and professionals and providing written feedback to the service.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all of this information to plan our inspection.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with 15 people living at the service about their experiences of being cared for. We also spoke with ten staff, including the interim manager (deputy manager), operations manager, senior care workers, care staff, housekeeping staff, maintenance staff and the cook. We reviewed four paper care plans and four electronic care plans and associated records including risk assessments and daily records. We reviewed three recruitment files, training records, supervision records and several audits, meeting minutes and other records relating to the running of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at complaints, care plans and quality assurance records. We spoke with three professionals who regularly visit the service.

Overall inspection

Good

Updated 4 September 2021

About the service

Fremington Manor is a residential care home providing personal and nursing care to 51 people aged 65 and over at the time of the inspection. The service can support up to 60 people.

Fremington Manor is a large country manor house which has been extended and adapted to meet the needs of people who are frail and elderly. There are passenger lifts to all floors with bedrooms on two floors and mainly communal spaces on the ground floor. There are level access garden areas.

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

People told us their experience of care and support had deteriorated over recent weeks due to lower level of staffing. Comments included “We are waiting much too long for call bells to be answered. The staff are doing their best, but they have been very short staffed” and “Staff are always very hurried; they are working hard but there is not enough of them and standards have slipped a little.” We heard that up until recently people’s needs were being met in a timely way.

The service does not currently have a registered manager, but the deputy manager was acting as interim manager. She and the operations manager were fully aware of staff shortages and were working to address these in a number of ways. They had recently lost 14 staff who left for various reasons and they were actively recruiting to fill these posts. They had new staff waiting to start but this was being held up due to waiting for the right checks to be in place to ensure they were suitable to work with potentially vulnerable people.

Staffing had also been short due to staff having to self-isolate as they had been in contact with someone who had tested COVID-19 positive or had recently tested COVID-19 positive themselves. The acting manager was seeking back up support from agencies but there was a shortage of agency workers to fill these gaps across the county. This was a regional and national issue at the time of writing the report.

The operations manager and interim manager held an extraordinary meeting following our first day of feedback where we identified people were being impacted from the low staffing levels. They agreed that meeting people’s basic needs had to take priority and so all staff, including ancillary staff such as kitchen, housekeeping and maintenance staff were being asked to help with tasks to support the care team. This included assisting with getting meals to people and where needed assisting with them eating their meal. The service had already ensured that all staff, irrespective of their role, had received moving and handling training and training on assisting people to eat and drink safely. The activities team were also asked to assist with aspects of care until the care team were up to sufficient numbers.

Following the inspection, we were informed that the provider had sourced four agency staff from outside of the area and had used a recruitment agency to find an interim experienced manager so the deputy manager could support the care team on the floor. We felt that in the circumstances the service were doing all they could to address the staff shortages.

We identified that due to the low staffing levels, records were not always being completed. On the first day we identified a person who was telling us they were hungry and thirsty. They were unable to assist themselves and there was no record of when they had last been supported to eat and drink. The service was in the process of moving from paper records to electronic records so some of the records may have been missed due to this change over. The provider made the decision to continue with the move to electronic records and by the second and third day of the inspection we could see a huge improvement in records such as food and fluid monitoring. Seventeen people had been identified as being at risk of poor food and fluid intake and they had records to show when food and fluid was offered and how much they had eaten and drunk each day. This meant the potential risk identified had been mitigated.

Therefore, people were supported to have a balanced diet. Where people were at risk of poor hydration or nutrition, they were being supported and monitored.

People received their medicines safely, and in the way prescribed for them.

Staff had training, support and supervision to ensure they had the right skills and qualities to meet people’s needs safely and effectively. Recruitment processes were robust. Staff understood safeguarding processes.

Systems and quality processes ensured all aspects of care delivery, the building and equipment were being reviewed and monitored on a regular basis. This included ensuring the views of people, their families and other stakeholders were considered.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 21/06/2021 and this is the first inspection. Although there had been no change to the provider, they had changed their legal entity, so this inspection covers all five key questions, and this is classed as their first rating.

Why we inspected

We plan to inspect all newly registered services within a 12-month period. We brought this inspection forward due to receiving information of concern that people’s needs were not being met due to low levels of staffing. We did find evidence to show staffing levels had fallen below the providers’ assessed levels, but this was due to sickness, staff self-isolating due to COVID-19 and staff leaving. The provider and interim manager had done everything they could to mitigate this risk.

We found no evidence during this inspection that people were at risk of harm from this concern, but we identified potential risks to harm which the provider had already identified themselves and had an action plan to address this.

Please see the safe and well-led sections of this full report.