• Care Home
  • Care home

Archived: Foxhill Manor Nursing Home

Foxhill Road, West Haddon, Northampton, Northamptonshire, NN6 7BG (01788) 510262

Provided and run by:
Mr Ramsamy Nullatamby

All Inspections

2, 10 June 2014

During a routine inspection

The registered provider and manager at Foxhill Manor Nursing Home is Mr Ramsamy Nullatamby. Mr Nullatamby is currently in day to day control of the regulated activities at Foxhill Manor. On 23 July 2013, we were advised that Grant Thornton UK LLP had been appointed as trustee for Mr Nullatamby with regard to the financial management of Foxhill Manor Nursing Home.

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; is the service caring? is the service responsive? is the service safe? is the service effective? is the service well lead?

This is a summary of what we found-

Is the service safe?

We found that some of the people who lived at Foxhill Manor Nursing Home engaged in high risk activities which had the potential to impact on themselves and others. Whilst these activities promoted people's independence there were no documented risk assessments to show how the risks were to be reduced or managed.

We also identified serious concerns relating to the safety of the environment. For example two of the bedrooms on the second floor had broken windows and one of the bathroom doors was hanging off its hinges. There was a lack of hot water in some of the bedrooms and bathrooms. We found that temperatures the temperature dispensed in the second floor shower and the ground floor bathroom ranged between 54 and 56 degrees Celsius which put people at risk of scalding. In addition the provider told us that the cooker was unsafe but they had continued to use it. We referred our concerns about unsafe water temperatures to the Health and Safety Executive.

Infection control systems were not in place, we looked at 12 of the 17 bedrooms and found the standard of cleanliness was poor; as were the communal bathrooms and two of the corridors. We found that two of the three communal wheel chairs had not been maintained in a clean and hygienic state nor were they maintained in good working order. We also found that some of the important fire safety checks had not been completed; we referred our concerns to the Fire Safety Officer.

We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to Care and welfare, Cleanliness and infection control, Safety and suitability of the premises and Safety, availability and suitability of equipment.

Is the service effective?

All of the people living at Foxhill Manor had an individual plan of care; these had been regularly reviewed to ensure that they contained appropriate information.

We saw people were comfortable and relaxed within their environment; in general people looked well cared for and were dressed according to their age; gender, culture and the weather conditions. We saw that people had access to a range of aids and adaptations to support their independence and mobility.

People had access to a range of activities which some people were able to engage with however people with access to board games and building blocks did not engage with them until staff supported them to do so; suggesting that these pastimes did not relate to their previous life experiences.

We saw that staff were responsive to people's individual needs; were protective of their privacy and dignity and used effective movement handling techniques.

We saw that people who were at an increased risk of the effects of pressure had access to pressure relieving equipment. We also saw that people assessed as being at nutritional risk were weighed regularly and had access to nutritional supplements and the NHS Dietetic Service. We also saw that people had access to general practitioners, district nursing services, community psychiatric nurses, podiatrists, dentists, opticians and other NHS services.

Is the service caring?

One person said 'The care is quite good here'. We saw that staff were swift to respond to people's needs and also to answer call bells. Staff treated people with respect and consideration and they were also mindful of their privacy and dignity.

We also observed that staff supported people to eat their meals with patience and consideration. We also observed that people who used the service were referred to by their preferred name.

Is the service responsive to people's needs?

People's needs were assessed and their individual care plans contained appropriate information about their needs and preferences. Individual plans of care also demonstrated that people were involved in decisions about their care and daily records demonstrated how the care and support was provided.

Defective medical equipment had been replaced and repairs to the stair lift to the second floor were ongoing. However two of the three communal wheelchairs were in need of significant repair to ensure people's health and safety.

People were able to select food from the menu which comprised balanced diet of freshly prepared food. However although fluid records showed that in general people had access to regular fluids; records were not always fully completed and totalled. Without this being done the provider and staff could not assure themselves that people were always in receipt of adequate amounts of fluid.

We have asked the provider to tell us how they will make improvements and meet the

requirements of the law in relation to Care and welfare and assessing and monitoring the quality of the service.

Is the service well lead?

Staff recruitment was managed effectively so that people were protected from the risks associated with the appointment of new staff. The provider had established a mechanism for obtaining the views of people who used the service and their representatives; we found that action was taken to address the concerns raised.

The provider had conducted quality assurance audits to ensure the safety of people who used the service. We found that where problems had been identified the provider had taken remedial action for example the replacement of medical equipment and repair of the stair lift. However two of the three communal wheelchairs were in need of significant repair to ensure people's health and safety. The provider also told us that the cooker was not fit for purpose but had continued to use it without taking the required action.

In addition, the provider's quality assurance checks had not identified serious concerns in relation to the maintenance of the premises and infection control systems. Risk assessments were in place to reduce and manage the impact of identified risk factors, such as the risk of falls. However there were no risk assessments in place relating to the engagement of high risk behaviours of some the people who used the service.

Fire safety records identified that checks on the emergency lighting had not been conducted and this was confirmed by the provider; we referred our concerns to the fire safety officer. Records showed people at risk of dehydration had fluid charts in place but were not always accurately completed; nor was their 24 hour intake calculated. Without this being done and reviewed on a daily basis the management could not be assured that people were in receipt of an adequate amount of fluids.

We have asked the provider to tell us how they will make improvements and meet the

requirements of the law in relation to assessing and monitoring the quality of the service.

10 March 2014

During an inspection looking at part of the service

We conducted a follow up inspection at Foxhill Manor Nursing Home on 10 March 2014 to review compliance with an outstanding compliance action relating to outcome 21: Records.

