Background to this inspection
Updated
10 October 2020
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act.
This was a targeted inspection to check whether the provider had met the requirements of the requirement notice in relation to Regulation 12 (Safe care and treatment) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. As part of this inspection we looked at the infection control and prevention measures in place. This was conducted as part of our Thematic Review of infection control and prevention in care homes.
Inspection team
The inspection was carried out by one inspector.
Service and service type
Fairmount Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The registered manager has left. A new manager has been appointed and is in the process of applying for registration with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
The inspection was announced at short notice. Due to the COVID-19 pandemic, we needed to check the COVID-19 status of the home and make arrangements to enter the home safely to reduce the risk of infection transmission. Inspection activity started on 11 August 2020, we visited the service on 26 August 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority commissioning and safeguarding teams and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We looked around the home and observed care. We spoke with three members of staff including the manager, deputy manager and a senior care worker. We looked at elements of three people’s care records, this included medication records and risk assessments. We looked at records relating to infection control and COVID-19 management.
After the inspection
We spoke with a relative and a health care professional about their experiences of the service.
Updated
10 October 2020
About the service:
Fairmount Nursing Home provides accommodation, care and support for up to 37 people over 65 years old including people living with dementia, people receiving end of life care and people on respite care. There were 31 people living at the service on our first inspection day and 30 people on the second.
People's experience of using this service:
People and relatives told us they had a positive experience with the care provided. One person said, “I would highly recommend this place to anyone, they are always pleasant and when I ask for something I get it.”
We found the service had deteriorated in the safe domain and continued requiring improvement in the well led domain since our last inspection. The service met the characteristics of requires improvement in two out of the five key questions. This was the first time this service is rated as ‘requires improvement.’
We found one breach of the regulations in relation to safe care and treatment because of risks to people due to inconsistencies in the management of medicines and management of some risks to people's care.
At this inspection, we found improvements were still required in how the service was managing people’s medicines. Medication was administered in a kind and person-centred way however, we found inconsistencies in the administration of thickeners prescribed to manage people’s swallowing difficulties and records did not always confirm time specific medication had been administered as required.
The management of risks was not always consistent. We found concerns with the support people were receiving with their moving and handling requirements. We could not be certain people who required specialist seating equipment to meet their postural and pressure relief needs were using the appropriate equipment.
There was a regular and varied programme of activities at the home and people spoke positively about the activities coordinator. However we found people, in particular those living with dementia, spent periods of time without being offered social stimulation.
The provider had several systems in place to monitor the quality of the service, but these had not always been effective in identifying or addressing the issues found at this inspection.
People and relatives spoke positively about the relationships established with staff. People’s care plans were personalised, however this information was not always kept secure. We made a recommendation about respecting people’s rights to dignity and privacy.
People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervisions and training.
The provider had developed several links with the community and partnerships to support care provision and service development.
Feedback from people, relatives and staff was positive and they felt the service was well-led. They told us the management team were always available to speak with and were approachable. The registered manager was responsive in addressing the issues found at this inspection and told us about plans they had to improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At our last inspection the service was rated Good (report was published on 28 October April 2016).
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We will continue to monitor the service to ensure that people received safe, high quality care.
Further inspections will be planned for future dates.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk