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Fountain Nursing and Care Home Limited Good

All reports

Inspection report

Date of Inspection: 7 August 2013
Date of Publication: 4 October 2013
Inspection Report published 04 October 2013 PDF

There should be enough members of staff to keep people safe and meet their health and welfare needs (outcome 13)

Not met this standard

We checked that people who use this service

  • Are safe and their health and welfare needs are met by sufficient numbers of appropriate staff.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 7 August 2013, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members, talked with staff and were accompanied by a specialist advisor.

We were supported on this inspection by an expert-by-experience. This is a person who has personal experience of using or caring for someone who uses this type of care service.

Our judgement

There were insufficient qualified, skilled and experienced staff to meet people’s needs.

Reasons for our judgement

There were insufficient appropriately skilled members of staff available to meet people’s needs.

We found that 23 people were living at this care home at the time of our inspection and they were being supported by one nurse and five care staff. The manager of the care home was also on duty together with a cook, a domestic and laundry staff.

Most people who used the service needed support with all of their personal care and social activities and had serious mobility disabilities. All but one person was unable to mobilise without assistance from care staff.

We found that the numbers of staff on duty reflected the planned staffing roster for the day (one nurse and five care assistants) and that the same level of staffing was planned for later in the day. At night, the duty roster indicated that there would be one nurse on duty together with two care assistants.

Systems were not in place to monitor and review people’s needs so that effective staffing levels are maintained. We asked the manager how she ensured that there was sufficient members of staff on duty at all times to meet the needs of people living in the home. We were told that levels of staffing had been assessed carefully and were determined by the numbers of people residing at the home and their personal needs. However when we asked for details of this assessment, we were told that there was no report, documentation or analysis available to demonstrate how staffing levels had been determined to ensure they were appropriate.

We spoke with four care staff and a nurse who worked at this care home. We found that care staff reflected the culture and gender of people using the service and that they had a good knowledge of all the people living in the home and their personal needs. Some members of staff told us that at certain times of the day, particularly in the morning, it was very busy helping people to get up, dressed and have their breakfasts. Comments included, “It’s too busy in the mornings” and “Lack of staff is an issue here.”

We observed people and their interaction with care staff in the communal areas of the care home. We saw that there was little interaction with people in the morning. We saw several people arrive for their breakfast after 9am. The last person to arrive for breakfast arrived at 10.15am. During our observations we noted that one person was kept waiting for more than an hour to be relocated to one of the lounge areas after she had finished eating her breakfast. We also saw that people who lived at the home were exposed to long periods of inactivity.

We spoke to people who lived at the home about the care staff and the level of service they provided. People were generally complimentary about the care staff but told us that there were insufficient members of care staff available to support them. Comments included, “The staff are okay to me, they are kind but there are not many to look after me” and “There’s not enough staff to look after me, I want to get up earlier but I have to wait” and “I rarely see staff except at meal times.”

We checked training records and found that care staff had received regular and relevant training and had the skills and knowledge to meet people’s individual needs.

We observed care staff use some ‘moving and lifting’ techniques during the day of our inspection. Some of these were inappropriate and unsafe and could have caused injury to themselves and discomfort to the people they were supporting. This meant that some staff did not have the required skills in order to provide safe care and support.

In order to safeguard the health and safety of people who use the service, the registered provider must take appropriate steps to ensure that, at all times, there are sufficient numbers of suitably qualified, skilled and experienced staff on duty to meet people’s needs. We found that although most staff were suitably qualified, skilled and experienced, that there were not always sufficient numbers on duty to safegu