We found people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained. We found that people's personal records including medical records, staff records and other records relevant to the management of the services were accurate and fit for purpose. We also found records were kept securely and could be located promptly when needed.

13 August 2013

During an inspection looking at part of the service

We found that although some improvement had been made in relation to Outcome 21 the provider had not achieved full compliance. We were advised that Grant Thornton UK LLP have been appointed as trustee to the business and on 6 August 2013 appointed a professional care management company to review management systems and care practices at the home and to drive improvements.

8 May 2013

During a routine inspection

We spoke with four people during our inspection at Foxhill Manor Nursing Home; they told us that they were able to make decisions about their daily lives such as times of rising and retiring to bed, choice of clothing, food and activities. People told us that staff explained their needs and asked for their consent before they carried out any personal care or support.

The people that we spoke with told us that they thought they were well looked after at Foxhill Manor Nursing Home and that the staff knew how they needed and wished to be supported.

One person told us 'I have settled in here and the staff know how I need to be cared for, they are patient and kind'. Another person commented 'its all right here, I have seen the doctor recently and been given pain killers, I go into town and visit relatives'.

People also told us that there were some activities that they could join in with if they wanted to. One person told us that there was an organised activity on a Monday and Friday; that there were occasional outings for small groups of people to access local facilities and in house musical performances; most recently a singer and guitar player which had been enjoyed.

We spoke with four people who lived at Foxhill Manor Nursing Home, they told us that they felt safe living there and that the staff were nice to them. People told us that they knew how to raise any concerns should they need to do so, that the staffing levels were adequate and that the staff had the skills to care for them.

However we found that the provider was not meeting the standard relating to record keeping.

3 December 2012

During an inspection looking at part of the service

We spoke with four people during our inspection, one person told us that they had been out shopping at the weekend and had bought personal items of clothing.

Three people told us they liked living at Foxhill Manor Nursing Home and that the food was good. One person told us that the food was lovely and joked that they sometimes ate too much. All of the people that we spoke with confirmed that the staff were kind.

1 October 2012

During a routine inspection

We spoke with four people during our visit to Foxhill Manor Nursing Home; two people told us they were able to make some decisions about their lives; however one person told us that they had not been involved in planning their care. One person also told us they were unable to access the community or visit relatives when they wanted. We saw another person ask staff if they could go out for a walk in the grounds; they were told that there was no-one available.

One of the people that we spoke with told us that the staff always asked for consent before delivering personal care. However other evidence did not demonstrate that formal consent was sought from people about other aspects of their lives.

One of the people we spoke with told us that they felt they were well looked after; they told us that the staff knew how they needed to be supported. Another person told us that they were comfortable living at Foxhill Manor, they told us that the staff were nice to them and they felt safe. However another person told us that they did not feel safe living there and they felt isolated because of the location of the home.

During our inspection we became concerned about the number of abusive incidents and other safeguarding concerns at Foxhill Manor Nursing Home and therefore referred our concerns to Northamptonshire County Council (NCC) Safeguarding Team, the NCC Commissioners and also the police.

5 March 2012

During an inspection looking at part of the service

Many of the people at living Foxhill Manor Nursing Home had a diagnosis of dementia; as such their ability to recall their experiences and express their views was limited. In order to obtain information about peoples' experiences of living at Foxhill Manor Nursing Home and assess how their needs were being met by the staff, we spent time observing people's engagement, demeanour and body language.

One person that we spoke with told us that some of their needs were being met, however they were unable to access some areas of the home including the bathroom facilities because of the layout of the building and lack of facilities.

One of the people we spoke with told us that they did not always feel safe living at Foxhill Manor Nursing Home because they had on a few occasions woken in the night to find another resident sitting on their bed or standing in their room.

A person also told us they wanted to go out independently but because of the rural location of the home and the cost of a taxi was too expensive and this made them feel very isolated.

12 September 2011

During an inspection in response to concerns

Many of the people who live at Foxhill Manor Nursing Home have a diagnosis of dementia, as such they are limited in their ability to recall and express their views and experiences. In these circumstances we observed people's interactions with staff, their body language and facial expressions to gain insight into their experiences of living at Foxhill Manor Nursing Home.

One of the people who was able to speak to told us that they were very happy at Foxhill Manor Nursing Home, they told us that the food was good and that they enjoyed the activities provided. Two other people told us that they liked their rooms and that they were comfortable living there.

Other people told us that they felt safe living at Foxhill Manor Nursing Home, they told us that the staff were nice to them and they thought that the staff looked after them well. They also thought that there were enough staff on duty to respond to their needs.

One person told us that no meetings had been held for residents or relatives to meet with the provider and the management. Others told us that they have been able to raise issues and express their views as they arose because they saw the provider and the new deputy manager frequently.

9 December 2010

During an inspection looking at part of the service

One person stated that 'the staff are all lovely'.

Another person told us that they were 'very happy living at Foxhill Manor'.

People who live at Foxhill Manor told us that they felt that they were well looked after.

They told us that they felt that there were enough staff on duty to meet their needs.

They told us that they liked the food and that there were choices available.

They told us that they liked the activities that were being provided.

People also told us that they felt safe living at Foxhill Manor and that the staff were nice to them and that 'the staff couldn't be faulted'.

They also told us that the staff were kind, considerate and helpful.

Another person told us that their room was comfortable and that they had everything that they needed.

One person told us that they had been cold during recent nights and that they had been sleeping in their dressing gown.