Background to this inspection
Updated
13 January 2021
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control practice was safe and the service was compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place.
This inspection took place on 29 December 2020 and was unannounced.
Updated
13 January 2021
Fremington Manor Nursing and Residential 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.
Fremington Manor Nursing and Residential Home accommodates a maximum of 60 people. People’s conditions varied, but the service placed a strong emphasis on end of life care and working collaboratively with local palliative care services.
The building comprises the original manor house with a purpose-built extension. There were 40 people resident at the time of the inspection.
The inspection took place on 9 and 10 January 2019 and was unannounced.
At our last inspection we rated the service good. At this inspection we found the standard of service had further improved and we have rated it as outstanding.
Why the service is rated outstanding.
People using the service were the priority at Fremington Manor Nursing and Residential Home. People received care, treatment and support tailored to their individual needs and of a very high standard.
A community hospice nurse said of the end of life care at the service, “(The service) puts patients first. There is nothing too much for patients. The registered and deputy managers have a deep commitment to palliative patients.”
There was exceptional commitment to meeting people’s diverse needs. This had included those associated with beliefs/faith, age and gender. The service continually researched information. This knowledge helped them provide empathy, in particular where people’s choices were in opposition to evidence based practice, such as pain and infection management.
The service was very caring because of the total commitment of staff to people’s welfare. People said staff were very kind. Staff expertly managed difficult, and sometimes embarrassing, situations putting the person at ease and upholding their dignity. Privacy and dignity were fully promoted.
The management understood the importance of valuing staff, all of whom spoke very positively about their work and praised the registered manager and provider organisation. There were robust systems for ensuring a safe and high standard of service. Any concern was promptly dealt with, openly and honestly and with a view to continual improvement. People’s, and staff views were always considered. Staff supervision ensured staff received the support they needed and any change at the service was managed expertly, listening to staff views throughout.
People received a high standard of care and treatment. One health care professional said, “The (staff) are second to none.” Staff praised their training, which fully equipped them for their work. External health care expertise was sought appropriately.
People had an in-depth assessment of their needs and wishes. Care plans enabled staff to understand important aspects of the person they were caring for. Risk was well managed in the least restrictive way possible.
People were fully protected through robust recruitment, staffing, infection control and management of the premises. Medicines were expertly managed for people although we have made one recommendation, based on one person’s records. All risk was effectively assessed and managed, in least restrictive ways.
Adaptation suitable for meeting people’s needs in a safe way was available where possible. All necessary equipment was in place to promote people’s independence and maintain safety. There were robust arrangements should an emergency occur, such as a fire.
People’s legal rights were understood and protected. Where people lacked capacity to make informed decisions these were made in their best interest.
People received a healthy and nutritious diet. There was a lot of choice of food and any negative feedback was followed up with the intention of meeting people’s preferences. Food and fluid intake concerns were properly managed.
The service fully met their legal obligations and kept themselves appraised of changes in legislation and good practice.