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Archived: Finch Manor Nursing Home Inadequate

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We are carrying out a review of quality at Finch Manor Nursing Home. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Inadequate

Updated 23 January 2018

We carried out an inspection of Finch Manor Nursing Home on 30, 31 October and 6 November 2017. The first day of the inspection was unannounced.

Finch Manor Nursing 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. The home is registered to provide accommodation with support for personal or nursing care for up to 89 adults. At the time of the inspection 65 people lived at the home.

The home had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

We last inspected the service in May 2017. During this visit we identified significant breaches of the Health and Social Care Act Regulations with regards Regulations 9,10,11,12,14,16,17, 18 and 19. These breaches were assessed by CQC as serious as they placed people who lived at the home at risk of significant harm. The home was rated inadequate and placed in special measures.

Following the last inspection, we met with the provider and the manager to discuss our concerns. We asked the provider to complete an urgent action plan to show what they would do and by when to improve the service and make it compliant with the Health and Social Care Act regulations. During this visit we found insufficient improvements had been made and that the provider had failed to adhere to the urgent action plans that they had submitted to The Commission. This meant that they failed to take appropriate and timely action to mitigate the risks to people’s health, safety and welfare identified at the May 2017 inspection.

We looked at the care files belonging to 14 people. We found their needs and risks were not properly assessed or managed. Some people had new risk management and care plans in place but they still failed to provide sufficient information on how to meet people’s needs and keep them safe. Records relating to people’s day to day care did not show they received the care and support they needed for example, some people had not received sufficient nutrition and hydration and little action had been taken to address this. Some people had not been repositioned in accordance with risk management advice and some people’s health monitoring had not been undertaken to identify and respond to changes in their physical well-being. Some pressure mattress settings remained unsafe and posed a risk to people’s skin integrity.

New capacity assessments were in place for some people but not others and we found that some people’s capacity was still not properly assessed in accordance with Mental Capacity Act 2005. Some people did not have capacity assessments in place for covert medication or bed rails and some capacity assessments had already been filled in before an assessment had taken place, There were best interest information in people’s care files where decisions on people’s behalf had been taken but sometimes these lacked detail of the discussions that had taken place. One person had conditions attached to their deprivation of liberty safeguard authorisation but despite this we found that the manager and staff had not ensured these conditions were compiled with. This meant that there was a risk that the DoLS was unlawful.

Some improvements had been made with regards to the management of medication for example, stock levels of people’s medications were correct and records indicated that most people had received the medication they needed. The improvements made however were insufficient. Concerns were still identified with regards to the use of thickening agents in the drinks

Inspection areas

Safe

Inadequate

Updated 23 January 2018

The service was not safe.

Medication arrangements had improved but issues with its administration, record keeping, the use of thickeners and covert medication were identified.

People�s risks in the planning and delivery of care were still not properly assessed or managed.

Parts of the premises were in need of repair and some of the fire safety arrangements were unsafe.

New staff employed since our last inspection were recruited safely by way of appropriate pre-employment checks but some recruitment decisions did not appear robust. Staffing levels were at times insufficient to meet people needs. The feedback from people who lived at the home and their relatives with regard to whether the home was safe, were mixed.

Effective

Inadequate

Updated 23 January 2018

The service was not effective.

Some improvements had been made in the way people�s capacity was assessed but these improvements were not consistently applied. This meant some people�s care failed to adhere to the mental capacity act and deprivation of liberty safeguard legislations.

The majority of staff had completed the provider�s mandatory training programme but had not received adequate supervision or appraisal in their job role.

Systems in place to monitor and manage people�s nutrition and hydration were not robust and did not ensure people received enough to eat and drink.

The environment of the home was not dementia friendly and did not support people who lived with dementia to remain as independent as possible.

Caring

Requires improvement

Updated 23 January 2018

The service was not always caring.

People did not always have regular baths or showers to maintain their dignity or personal care needs.

Some people�s personal information was pinned up in their bedrooms and the language used in one person�s care plan was disrespectful.

Records relating to people�s care had been completed retrospectively, were not always accurate or properly completed.

Staff were kind, patient and caring in all interactions and were observed to know �the person� they were caring for.

Responsive

Inadequate

Updated 23 January 2018

The service was not responsive.

Some people�s care files now contained person centred information. This was an improvement from our last inspection.

Dementia care planning was poor. Information about how people communicated their needs and the support they required when they became distressed or agitated required improvement.

Some people�s care plans were contradictory and confusing .This placed people at risk of receiving care that did not meet their needs.

Daily records in relation to people�s care did not demonstrate that people always received the care they need to keep them safe and well.

Few activities were provided to occupy and interest people. People and relatives voiced concerns about this.

There was a complaint system in place but concerns about the quality of the food were raised again at this inspection. People�s feedback on how well the manager responded to complaints or, concerns was variable.

Well-led

Inadequate

Updated 23 January 2018

The service was not well led.

There were no effective systems or processes in place to ensure that the service was safe, effective, caring, responsive or well led.

The manager and provider failed to adhere to the urgent action plan provided to The Commission after the last inspection. This meant people continued to experience poor and unsafe care.

The manager failed to demonstrate they had the skills and competencies to manage the service. Prior to our inspection concerns had also been reported to the Commission about the negative culture of management at the home.