Background to this inspection
Updated
19 May 2021
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors 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
Friary Fields 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.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
This inspection was unannounced.
What we did before inspection
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, clinical commissioning group, infection prevention and control team, Nottinghamshire fire and rescue service and other professionals who work with the service. We contacted Healthwatch; Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used all of this information to plan our inspection.
During the inspection
We spoke with nine people who used the service and two relatives about their experience of the care provided. We spoke with eight members of staff including the providers, registered manager, senior care workers, care workers, domestic staff and the cook. We spoke with two visiting professionals who regularly visit the service during the inspection.
We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
19 May 2021
About the service
Friary Fields is a residential care home providing personal care and support to 22 people aged 50 and over at the time of the inspection. The service can support up to 34 people.
The service accommodates people in one adapted building with people’s bedrooms on two floors. It has shared lounges and dining areas and a conservatory providing access to a garden area with raised flower beds and seating areas. There is an access ramp for people who use a wheelchair.
People’s experience of using this service and what we found
People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.
The environment was poorly maintained, unclean and not furnished to a good standard.
People were not safe. Risks were not assessed and appropriately managed. We found no evidence that people had been harmed however, systems were either not in place or robust enough to demonstrate safety was effectively managed
When significant incidents had occurred, action was not always taken to keep people safe. The registered manager had failed to notify the CQC of significant events.
People did not receive an appropriate food and drinks to meet their specific dietary requirements.
People and relatives said they liked the staff. Staff were kind and caring. People's privacy and dignity was not always maintained.
Records showed that when people became unwell or needed additional support they had access to a range of health and social care professionals in respect of their well-being.
Staff recruitment was safe. Appropriate checks were undertaken to ensure staff employed were suitable to work with vulnerable people. Staff had access to mandatory training to do their job role and received regular supervision from their line manager.
Rating at last inspection
The last rating for this service was Good (published 3 January 2018).
Why we inspected
The inspection was prompted in part by notification of a specific incident. Following which a person using the service was hospitalised. This incident is subject to an ongoing adult’s safeguarding investigation. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of people’s safety within the service. We were informed that the service failed to seek prompt medical attention for a person living in the service and the service lacked robust infection control processes. This inspection examined those risks.
We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive and Well Led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Friary Fields Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to premises and equipment (cleanliness and physical environment), safe care and treatment, the need for consent, lack of person – centred care, and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.