You are here

Archived: Fauld House Nursing Home Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 7 August 2019

During a routine inspection

About the service:

Fauld House Nursing Home is a residential care home that was providing personal and nursing care to 45 people aged 60 and over at the time of the inspection. The service can support up to 48 people. The home accommodates people across two separate floors, each of which has separate adapted facilities and lift. Some of the people living in the home had a diagnosis of early stage dementia. The home is situated in the village of Tutbury near to Burton-Upon-Trent in Staffordshire.

People's experience of using this service and what we found:

Although people were supported to be safe, there were recording issues with some aspects of the care and support including the application of creams. We established that no one had come to harm but this could cause confusion to staff and visiting healthcare professionals. We have made a recommendation about this that can be seen in the 'Safe' section of this report.

People said that they felt safe. Staff received safeguarding training and had a good understanding of the principals involved in acting when abuse was suspected.

Save for some issues with the recording of the administering of creams, medicines were managed safely and this meant that people received their medicines as prescribed by healthcare professionals.

Staff told us they received good support from senior staff, including nurses and the registered manager. We did note that most of the checks and audits at the home were completed by the registered manager. There was an absence of documented input by others including nursing staff and provider. We also noted that whilst the registered manager was unavailable during the early part of 2019, insufficient support and oversight had been provided. This had led to insufficient progress around improvements that were required after an inspection by the quality assurance team of the local authority in March 2019. We have made a recommendation about this that can be seen in the 'Well-led' section of this report.

People's needs were met through assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff had good knowledge and skills and this ensured people's needs were well met.

The provider had a recruitment process but some checks had not always been completed before staff started work. This was resolved after the inspection. Any issues with staff were dealt with promptly using a fair and thorough disciplinary process.

People's needs were met through robust assessments and support planning. The service worked with healthcare and social professionals to achieve positive outcomes for people. Staff and carers had good knowledge and skills and this ensured people's needs were well met. We saw good examples of when people had been supported to maintain a healthy and balanced diet.

People told us carers and staff were compassionate and kind and during the inspection, we observed this to be the case. Management and staff knew people well. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received care and support that was person-centred. We saw examples of how the care and support people received enriched their lives through meaningful activities. The service had a robust complaints policy.

The values and culture embedded in the service ensured people were safe and at the heart of the care and support they received. The registered manager and nursing staff planned and promoted holistic, person-centred, high-quality care resulting in good outcomes for people. People knew how to feedback their experiences and this was considered and acted upon by the registered manager.

There was an end of life policy in place that could be used if appropriate. Staff members had been trained around this and were able to ensure best practice was

Inspection carried out on 24 January 2017

During a routine inspection

This inspection took place on 24 January 2017 and was unannounced.

At our last inspection in February 2016, we rated the home as Requires Improvement overall. Improvements were needed to ensure the provider was following the legal requirements when supporting people to make decisions about their care required. Action was also needed to ensure the quality and safety checks carried out by the manager were effective in maintaining and improving the care people received. At this inspection, we found the required improvements had been made.

Fauld House provides accommodation, personal and nursing care for up to 48 people. At the time of the inspection, 45 people were using the service. There was a registered manager at the service. 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.

People felt safe living at the home and their relatives were confident they were well cared for. If they had any concerns, they felt able to raise them with the staff and management team. Risks to people’s health and wellbeing were assessed and managed and staff understood their responsibilities to protect people from the risk of abuse. People’s care was regularly reviewed to ensure it continued to meet their needs. There were sufficient, suitably recruited staff to keep people safe and promote their wellbeing. Staff were received training and support to ensure they had the skills and knowledge to provide the support people needed.

Staff gained people’s consent before providing care and understood their responsibilities to support people to make their own decisions. Where people needed to be restricted of their liberty in their best interests, the registered manager had made the necessary applications for approval.

Staff had caring relationships with people and promoted people’s privacy and dignity and encouraged them to maintain their independence. Staff knew people’s preferences and supported them to have choice over how they spent their day. People were supported to eat and drink enough to maintain a healthy diet. People were able to access the support of other health professionals to maintain their day to day health needs.

People received personalised care and were offered opportunities to join in social activities and follow their interests. People were supported to maintain important relationships with friends and family and staff kept them informed of any changes.

There was an open and inclusive atmosphere at the home. People and their relatives were asked for their views on the service and this was acted on where possible. People knew how to raise complaints and were confident their concerns would be taken seriously. Staff felt supported by the registered manager. The registered manager and provider carried out checks and audits to continuously monitor and improve the service.

Inspection carried out on 24 February 2016

During a routine inspection

This inspection took place on 24 February 2016 and was unannounced. Our last inspection took place on 21 January 2015 and we found the service was not meeting the legal requirements where people were being restricted in their best interests and did not have systems in place to ensure that medicines were managed safely. The provider sent us an action plan and told us the legal requirements would be met by March 2015. We found that some improvements had been made, but identified that other improvements were needed.

Fauld House provides accommodation, personal and nursing care for up to 48 people. At the time of the inspection, 47 people were using the service. There was a registered manager at the service. 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.

People received their medicines when they needed them but some improvements were required to ensure medicines were recorded accurately in order that administration could be monitored effectively. Further improvements were needed to ensure the quality monitoring checks carried out by the registered manager were effective in maintaining and improving the care people received. The provider had taken action to ensure that where people were restricted of their liberty in their best interests, this was authorised in accordance with the legal requirements. However, although staff understood they should support people to make their own decisions, they did not fully understand how to apply the Mental Capacity Act 2005.

