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Foxton Grange Requires improvement

Reports


Inspection carried out on 26 February 2019

During a routine inspection

About the service: Foxton Grange is a care home that was providing personal and nursing care to 27 people living with dementia aged 65 and over at the time of the inspection.

People’s experience of using this service:

¿There had been several different managers since our last inspection in 2016 which had impacted on the stability of the home and staff morale.

¿Action plans to address shortfalls identified through the systems in place to monitor the quality and performance of the service, had not always been completed in a timely way.

¿Care plans needed to be improved to enable staff to provide care in a more person-centred way.

¿Complaints had not always been addressed within the timescales laid down in the providers policy.

¿Staff were friendly, passionate about their work and caring; they treated people with respect, kindness, dignity and compassion.

¿People developed positive relationships with staff.

¿People were protected from the risk of harm and received their prescribed medicines safely.

¿Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

¿ Staff had access to the support, supervision and training that they required to work effectively in their roles.

¿People were supported to maintain good health and nutrition.

¿Staff knew their responsibilities as defined by the Mental Capacity Act 2005 (MCA 2005). The provider was aware of how to make referrals if people lacked capacity to consent to aspects of their care and support and were being deprived of their liberty.

¿Information was provided to people in an accessible format to enable them to make decisions about their care and support.

¿The service met the characteristics for a rating of “good” in three of the five key questions we inspected and rating of “requires improvement” in two. Therefore, our overall rating for the service after this inspection was “requires improvement”.

More information is in the full report

Rating at last inspection: Good (report published 16 September 2016)

Why we inspected: This was a scheduled inspection based on previous rating.

Follow up: We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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

Inspection carried out on 28 July 2016

During a routine inspection

This was an unannounced inspection that took place on 27 July 2016.

Foxton Grange is registered to provide personal care and nursing home. It is situated in Leicester and accommodates up 36 older people, some of whom are living with dementia. At the time of our inspection there were 33 people using the service.

At the time of our inspection the service did not have a registered manager. This 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. A manager was in post and told us they intended to apply to CQC to become the next registered manager.

During our inspection the people using the service were relaxed, comfortable and safe. Staff supervised people discreetly and were quick to provide support and reassurance when it was needed. Staff understood the importance of protecting the well-being of people who might not be able to say if something was wrong.

The design and layout of the premises contributed to people’s safety. All areas were bright, clean and uncluttered. Communal areas led onto secure, enclosed gardens. We saw people enjoying these safely both on their own and with staff.

There were enough staff on duty to keep people safe and meet their needs. Staff had time to interact and socialise with people as well as providing personal and nursing care. At no time was anybody left waiting for assistance or treated in any way that would compromise their safety.

Prior to our inspection there had been some issues with medication management at the service. These were in the process of being resolved. Staff were working to an action plan and audits showed continual improvement in medicines safety over the last three months.

The staff were well-trained and understood people’s needs and individual preferences. They gave us examples of how they provided flexible care to fit in with people’s individual routines. For example if a person did not want to eat at a particular time staff served their meal at the time they chose. This approach gave people the freedom to decide what they wanted to do and when.

Staff treated people with care and kindness. They used different ways of enhancing that communication, for example by touch, ensuring they were at eye level with a person who was seated, and by altering the tone of their voice appropriately. They told us they liked working at the service because they had the opportunity to get to know and spend time with the people they supported.

People’s records and the care provided were personalised. Each person had a document called ‘My Life Story’ which included information on their background, family, work, and important life events. It also listed their favourite things including food, drinks, music, books, films, and clothes. It set out their care preferences and helped staff to provide care in the way people wanted it.

People told us they enjoyed the activities provided at the service. These were available every day, including weekends, on a group and one-to-one basis. One of the activities coordinators told us baking and exercise classes were especially popular with people. Music therapy sessions were provided twice a week and a visiting entertainer came once a month to hold a group concert.

There was a positive and calm atmosphere at the service. Staff were kind and helpful. They constantly interacted with the people using the service and included them in conversations and activities. The manager told us relatives were central to quality assurance as the people using the service were not always able to give their views due to their mental health needs. The manager had recently met with relatives to get their views on the service and whether any changes were needed

There were arrangements in place to regularly assess a

Inspection carried out on 4 and 8 August 2014

During a routine inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

Foxton Grange is situated to the north-east of Leicester city. It accommodates up 36 people living with dementia. When we visited there were 32 people living at the home.

There was a registered manager in post at the time of this unannounced inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People were safe at the home and staff knew what to do if they had any concerns about their welfare. Records showed staff had thought about people’s safety and how to reduce risk. They also knew how to protect people under the Mental Capacity Act Deprivation of Liberty Safeguards (MCA DoLS).

People told us they felt safe at the home and comfortable with the staff. Relatives said their family members were well-cared for and respected as individuals. Staff worked well with people whose behaviour was, at times, challenging and knew how to comfort and reassure them.

There were enough staff on duty to meet people’s needs. Staff had the skills and knowledge they needed to provide effective care. They also had time within their working day to socialise with people and support them with their hobbies and interests.

The food was home-cooked and prepared in the way people wanted it. Staff knew people’s likes and dislikes and menus reflected these. People were supported to have a balanced diet and to have plenty to drink. Dieticians were involved If people needed extra help with nutrition and hydration.

People’s preferences were central to how their care was provided. They had access to health care professionals when they needed it. Staff took prompt action if there were any concerns about a person’s health.

The staff were caring and we saw many examples of staff communicating with people in a kind and sensitive way. Activities were a big part of life in the home and included music and drama therapy, visiting entertainers, trips out, and cookery. One-to-one activities were provided for people who preferred these, including swimming and hand massages.

People were involved in making decisions about their care, treatment and support. Staff knew their personal histories, likes, dislikes, and preferences. This meant staff got to know the people they supported and provide appropriate care. The home welcomed and catered for people from a range of cultural backgrounds.

The manager was friendly and approachable and knew the people who used the service and their relatives well. She listened and acted when people made suggestions about improving the service. The quality of the service was monitored and the people who used the service, relatives, and staff were central to that process.

Inspection carried out on 4 April 2013

During a routine inspection

Most of the people who used the service were unable to give their views due to illness or disability. However we talked to relatives, and observed people being cared for by the staff at Foxton Grange.

Relatives told us the care at Foxton Grange was good and staff catered for the individual needs of the people who used the service. One relative said, �My relative has her hair done, her nails done, and a bubble bath twice a week.� Another commented, �The chef is really good and knows just what my relative likes. Soft food is presented beautifully � the vegetables are all done separately and the mashed potatoes are piped.�

Relatives said they thought the home had good staffing levels and a good staff team. One relative told us, �The staff here have always put the residents first and the care has always been excellent.� Another said, �The staffing seems better organised and I�ve never seen any residents left alone. Staff morale has improved and it�s nice to see the staff laughing and joking.�

Relatives also told us staff worked well with people who suffered from dementia. One relative told us, �The manager and deputy are both first class nurses and understand dementia care very well.� Another commented, �The carers are very good with confused residents. They are patient and gentle. They are always sitting with my relative and talking to her.�

Reports under our old system of regulation (including those from before CQC was created)