We carried out a review of the data available to us about Fosse House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Fosse House, you can give feedback on this service.
We found the following examples of good practice.
Where visits were being provided at the service, there were robust infection control procedures in place. Visitors were provided with guidance, personal protective equipment (PPE) and completed testing for COVID-19. Where applicable, their COVID-19 vaccination status was also checked.
The service had a process in place to ensure safe admissions. Any admission was carefully planned, with periods of isolation being completed where required and in accordance with guidance.
Risks to people and staff in relation to their health, safety and wellbeing had been assessed. There was support for staff in place which included training, guidance and access to additional support at provider level.
All staff working at the service had been fully vaccinated against COVID-19 or had declared themselves medically exempt. The provider had introduced a process to ensure that staff met the vaccination requirements and had provided evidence to their satisfaction.
Fosse House 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
Fosse House is a care home without nursing registered to provide accommodation and personal care for up to 81 older people. At the time of this inspection 76 people were accommodated at Fosse House.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
When we last inspected the service in June 2016 the service was rated as Good. At this inspection we found that standards had been maintained and in one area further improvements had been made to provide outstanding experiences for people who lived at Fosse House. The staff team had worked tirelessly to provide people with excellent opportunities to enjoy personalised activities and outings as well as experience new things that they had only ever dreamt of previously. The registered manager and staff team demonstrated a 'can do' attitude to ensuring people enjoyed opportunities for engagement and stimulation. The provider had arrangements to receive feedback from people who used the service, their relatives, external stakeholders and staff members about the services provided. People were confident to raise anything that concerned them with staff or management and were satisfied that they would be listened to.
People felt safe living at Fosse House. Staff understood how to keep people safe and risks to people's safety and well-being were identified and managed. The home was calm and people's needs were met in a timely manner by sufficient numbers of skilled and experienced staff. The provider operated robust recruitment processes which helped to ensure that staff employed to provide care and support for people were fit to do so. People's medicines were managed safely.
Staff received regular one to one supervision from a member of the management team which made them feel supported and valued. People received the support they needed to eat and drink sufficient quantities and their health needs were well catered for with appropriate referrals made to external health professionals when needed.
People and their relatives complimented the staff team for being kind and caring. Staff were knowledgeable about individuals' care and support needs and preferences and people had been involved in the planning of their care where they were able. Visitors to the home were encouraged at any time of the day.
There was an open and respectful culture in the home and people, their relatives and the staff team were comfortable to speak with the registered manager if they had a concern. The provider had arrangements to regularly monitor health and safety and the quality of the care and support provided for people who used the service.
Fosse House is a purpose built residential care home. It provides accommodation and personal care for up to 81 older people, some of whom live with dementia. The home is comprised of residential, dementia care and enablement units spread over two floors where staff provide care and support for people with varying needs and levels of dependency. At the time of our inspection there were 78 people living at the home.
There is a manager in post who is in the process of registering with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.
Robust and effective recruitment processes were used to ensure that all staff employed at the service were of good character and had the skills, abilities and experience necessary to do their jobs.
There were sufficient numbers of staff available who were deployed in a consistent and effective way across the home. Staffing arrangements reflected and took account of people’s individual needs and levels of dependency which meant that care and support was provided in a calm and patient way.
People told us they felt safe at the home. Staff received training in how to safeguard people against the risks of abuse and knew how to report any concerns they had, both internally and externally if the need arose.
Appropriate steps were taken to ensure that identified risks to people’s health, safety and well-being were mitigated in a safe and effective way that promoted their independence. Accidents, falls and injuries were recorded and investigated thoroughly to identify emerging risks, patterns and trends.
Medicines were stored, administered and managed safely. People were supported by trained staff to take their medicines on time and in accordance with prescriber’s instructions.
Plans and guidance were in place to help staff deal with unforeseen events and emergencies. Fire and other safety equipment was checked and tested regularly to keep people safe. Personal evacuation plans, tailored to people’s individual health and mobility needs, were in place for everybody who lived at the home.
Staff obtained people’s consent before providing the day- to- day care and support they required.
The service acted in accordance with the requirements of the MCA 2005 where appropriate and people were fully involved in ‘do not attempt cardio pulmonary resuscitation’ (DNACPR) decisions. However, people’s consent and agreement to their care and support was not always accurately reflected in their plans of care.
People, relatives and health care professionals were positive about the skills, experience and abilities of permenant care staff who received the training, supervision and support they needed to perform their roles effectively.
People were supported to eat a healthy balanced diet that met their individual needs and dietary requirements. Menu choices and alternatives were available at mealtimes and people were given appropriate levels of support by staff who were familiar with their personal preferences.
Staff met people’s day-to-day health and welfare needs in a safe and effective way and they were supported to attend appointments and to access specialist health and social care services where necessary and appropriate.
People were cared for and supported in a kind and compassionate way by staff who clearly knew them well and respected their privacy and dignity. Information about people’s medical histories was held securely and in a way that maintained confidentiality. People and relatives were involved in the planning and reviews of the care received. However, this was not always accurately reflected in their individual plans of care.
People received personalised care and support that met their individual needs and took full account of their preferences and personal circumstances. However, individual plans of care did not always contain sufficient information about people’s backgrounds and life histories. Opportunities were provided for people to take part in a wide range of activities relevant to their needs and interests.
