Fourways Residential Home

Updated 7 February 2023

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. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Fourways Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fourways Residential Home is a care home without] nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for one month and had applied to become registered. We are currently assessing their application. Throughout this report they are referred to as the manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we already held and had received about the service since the time of the last inspection. We sought feedback from the local authority, safeguarding team and other professionals who work with the service. We checked information held by the fire service, environmental health officer, Companies House, the Food Standards Agency and the Information Commissioner’s Office. We checked for any online reviews and relevant social media, and we looked at the content of the provider’s website. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people and 3 relatives. We observed people’s care and staff interaction with them. We spoke with 13 members of staff, including the manager, deputy manager, nominated individual (assistant director) the chef, activities coordinator, 3 senior care assistants, 3 care assistants and a cleaner. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the provider (director). We asked staff to share their experience about working at the home. We reviewed a range of digital records including 14 people’s care records and medicines administration records. We inspected 3 personnel files of staff who had been recruited since the last inspection. We also looked at a variety of documents relating to the management and quality assurance of the service, including policies and procedures were also reviewed. We wrote to the home manager and nominated individual after the site visit and requested some further information. After the site visit we continued to seek clarification from the provider to validate evidence found. We spoke with 4 relatives and 4 health and

Updated 7 February 2023

About the service

Fourways Residential Home is a care home without nursing that provides personal care for up to 20 older people, some of whom may be living with dementia. At the time of our inspection there were 14 people living at the service, two of whom had been admitted to receive respite care. The care home, which is set in a residential area, accommodates people in one adapted building, arranged over two floors. There was a communal lounge and a communal dining area on the ground floor. There was a substantial garden at the rear of the building.

People’s experience of using this service and what we found

People experienced safe care from staff who had been trained to protect them from abuse and avoidable harm. Risks to people were assessed, monitored and managed safely, whilst promoting their freedom and independence. The manager deployed enough suitable staff with the right mix of skills, competence and experience to meet people’s needs safely. We observed some discrepancies regarding medicines management, which the manager immediately addressed. Staff consistently applied good infection control and food hygiene practices. Staff were encouraged and supported to raise concerns and report incidents and near misses, The manager or deputy manager reviewed these incidents daily and took action to reduce the risk of future recurrence.

Assessments of people’s needs were comprehensive, identified expected outcomes and were reviewed and updated regularly to ensure they reflected people’s changing needs. The management team supported staff to maintain their professional skills and worked well with partners to make sure staff were trained to follow best practice. People were encouraged to eat a healthy balanced diet and staff effectively monitored the risks associated with poor hydration and nutrition. The management team made timely referrals to relevant professionals and services and staff acted swiftly on their recommendations to achieve good outcomes for people. The manager had sought and implemented guidance from a recognised source to adapt the environment to improve people’s quality of life and promote their wellbeing.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The manager and deputy manager inspired staff to be committed to delivering care and support that treated people with compassion, kindness dignity and respect. Staff anticipated people’s needs and quickly recognised when people were in pain, distress and discomfort and provided sensitive and respectful care. Staff supported people to be fully involved in decisions about their care.

People were empowered to make choices and have as much control and independence as possible. Staff enabled people to carry out person-centred activities, hobbies and interests, and supported them to maintain relationships that matter to them. Staff actively promoted companionship within the home. Complaints were dealt with in an open and transparent way and used identified learning to improve the quality of the service. People were sensitively supported to make decisions about their preferences for end of life care. Staff had received additional training to support people who required end of life care.

The management team promoted a strong caring, person-centred culture where people and staff felt valued. Staff were passionate about their role and consistently placed people at the heart of the service. The service involved people, their family, friends and other supporters in a meaningful way. The manager understood their responsibilities to inform people when things went wrong and the importance of conducting thorough investigations to identify lessons learnt to prevent further occurrences. The manager and deputy manager operated robust measures to monitor quality, safety and the experience of people within 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 and update

The last rating for this service was requires improvement (report published 21/04/2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We carried out an unannounced inspection of this service on 24 March 2022. Six breaches of legal requirements were found in relation to person-centred care, safe care and treatment, nutritional and hydration needs, premises and equipment, good governance and staffing. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this comprehensive follow up inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report covers our findings in relation to the Key Questions Safe, Effective, Caring, Responsive and Well-Led which contain those requirements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fourways Residential Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.