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Fewcott House Nursing Home Outstanding

All reports

Inspection report

Date of Inspection: 13 October 2011
Date of Publication: 29 November 2011
Inspection Report published 29 November 2011 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Meeting this standard

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

Our judgement

The service had assessed the needs of people who lived in the home. This included any risks to their health and how those risks could be reduced except in relation to behaviour plans. People living in the home, and their relatives, where appropriate, were involved in planning and reviewing the care and support given. Care plans for people under 60 did not have specific guidance for staff to ensure their care was age appropriate.

Overall Fewcott House Nursing Home was meeting this essential standard, but to maintain this we suggested some improvements were made.

User experience

People told us that they liked living in the home. They said that their families always felt welcome and one person described it as a ‘magnificent’ home.

People told us that they were involved in the development of their plans of care and any changes made to them.

Other evidence

There were 25 people resident in the home on the day of the inspection visit. Fewcott House Nursing Home was registered for 35 people but there were ongoing building and refurbishment works in progress. Building work is to include re-instating all en-suites that had been condemned as not adequate. People were using commodes and sharing bathrooms.

We arrived at 11.30 am, five people remained in bed. Three people were nursed in bed because they were very frail and two chose to stay in bed. One of those who had chosen to stay in bed wanted to get up at 12:00 and was assisted to do so. This person did not have fluids available or access to their call bell. However, staff told us that they were checked regularly to see when they wanted to get up and were offered drinks. Others who were nursed in bed had fluid and nutrition charts, and call bells were available for those who were able to use them. Plans of care included how frequently people needed to be checked. We were told that only one person in the home had a pressure wound, they had only been resident in the home for a few days. The home was developing a nursing plan for them that included wound care.

We observed care during a meal time and throughout the visit. We watched part of a music session. Staff treated people with respect and were seen to be interacting positively and sensitively with the people in their care. There were some instances of staff treating people with learning disabilities in a ‘child like’ way. For example, staff called two people ‘good girls’ and said ‘aren’t they sweet’ within their hearing, However, the two people reacted positively to the staff. Staff were observed to be kind and attentive and were responding to peoples’ needs quickly and efficiently. Staff were seen to be interpreting behaviours to enable them to meet needs that people were not always able to verbalise. People had meals on time and prepared as noted in their care plans. The cook was observed talking to people about the meals for the day and asking if there was anything they wanted that was not on the menu. One person told us that they were asked everyday about their food requirements. Nurses and care staff had a good knowledge of peoples’ needs and gave them care accordingly.

The plans of care seen included all the relevant information to enable staff to appropriately care for people, with the exception of age appropriateness. For example, pre-admission assessments, life history charts which included phobias, habits and unpleasant life events, likes, dislikes and preferences, a mental capacity screening check list, a personal emergency evacuation plan, a nutritional screening tool, weight charts and personal support plans which included what time people chose to retire and rise and how people made choices. People or their representatives signed the plans of care. Several of the people who lived in the home were under 60 and had physical or learning disabilities. There was no detail in their care plans about how to ensure care was age appropriate.

Health appointments and visits by other professionals were recorded and showed that the doctor or specialists were consulted regularly and as appropriate. For example, one person had a behavioural assessment completed by a psychiatrist and another had contact with a specialist Parkinson’s nurse.

Plans of care included any relevant risk assessments for individuals. These included risk assessments for falls, personal safety, nutrition assessments and monthly or weekly weight monitoring as the assessment required, moving and handling, skin integrity and fire. Some of the risk assessments were detailed, for example lifting and handling. Some assessments did not include the detail of how to minimise the risk. For example, the behaviour assessments noted peoples’ behaviours, the risk these posed but there was little detail of how to minimise the assessed risks. Some people had bed rails, they told us they felt safer with them