Complaints, concerned and issues raised by people who lived at the home and their relatives were responded to in a prompt and positive way. People knew how to complain and told us their views about the service and how it operated were taken into account.
People who received a service, relatives, staff and health care professionals were positive about the new manager and leadership arrangements at the home. Staff were clear about their roles and responsibilities and told us they felt valued and well supported.
Although effective systems were used to monitor risks and quality assure the services provided, people’s individual plans of care were not always as complete or up to date as they should have been. The manager is aware of this and has taken steps to make the improvements required in this area.
The inspection took place on 18June 2015 and was unannounced. At our last inspection on 04 July 2013, the service was found to be meeting the required standards. Fosse House is a purpose built residential care home. It provides accommodation and personal care for up to 81 older people, some of whom live with dementia. The home is comprised of residential, dementia care and enablement units spread over two floors where staff look after people with varying needs and levels of dependency. At the time of our inspection there were 76 people living at the home.
There is a manager in post who has registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.
The CQC is required to monitor the operation of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are put in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of the inspection we found that some people had aspects of their freedoms restricted. It was unclear in some cases as to whether appropriate applications had been made in full compliance with the DoLS and relevant requirements of the MCA 2005.
Staff obtained people’s consent before providing the day to day care they required. However, where ‘do not attempt cardio pulmonary resuscitation’ (DNACPR) decisions were in place, we found that some had not been made with the proper consent of the people concerned or in line with the MCA 2005.
People told us they felt safe at the home. Staff had received training in how to safeguard people against the risks of abuse. However, not all staff knew how to report concerns externally.
We found that the effectiveness of staff deployment lacked consistency across different units at the home. In some units we saw there were sufficient numbers of staff to meet people’s needs promptly in a calm and patient way. However, in ‘Swallow’ unit on the first floor we found there were often insufficient staff to cope with the demands placed upon them.
Safe and effective recruitment practices were followed to check that staff were of good character, physically and mentally fit for the role and able to meet people’s needs. We saw that plans and guidance had been put in place to help staff deal with unforeseen events and emergencies.
People were positive about the skills, experience and abilities of the staff who supported them. We found that staff had received training and refresher updates relevant to their roles. Staff had regular supervisions to discuss and review their performance and professional development.
We found that people had not always been supported to take their medicines safely or as prescribed. People’s health needs were not met in a safe and effective way in all cases. The environment and equipment used, including mobility aids and safety equipment, were well maintained and kept people safe.
People expressed mixed views about the standard and choice of food provided at the home. We saw that the meals served were hot and that people were regularly offered a choice of drinks. However, although care staff were familiar with people’s dietary requirements, we found that the information was not always shared with the chef in an effective way.
People had access to health care professionals when necessary. However, we found that their health needs had not always been met in a safe and effective way.
Most people told us they were looked after in a kind and compassionate staff who knew them well. However, we found some examples of where support was provided in a way that did not respect or promote people’s dignity. We also found that the quality of care provided often lacked consistency across different units and floors at the home. In some areas we saw that staff provided support in a patient, calm and reassuring way that best suited people’s individual needs. In other areas for example in the ‘Swallow’ unit on the first floor, staff appeared rushed and did not interact with people in a positive or caring way.
People had access to information and guidance about local advocacy services. Information contained in records about people’s medical histories was held securely and confidentiality sufficiently maintained. Although not always obvious in the guidance given to staff, people and their relatives told us they were involved in the planning, delivery and reviews of the care provided.
People told us they received personalised care that met their needs and took account of their preferences. We found that most staff had taken time to get to know the people they supported and were knowledgeable about their likes, dislikes and personal circumstances. However, we found that the guidance and information provided about people’s backgrounds and life histories was both incomplete and inconsistent in many cases.
People expressed mixed views about the opportunities available to pursue their social interests or take part in meaningful activities relevant to their individual needs. We saw that where complaints had been made they were recorded and investigated properly. People and their relatives told us that staff listened to them and responded to any concerns they had in a positive way.
People were positive about the management and leadership arrangements at the home. However, we found that the methods used to reduce risks, monitor the quality of services and drive improvement were not as effective as they could have been in all areas.
At this inspection we found the service to be in breach of Regulations 11, 12, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
We found that the home was meeting the standards we had inspected. People's needs had been assessed and were being met appropriately. There was a system for the administration and management of medicines. There were sufficient numbers of staff on duty to meet the needs of people and there were systems in place to assess and monitor the quality of service.
lives and said 'You can please yourself when you get up and go to bed' and 'The staff
are good with your dignity and they are respectful.'
A relative told us that the care as it is now is absolutely fine and that staff have been very attentive to their relative. They said "There are some really good people working here."
A visiting health professional with whom we spoke praised the staff saying they were "very helpful and friendly, informative, they had a good rapport and relationship and that it "works like clockwork."
Relatives told us they were confident that people were safe living in Fosse House. One person said "I believe my relatives are absolutely safe here."
Relatives had very positive views about the staff team. They told us: "They are absolutely brilliant here, you can just tell it comes from the heart, it's very reassuring." and "There is always someone here to talk to if we need to, they drop everything to talk to us" and "The manager has been fantastic since she's been here."
Relatives with whom we spoke confirmed that they received annual assurance questionnaires for them to complete, they were confident that any identified shortfalls were addressed immediately. One person said "we have certainly got no complaints."