Fewcott House Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant people were safe and protected from avoidable harm.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had systems in place to ensure any incidents/accidents or complaints were recorded, investigated and acted upon. The management team analysed these to identify any themes and whether further action was required. Lessons learnt were shared to promote improvement with the staff team.

Staff felt able to raise concerns and were kept updated following incidents. We heard “[We are kept informed] via the care plan and the handover at the start of each shift” and “I will record the incidents and discuss at handover. I feel comfortable to raise any concerns I may have.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People were safely supported to transition from their own home, hospital or from other care services. Upon admission to the service, a holistic approach to care was followed to support people to manage their care with other providers. This included registering people with the local GP surgery, arranging medicines, liaising with the district nurse team and other health professionals. If people decided to move to another service, the registered manager deputy and staff supported people through their transition.

People’s care and support plans were regularly reviewed to ensure they remained reflective of people’s needs. This meant staff were able to provide up to date information to healthcare partners when people’s needs changed.

Records evidenced people were referred to healthcare professionals for advice when required. Healthcare professionals told us the staff team were consistently proactive in seeking professional advice and support from the local practice teams and the home visiting service, which provided both planned and reactive care. One professional told us, “I find Fewcott [House]to be very proactive in supporting the residents, [and the] care team engage with our recommendations to support physical, emotional and mental wellbeing.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination and neglect. The provider shared concerns quickly and appropriately.

People were protected from the risk of abuse. Policies relating to safeguarding and whistleblowing were in place. Staff had received training to enhance their understanding of how to protect people from any form of discrimination and were aware of when and how to report concerns. Staff felt confident concerns raised would be dealt with appropriately. One member of staff said, “If see anything in the home that is not right, I go report it all the time. They [management] always tell us about safeguarding.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this is usually through the Mental Capacity Act 2005 (MCA) application procedures called the Deprivation of Liberty Safeguards (DoLS). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. Where restrictions had been placed on one person’s liberty to keep them safe, the registered manager had worked with the local authority to seek lawful authorisation for this. This ensured any conditions of the authorisation were being met. Where a concern on inspection regarding Best Interests Decisions being made raised concerns, the management listened and took appropriate action immediately.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

One professional told us, “[Management] have an open conversation, positive risk-taking and person-centred approach with a "can do" solution focused perspective, which is reflected in the care team.” This meant people were supported with making decisions that mattered to them.

People were assessed for risks such as skin damage, malnutrition, falls and choking. When risks were identified, care plans provided guidance for staff on how to reduce these risks. For example, some people were at risk of skin breakdown, care plans reviewed included information such as pressure relieving equipment in use, how often staff needed to support people to change position, and how to monitor for skin damage.

People had the equipment they needed to help keep them safe, such as walking frames and sensor mats to support their mobility. Management regularly reviewed care plans and risk assessments.

One relative said, “The staff all appear to be well trained. I have received support to safely take [person] for walks in the local area, all without incident.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider employed a maintenance worker who undertook health and safety checks, including PAT (Portable Appliance) testing, which is a process of inspecting and testing electrical appliances within the home to ensure they are safe. Personal emergency evacuation plans (PEEPS) were up to date, however further clarity was required in such as the description of the evacuation chair. We discussed this with the provider during the inspection, who was responsive and made the necessary changes to the language used straight away.

All staff had had manual handling training.

Following a fire risk assessment, most required actions had been completed. Two outstanding actions were in progress concerning a door whose glass did not meet the fire regulations. Management had engaged a door specialist to make the improvements needed to meet fire safety requirements and reassurances were given that this work would be completed in a timely manner. Recent fire safety checks had been completed.

One relative said, “[Person] is continually checked. [Staff] respect mine and person’s wishes. There are safety gates and doors. [Staff] watch who is behind you when you are coming and going. Risk assessments are always ongoing.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

During the inspection we observed call bells were answered in a timely manner. The service audited response times to call bell alerts to help ensure appropriate numbers of staff were in place at key times of the day. Staff were visible, were not rushing, and took time to sit and talk with people.

New staff were recruited safely, following appropriate recruitment procedures, including Disclosure and Barring Service (DBS) checks and verification of relevant employment history. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Recruitment records were up to date and all staff were up to date with their training.

Staff received supervision and support. We heard “I speak with management every time I need, it is very easy, if we need something I just go and talk to them and they do it quick. They come and check the work we do and tell us if something needs done. Every few months I have supervision with deputy or manager and I say if there is anything.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Personal protective equipment (PPE) was used appropriately, and stock levels were maintained. 

Relatives and professionals told us they felt the home was clean and well maintained. We received the following comments from people, “All my [relative’s] clothes are clean and ironed. It all got labelled. Home [Fewcott House] doesn’t smell. It always looks clean.” One professional said, “[Fewcott House] always looks clean.” However, during the first site visit to the home, issues around cleanliness were identified. We addressed this with the provider and they took immediate action to rectify the concerns. We found no concerns with the cleanliness of the home during our second visit to the home.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Systems were in place to ensure people received their medicines as prescribed. Staff received training and checks to ensure they had the knowledge and skills needed to manage and administer medicines safely. The management told us that staff are aware of STOMP (stopping over medication of people with a learning disability and autistic people) and the staff understand STOMP principles and apply it within the home.

During the inspection, a review of medicines was conducted. All medicines checked were found to be correctly stored, accounted for, and in accordance with relevant guidance. No discrepancies were identified. A relative told us, “They [Staff] are really good with [persons] meds, [person] spits [them] out. They consulted with me and the doctor about what to do. [Person] is on patches now to reduce the amount of tablets[person]takes and [this] has [been] effective.”