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Fourways Residential Home Good


Inspection carried out on 16 May 2018

During a routine inspection

Fourways Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Fourways Residential Home is registered to provide personal and nursing care for 21 people. There are two floors and a passenger lift by the front door. The front door is accessible to people using wheelchairs as is the garden.

At our last inspection we rated the service Good. At this inspection we found the service remained Good overall, with one key question now being rated as ‘Outstanding’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager working at the home. A registered manager is a person who has registered with the CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager is also one of the directors of the company that owns the service. They have delegated the day to day to running of the home to a home manager and two deputies. However, the registered manager visits the home on most days and is actively involved in the running of the home.

People visiting, living and working at the home spoke highly of the quality of the care, the calibre of the staff and the well maintained environment, including an accessible garden complete with a range of seating areas and a summer house. One visitor said they regularly visited people living at other care homes in the area and said “this is my favourite.” Another visitor said “we knew the moment we walked in that Fourways was the right place.” People told us they were treated as equals and enjoyed the social life of the home as there were a wide range of activities and opportunities to learn and participate in different events. A newsletter kept people informed and the investment of a television, which showed pictures from events and activities at the home, had proved popular with people living at the home and their visitors.

Staff were quick to respond to people’s changing needs, providing high quality end of life care with professionalism and compassion. Families praised the support they received from staff to cope with this experience. They said staff comforted them and they gained immense reassurance knowing the staff members’ commitment to make their relative feel safe, at peace and pain free. The provider always provided transport to medical appointments, as well as company during these journeys and support, if needed, during appointments. People were positive about this type of support as the stress of planning of appointments was reduced as they were not reliant on organising their own transport. People told us staff were attentive and varied their support depending on how they were feeling.

People praised the high standard of food, the choice and the responsiveness of staff to make alterations to the menu based on feedback and suggestions. Many people chose to eat in the dining room; meals were a social occasion with people staying to chat over a drink after the meal. The provider shopped for all the food on a weekly basis to ensure the quality was of a high standard. They had invested in a dessert trolley so that a range of fresh fruit and desserts could be taken to people who chose to eat in their rooms as well as proving a clear choice for people in the dining room.

People said they could speak with any of the staff if they had a concern and were confident actions would be taken, if required. There was a strong commitment to staff trainin

Inspection carried out on 7 and 11 January 2016

During a routine inspection

We carried out an unannounced comprehensive inspection on 7 and 11 January 2016. Fourways Residential Home is a detached house set in its own grounds a short distance from the Sidmouth town centre and provides care and accommodation for up to 21 older people. The home had increased it’s occupancy in September 2015 following a new extention. The new extention added two further bedrooms and included a hairdressing salon, a dedicated staff training room and the relocation of the services kitchen which had increased communal space.

On the first day of the inspection there were 20 people staying at the service. One of these people were staying at the home for a short respite stay and had left by the second day of our visit.

We undertook an inspection in July 2013 and found the service was meeting the regulations of the Health and Social Care Act (2008).

The registered provider is also the registered manager of the service. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered person employed a care manager who undertook the day to day running of the service with their support.

Everyone was positive about the registered person and care manager and felt they were approachable and caring. The care manager was very visible at the service and undertook care shifts and did not have any allocated supernumary time to undertake managerial duties. They promoted a strong caring and supportive approach to staff and people at the service.

There were sufficient staff numbers of suitable staff to keep people safe and meet their needs. The staff, care manager and careworkers from the providers other service undertook additional shifts when necessary to ensure staffing levels were maintained. However this meant the care manager had undertaken a lot of additional shifts which meant they were rushed and having to prioritise their managerial duties.

The registered person, care manager and staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (MCA) 2005. Where people lacked capacity, mental capacity assessments had been completed and best interest decisions made in line with the MCA.

People were supported by staff who had the required recruitment checks in place. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns. The majority of care staff had undertaken relevant qualifications in health and social care. Staff had the skills and knowledge to meet people’s needs and had annual updates to maintain their knowledge.

People were supported to eat and drink enough and maintained a balanced diet. People and visitors were positive about the food at the service.

