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Fewcott House Nursing Home Outstanding

All reports

Inspection report

Date of Inspection: 14 August 2013
Date of Publication: 18 September 2013
Inspection Report published 18 September 2013 PDF

Staff should be properly trained and supervised, and have the chance to develop and improve their skills (outcome 14)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by competent staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 14 August 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and reviewed information given to us by the provider. We reviewed information sent to us by commissioners of services and talked with other authorities.

Our judgement

People were not always cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

Reasons for our judgement

One person told us “the staff do their best, some nice ones have gone though”. During our visit we paid particular attention to looking at support to nursing staff due to concerns that had been shared with us. We spoke with the two nurses on duty and looked at the training and supervision records for six nurses.

The provider did not have suitable arrangements in place to ensure that the nurses were appropriately supported in relation to their responsibilities. At the time of our visit the nursing staff told us that Fewcott House was understaffed in terms of nursing support and that there was “no clinical person” for the nurses “to turn to”. We were told that it was Fewcott House’s policy that all staff would receive supervision four times per year and an annual appraisal and that new staff would receive supervision more regularly. We looked at six nurses’ files. Regular records of supervision were not present. Two files for longstanding employees did not contain any supervision records. We found that annual appraisals had not occurred regularly for the four nurses who had been in post for over a year; only two had received appraisals and these were in 2010 and 2011.

Where supervision had taken place we could see that training needs had been identified and addressed. For example, one supervision record from May 2013 identified that the staff member required training in medication. We saw from the training record that this member of staff had undertaken medication training in June 2013.

Fewcott House provided support to people with a range of needs including mental health, learning disability, physical disability and dementia. We looked at the training matrix for all staff employed at Fewcott House and could see that some staff had been provided with training in a range of topics. One nurse we spoke with said they still had some basic training outstanding and that specialist training was provided to depending on the needs of people who were moving to Fewcott House.

We looked at the training records which indicated that four out of six nurses had not undertaken infection control training and two had not undertaken safeguarding training. This supported the comments of the nurses about basic training. We could see from the training matrix that 15 out of 28 care workers and nurses received training in relation to Parkinson’s at the start of 2012; this also supported the comments of the nurse about specialist training. We were informed that a number of gaps in staff training had already been identified prior to our inspection, and that the provider was in the process of addressing these.