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Fremington Manor Nursing and Residential Home Outstanding

Inspection Summary


Overall summary & rating

Outstanding

Updated 6 March 2019

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 manag

Inspection areas

Safe

Good

Updated 6 March 2019

The service was safe.

Arrangements for recruitment, staffing, infection control and medicines management ensured people received a safe service.

People said they always felt safe. Risk was well managed, in least restrictive ways.

The premises were kept in a safe state, through regular maintenance and servicing.

There were robust arrangements should an emergency occur.

Effective

Good

Updated 6 March 2019

The service was effective.

People praised the care and treatment they received. External health care advice was sought and followed appropriately.

Staff were complimentary about their training. They received support and supervision to a high standard.

People�s legal rights were understood and upheld. Staff demonstrated in-depth knowledge of the Mental Capacity Act 2005, associated Deprivation of Liberty Safeguards and best interest decisions.

People�s dietary needs were met in a safe way. Dietary concerns were followed up.

Equipment and adaptations promoted people�s independence.

Caring

Good

Updated 6 March 2019

The service was caring.

Staff demonstrated deep commitment to people�s care and welfare.

Caring relationships were made between people using the service and staff. Every comment received about the care provided, and staff kindness, was very positive.

People praised the staff approach to embarrassing situations, saying how much this put them at ease.

People�s dignity and privacy were completely upheld.

Responsive

Outstanding

Updated 6 March 2019

The service was very responsive.

There was a deep commitment to patients receiving end of life care. That care was delivered expertly by staff trained to a high standard in the subject.

There was exceptional commitment to meeting people�s diverse beliefs and choices, however those choices challenged medical best practice. This approach meant people received the service they wanted and eventually, a peaceful death.

Activities were arranged in accordance with people�s needs and choices, where ever possible.

People�s needs were fully assessed and their care planned and kept under review.

Complaints were effectively managed and any concern fully investigated.

Well-led

Outstanding

Updated 6 March 2019

The service was very well-led.

The provider and registered manager were passionate about achieving high standards. There were clear visions and values, which informed how the service was managed.

People�s and staff�s views were a high priority and informed decision making.

People, their representatives and staff spoke very highly of the management. They felt valued, and were valued by management.

Continual improvement in the service was achieved through robust quality monitoring.