People said staff treated them with dignity and respect at all times in a caring and compassionate way. People received their medicines in a safe way because they were administered appropriately by suitably qualified staff and there were effective monitoring systems in place.

People had access to a rolling programme of activities at the service. People were encouraged and supported to develop and maintain relationships with other people at the service to avoid social isolation.

People’s needs and risks were assessed before admission to the home. Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely and these were reviewed on a regular basis. They were personalised and people had been involved in their development. People were involved in making decisions and planning their own care on a day to day basis. They were referred promptly to health care services when required and received on-going healthcare support.

The premises were well managed to keep people safe. There were emergency plans in place to protect people in the event of a fire or emergency.

The provider had a thorough quality assurance and monitoring system in place. This included regular audits, quality monitoring visits and annual surveys for the provider to assess the effectiveness of the service provided. The responsible person actively sought the views of people, their relatives, outside professionals and staff. There was a complaints procedure in place and the registered person and care manager had a clear understanding of how to respond to concerns.

Inspection carried out on 30 July 2013

During a routine inspection

We carried out this inspection unannounced on 30 July 2013. There were 15 people living at the home at the time of the inspection with three vacancies. We spoke with the manager and provider, two staff and five people living at the home. People living at the home were very positive about the care that they received. Comments included �I didn�t want to come to a home but it�s wonderful. Now we don�t have to worry�.

We found that people� s care was comprehensively assessed prior to admission and that information from external health professionals and families as appropriate, was used to ensure that personalised care planning was in place. Staff were knowledgeable about people�s needs and had easy access to clear information so that these needs could be met.

The home was very well maintained with a rolling maintenance programme. Vacant rooms were being refurbished and the home had policies in place to ensure that the home was kept clean and hygienic. The home did not employ a cleaner but we saw that staff had time to follow the cleaning rota and spend time with people living at the home.

There was a robust complaints and recruitment system. These ensured that people were able to voice any concerns and that they would be listened to and that people were protected from unsuitable staff. Records were generally well kept and stored securely.

Inspection carried out on 6 February 2013

During a routine inspection

Staff we spoke with were very clear about the rights that people have to make choices and the need to balance this right with their duty of care. They understood processes to follow if they thought someone may lack capacity to make an informed decision and what they needed to do to try to help the person have the information they required to make an informed choice.

People we spoke with told us they were very happy at Fourways and were well looked after. One person said �one thing I like is we are never on our own. When you have to live in a home you couldn�t get anything better�.

The organisation has clear policies for managing medicines and these were followed by staff.

Staffing on duty were trained and in sufficient numbers to provide the necessary care. One person told us there were a �lot of staff� and another person said that staff �always come straight away when we ring our bell�.

There is a detailed complaints policy that is accessible to people that live at Fourways and evidence that complaints are taken seriously and the provider learns from them.

Inspection carried out on 19 March 2012

During a routine inspection

We visited Fourways Residential Home unannounced on 19 March 2012. There were 17 people living at the home with one vacancy and a double room being used as a single. When we arrived people were going about their day as they wished. Some people were relaxing in the lounge and others were sitting outside on the terrace or in their rooms.

We spoke to 6 people about what it was like to live at Fourways and spent lunch time talking to two people in depth. We spent time observing care delivery in the communal areas and looked at all areas of the home. We spoke to the deputy manager and two staff and looked at records. People told us that it was �very nice�, it�s all very good� and a testimony written recently for the home�s Statement of Purpose by a resident said �this is a home where each person is treated as an individual and yet there is a wonderful feeling of togetherness between staff and residents�. All the people we spoke to living at the home were very positive about their experience there.

We saw that the home focussed on people�s choice about how they wanted to live their lives. Staff were aware of people�s likes and preferences and there was good communication between the staff and people living there. This included regular resident�s meetings, choices of relevant activities, a resident�s notice board showing meeting minutes and a complaints book showing that concerns were acted upon and recorded in a timely way no matter how small.

People felt that they were well cared for and involved in the community. People were encouraged to take advantage of lifts to the town provided regularly by the home and topical events are celebrated.

Staff are well trained and knowledgeable about people�s needs and how to meet them. We saw that care records were detailed and that staff were caring for people in a person centred way.

Reports under our old system of regulation (including those from before CQC was created)