Florence Court Care Home

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.

Follow up

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.

Florence Court Care Home (hereafter referred to as Florence Court) is a residential home providing personal care to up to 75 people. The service provides support to older people, some of which live with a dementia. At the time of our inspection there were 20 people using the service. The home provides purpose-built accommodation over four floors providing a safe environment that meets people’s physical and social care needs.

People’s experience of using this service and what we found

People told us they felt safe. Staff understood their role in identifying and reporting concerns of abuse or poor practice. Risks to people were assessed, monitored and reviewed regularly. Staff knew people well and provided safe care whilst respecting people’s rights and freedoms. Staffing levels met people’s assessed needs. Medicines were administered safely by trained staff who had their competencies regularly checked. Infection, prevention and control measures were in line with current best practice.

Staff had an induction, on-going training and support that enabled them to carry out their roles effectively. People’s eating and drinking needs were understood and met by both the catering and care teams. People had access to healthcare and were involved in decisions about their wellbeing. The environment provided a range of spaces for both private and social time. Specialist equipment to aid people with bathing and moving and transferring was in place.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People described the staff team as kind and caring. Staff spoke positively about people and were knowledgeable about their life histories, people important to them and their lifestyle choices. People told us they felt involved in decisions about their care and day to day lives. Staff understood the importance of respecting people’s privacy, dignity and independence.

Care was person centred and respected people’s individuality. Staff were responsive to people’s changing care needs. Social activities were varied, reflected people’s interests, cultures and beliefs and included accessing the local community. People and their families felt confident to raise a complaint and felt listened to. People had an opportunity to talk about their end of live wishes. Staff worked in partnership with GP’s and community nurses ensuring people’s end of life needs were met.

The culture of the home was described as friendly, open and inclusive. People, their families and the staff team had opportunities to share their views and have a voice. Staff spoke positively about their work and were focused on providing person centred care to people living at Florence Court. Quality assurance processes were multi layered and effective at driving and sustaining improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 3 August 2021 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.