People felt safe living at the home and if they had any concerns, they were confident these would be addressed by the staff and management team. Risks to people’s health and wellbeing were assessed and managed and safeguarding procedures were in place to protect people from abuse. People’s care was regularly reviewed to ensure it continued to meet their needs. There were enough staff to keep people safe and promote their wellbeing. Staff had been recruited using clear guidance and staff received training so they had the skills and knowledge to provide the support people needed.

People received personalised care and were offered opportunities to join in social and leisure activities. Activities coordinators tailored or adapted the activities to meet people’s individual needs and abilities. Staff knew people well and encouraged them to have choice over how they spent their day. Staff were kind and caring and promoted people’s privacy and dignity and supported them to maintain important relationships. People told us the food was good at the home and they were supported and encouraged to eat and drink enough to maintain a healthy diet. People accessed the support of other health professionals to maintain their day to day health needs.

People and their relatives felt comfortable approaching the registered manager and staff with any concerns and were confident action would be taken. The registered manager investigated and monitored complaints and made improvements to the service where needed. People and their relatives were asked for their views on the service and were satisfied this was acted on where possible.

Inspection carried out on 21 January 2015

During a routine inspection

We inspected this service on 21 January 2015. This was an unannounced inspection. Our last inspection took place in November 2013 and at that time we found the home was meeting the regulations we looked at.

The service was registered to provide accommodation, personal and nursing care for up to 48 people. People who use the service have physical health and/or mental health needs, such as dementia.

At the time of our inspection 42 people were using 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 and associated Regulations about how the service is run.

We identified that improvements were required to ensure people received their medicines safely. You can see what action we told the provider to take at the back of the full version of the report.

Some people were unable to make certain decisions about their care. The Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) set out requirements to ensure where appropriate, decisions are made in people’s best interests when they are unable to do this for themselves. We found that the staff did not have an up to date understanding of the DoLS to manage the restrictions they placed on people. We recommended that the provider ensures staff have the knowledge and skills required to meet the requirements of the DoLS.

We also made a recommendation that the provider reviewed the effectiveness of the tools they used to monitor and improve quality as these were not always effective.

Significant incidents were not always reported to us by the registered manager. This meant the registered manager was not meeting the requirements of their registration with us.

There were sufficient numbers of staff to promote people’s safety and the staff had received training to enable them to meet people’s needs. Staff understood how to keep people safe and reported safety concerns to the registered manager when required. The registered manager monitored safety incidents and took action to reduce any further incidents from occurring.

Care was provided with kindness and compassion and people’s independence and dignity were promoted.

People’s dietary needs were met. People chose the food they ate and specialist diets, such as; diabetic diets were catered for.

People’s health and wellbeing were monitored and staff worked with other professionals to ensure people received medical, health and social care support when required.

Systems were in place to enable people to receive end of life care in accordance with their care preferences and needs.

People were involved in an assessment of their needs and care was planned and delivered to meet people’s individual care preferences. People were also encouraged and enabled to participate in activities that were important to them.

The registered manager regularly sought and acted upon people’s views of the care. This led to improvements in care. Complaints about care were managed in accordance with the provider’s complaints policy.

There was a positive and inclusive culture within the home and a management structure was in place to support the staff and improve the quality of care. There had been a recent change in the management team and people and staff told us this change had led to some recent improvements in care.

Inspection carried out on 4 November 2013

During an inspection to make sure that the improvements required had been made

This inspection was unannounced which meant the provider and the staff did not know we were coming. We spoke with five people using the service, four visitors and three staff. At our last inspection in June 2013 we made three compliance actions in relation to staffing, quality assurance and the management of medicines. This meant the provider needed to make improvements in these areas to demonstrate they were fully protecting people using their service.

During this inspection we found that suitable and sufficient improvements had been made where we had identified concerns. We saw the provider had put right what was required. This meant the provider could demonstrate people�s medication was handled safely, there were sufficient staff to support people, and there were systems in place to assess the quality of the service provided.

People we spoke with were happy with the care and support they received, one person using the service said, �The staff are great. They help you; they don't see you stuck for anything.�

On this inspection we also checked to make sure people were suitably fed and hydrated. We looked at records to make sure these were stored securely and held the information required. People liked the meals offered and we saw suitable records were in place.

Inspection carried out on 24 May 2013

During a routine inspection

During our inspection we spoke with six people who used the service, five relatives, four members of staff and the manager. People told us they were happy with the care they received. One person told us, �I am okay here, I think they look after me well.� A visitor said, �It has got potential, the care is good.� We found that people were treated with dignity and respect. Their individuality was recognised and they were supported to make their own choices.

We saw that people�s care records contained up to date information. This meant that information was recorded accurately to guide staff on how to support people.

During our last inspection in August 2012 we found medication management needed improvement. On this inspection we saw that suitable systems were still not in place. This meant the required improvements had not been made.

We saw that staff engaged with people in a friendly manner and people told us suitable care and support were provided. Some people including visitors and staff considered there were not always sufficient staff on duty to meet the needs of people using the service.

The home does not have a registered manager in place as required in The Care Quality Commission (Registration) Regulations 2009. We will be contacting the provider about this.