Background to this inspection
Updated
13 January 2016
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on the 27 November and 3 December 2015, it was unannounced. The inspection team consisted of an inspector, an expert by experience and their support assistant.Our expert had experience of health and social care services.
The registered manager was available and supported the inspection process. We spoke with seven people, and three relatives. We looked at the personal care records and support plans for five people. We looked at the medicine records; activity records; and five staff recruitment records. We spoke with the registered manager, two nurses and four care staff, and observed the care interaction and staff carrying out their duties, such as giving people support at lunchtime.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks for some key information about the service, what the service does well and improvements they plan to make. We sought the views of health and social care professionals who visited the home.
Before the inspection we examined previous inspection reports and notifications sent to us by the registered manager about incidents and events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection.
At the previous inspection on 4 March 2014, the service had met the standards of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.
Updated
13 January 2016
We carried out this inspection on the 27 November and 3 December 2015, it was unannounced.
Fort Horsted is a nursing home providing accommodation for up to 30 people, some of whom are living with dementia and require nursing and personal care. All accommodation is arranged on the ground floor. The home is located in a residential area of Chatham, Kent. At the time of the inspection, 27 people lived at the service.
The service had a registered manager. A registered manager 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.
There were sufficient numbers of staff to meet people’s needs. Staff were available throughout the day, and responded quickly to people’s requests for help. Staff had the knowledge and skills to meet people’s needs, and attended regular training courses. Staff were supported by the registered manager and felt able to raise any concerns they had or to make suggestions to improve the service for people.
People demonstrated that they were happy at the service by smiling and chatting with staff who were supporting them and greeting the manager warmly. Staff interacted well with people, and supported them when they needed it.
Staff were recruited using procedures designed to protect people from unsuitable staff. Staff were trained to meet people’s needs. They met with the supervisor and discussed their work performance at one to one meetings and during annual appraisal, so they were supported to carry out their roles.
People were protected against the risk of abuse. People told us they felt safe. Staff recognised the signs of abuse or neglect and what to look out for. Both the registered manager and staff understood their role and responsibilities to report any concerns and were confident in doing so.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager understood when an application should be made. They were aware of the Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. The service was meeting the requirements of the Deprivation of Liberty Safeguards.
There were risk assessments in place for the environment, and for each person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. There were systems in place to review accidents and incidents and make any relevant improvements as a result.
People and their relatives were involved in planning their own care, and staff supported them in making arrangements to meet their health needs. Nursing staff carried out on-going checks of people’s health needs, and contacted other health and social care professionals for support and advice.
Nursing staff managed and administered medicines for people. Medicines were administered, stored, and disposed of safely. People received their medicines as prescribed.
People were provided with a diet that met their needs and wishes. Menus offered variety and choice. People said they liked the food. Staff respected people and we saw several instances of a kindly touch or a joke and conversation as drinks or the lunch was served.
Staff encouraged people to undertake activities and supported them to become more independent. Staff spent time engaging people in conversations, and spoke to them politely and respectfully.
The providers and the registered manager investigated and responded to people’s complaints. People knew how to raise any concerns and relatives were confident that the registered manager dealt with them appropriately and resolved them where possible.
There were systems in place to obtain people’s views about the service. These included formal and informal meetings; events; questionnaires; and daily contact with the registered manager and staff.
The providers and registered manager regularly assessed and monitored the quality of care to ensure standards were met and maintained. The providers and registered manager understood the requirements of their registration with the Commission.