Background to this inspection
Updated
19 April 2019
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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team:
The inspection team consisted of one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type:
Fabee Nursing Home 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.
Fabee Nursing Home accommodates up to 17 people in one adapted building. At the time of the inspection there were 12 people living there. People living at the home had a range of needs. Some were associated with old age and frailties associated with old age. Other people had more complex health needs which included diabetes and stroke. Some people were living with a dementia type illness.
The service had a manager registered with the Care Quality Commission. The manager was also the provider and is legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection:
The first day of this inspection was unannounced.
What we did:
Before the inspection:
¿ We reviewed the information, we held about the service and the service provider.
¿ The registered provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
¿ We looked at the notifications we had received for this service. Notifications are information about important events the service is required to send us by law.
During the inspection:
¿ We reviewed the records of the home. These included three staff recruitment files, training, medicine and complaint records. Accidents and incidents, quality audits and policies and procedures along with information about the upkeep of the premises.
¿ We looked at five care plans and risk assessments along with other relevant documentation to support our findings. This included ‘pathway tracking’ two people living at the home. This is when we check that the care detailed in individual plans matches the experience of the person receiving care. It is an important part of our inspection, as it allows us to capture information about a sample of people receiving care.
¿ We spoke with seven people who lived at the home, three visitors and ten staff members, this included the provider. We also spoke on the telephone to three people’s relatives and one healthcare professional.
¿ We spent time observing people in areas throughout the home and could see the interaction between people and staff. We watched how people were being cared for by staff in communal areas. This included the lunchtime meals.
Updated
19 April 2019
About the service: Fabee Nursing Home is a residential care home that was providing personal and nursing care for up to 17 older people. People living at the home had a range of needs. Some were associated with old age and frailties associated with old age. Other people had more complex health needs which included diabetes and stroke. Some people were living with a dementia type illness.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
People’s experience of using this service:
¿ We found some improvements were needed to people’s records to ensure they contained all the information about people and fully reflected their care and support needs.
¿ People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, information about how decisions had been made had not been recorded. We identified this to the provider as an area that needs to be improved.
¿ Improvements were needed to some aspects of the audit and monitoring system. As improvements to people’s records and information about people’s capacity had not been identified by the provider.
¿ Other aspects of the audit system identified areas for improvement and these were addressed in a timely way.
¿ People and their relatives told us they felt safe at the home. Staff had a good understanding of the risks associated with the people they supported. Risk assessments provided further information for staff about individual and environmental risks. People were protected from the risks of harm, abuse or discrimination because staff knew what actions to take if they identified concerns. The home was clean and tidy throughout.
¿ People were supported to receive their medicines when they needed them. There were enough staff working to provide the support people needed, at times of their choice. Recruitment procedures ensured only suitable staff worked at the service.
¿ People's health and well-being needs were met. They were supported to have access to healthcare services when they needed them. Staff received training that enabled them to deliver the support that people needed. Staff received support from the provider and their colleagues. People's dietary needs were assessed and people received the support they needed with their meals.
¿ Nurses completed clinical training which reflected the needs of people in the home. Nurses also completed revalidation with the Nursing and Midwifery Council (NMC) to help demonstrate they maintained their knowledge and skills.
¿ People were supported by staff who treated them with kindness, respect and compassion. Staff understood people’s needs, choices and histories and knew what was important to each person. People were enabled to make their own decisions and choices about what they did each day.
¿ People received support that was person-centred and met their individual needs, choices and preferences. People’s engaged in a range of activities that they enjoyed and were meaningful. Complaints had been recorded, investigated and responded to appropriately.
Rating at last inspection:
¿ Requires improvement. (Report published 20 March 2018). At our last inspection, there were four breaches of the regulations. The provider sent us an action plan and told us how they would address these issues.
¿ At this inspection we found these regulations had been met. However, improvements were needed in the key question well-led. The overall rating for the service is now good.
Why we inspected:
¿ This was a planned inspection based on the rating at the last inspection.
Follow up:
¿ We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.