Florence Court Care Home (hereafter referred to as Florence Court) is a residential care home providing accommodation and personal care to up to 75 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 32 people using the service. The home provides purpose-built accommodation over 4 floors with 2 currently in use.
People’s experience of using this service and what we found
People and their relatives told us the service provided good care and people’s needs were met by caring staff.
Since October 2022 the home had experienced an infestation of flies, and this had posed risks to people’s health and wellbeing. We found these risks had not been robustly assessed and this had placed people at risk of harm.
Other risks to people’s health and wellbeing had not always been assessed to ensure action had been taken to mitigate these. Where action had been identified to support the management of risks, these had not always been completed.
Skin injuries had not always been recognised or investigated as incidents of possible abuse. Safeguarding incidents had not always been reported to the local authority or to CQC. We found no evidence that people had been abused, but the procedures in place to protect people from abuse were not robust.
People were not always supported to have maximum choice and control of their lives. Staff supported people in the least restrictive way possible. However, it was not always evident decisions had been made in people's best interests in line with the Mental Capacity Act (MCA). We have made a recommendation about the application of the MCA.
The provider has acted to make improvements and was working with the local authority and others, including environmental health, to promote the safety of people using the service.
There were enough staff to meet people’s needs. People’s medicines were managed safely.
Quality assurance systems were in place but had not been effective in identifying the concerns we found. The governance approach to risk management had been limited and had not involved all stakeholders in a timely way. Decisions about people’s care when they lacked capacity were not always recorded to show their best interests had been considered. Whilst relatives we spoke with were happy with the care their relatives received, there was some dissatisfaction with the feedback from the service to concerns raised about the infestation. Not all serious incidents had been reported to the CQC as required.
The registered manager took action to address the shortfalls we found and is engaged in an improvement process, supported by the provider and local authority health and social care professionals.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was good (published 23 December 2022).
Why we inspected
We undertook a targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about risks to people from infection prevention and control concerns. A decision was made for us to inspect and examine those risks. We inspected and found there was a concern with the management of these risks, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement and Recommendations
We have identified breaches in relation to safeguarding, risk management, governance, and notification of incidents to CQC at this inspection.
Please see the action we have told the provider to take at the end of this report.
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.