Archived: Fort Horsted Nursing Home

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.

People who used the service or their representatives had been involved in discussions about whether they wished to have their bedroom doors open or closed, both in the day or during the night, if they were in or out of their rooms. Staff who we spoke with understood the importance of protecting people's privacy and dignity. They told us, "We always ask them if they want their door open or closed." "We always make sure the door is closed when we are doing personal care". This meant that people's privacy and dignity were protected in accordance with their individual preferences.

People were not always involved in planning their care and treatment, they were treated with respect, however their privacy and dignity was not always protected.

People received care and support that was well planned and sensitively delivered.

People received the medicines they needed when they needed them.

Robust recruitment and selection procedures ensured that people were cared for by suitable staff.

Effective quality assurance procedures ensured that people were provided with a good service.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance with four of the standards we inspected.

We have set a compliance action requiring the provider to produce a report setting out how and by when changes will be made to make sure people's privacy and dignity is protected.

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People told us, "They always treat me with respect and I can choose what I want to do. I like to stay in my room, they bring me my meals here" "They do their best to do things the way I like.' All the people we spoke with told us they were very comfortable in the home. They said, "The staff are very good." "I have no complaints." People told us staff helped them with their medicines and brought them to them at the times they needed them. People we spoke positively about the management and staff at the home. They said, "Everyone is very kind."