Fornham House Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. One relative told us, “When [family member] had a minor fall, they [staff] immediately put the measure in place of an alarm mat by their bed.”

The leadership team conducted investigations when incidents occurred and took appropriate action to prevent recurrences. We saw that ‘lessons learned’ including best practice were shared at daily leadership meetings and with staff teams. A member of staff told us, “[People] are discussed each day at the stand-up meetings, any incidents that have happened are then discussed, and lessons learned and ways to improve are also considered.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Suitably trained staff completed and regularly reviewed assessments of people’s health and well-being, risks and wishes, to make sure they accurately reflected their needs. Care plans were developed and staff worked effectively with health and social care professionals to make sure people received appropriate support that met their needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe and well cared for.One relative told us, “It’s a very good support setup, yes very safe.” Another relative said, “I feel there appears to be a good staff: resident ratio with staff who are non-agency which gives me reassurance that their training and performance is monitored more closely.”

The provider had safeguarding policies and procedures in place and staff had completed training for safeguarding adults. Staff confirmed they always report any concerns and told us they would also follow the whistleblowing policy if needed. One staff member said, “If I noticed any safeguarding concerns I would stop it and report it.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. One person said, “It is all good, the staff are nice and kind – I feel safe here, it is the care.”

Risk assessments relating to the health, safety and welfare of people using the service were completed and were person‑centred, reflecting individual needs, preferences and levels of risk. These assessments covered key areas such as mobility, falls, skin integrity and the environment. Staff used appropriate equipment and supportive measures to minimise identified risks while promoting people’s independence wherever possible. For example, sensor alarms were used for people who were at increased risk of falls, enabling staff to respond promptly while allowing people greater freedom of movement.

People’s risk assessments and care plans were regularly reviewed, including following incidents, changes in health or mobility, or at planned review intervals. Updates were clearly recorded and communicated to staff to ensure care delivery remained consistent, effective and responsive. These reviews helped ensure that risk management strategies continued to reflect people’s current needs and remained effective in keeping them safe.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

The environment required improvement as areas of the home were in a poor state of repair and in need of redecoration. These issues contributed to an overall standard that did not fully support the delivery of high‑quality care. The provider was responsive to concerns raised during the inspection and took immediate action to cover an exposed hot water pipe and replaced heavily soiled furniture. They also told us there were plans in place to improve the premises and upgrade affected areas. The condition of the environment at the time of inspection demonstrated the need for more timely and effective action to ensure people live in a well‑maintained setting.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us they received prompt support, however, some relatives mentioned delays with people receiving personal care on occasion. We noted that senior staff regularly assessed people’s dependency levels and used this information to determine staffing levels.

Many staff told us there were sufficient staff unless there were exceptional circumstances and then frequently the registered manager or deputy manager would ‘step in’ to assist staff where possible. A staff member said, “There are enough staff most of the time, unless staff are on holiday or off sick. If a [person] presses their buzzer when they're in the lounge a carer will come and attend to the [person] quickly.” Another member of staff told us, [deputy manager] is also very good at covering shifts [they] will put out on the what’s app group and if last minute sickness can’t be covered [deputy manager] and [registered manager] will both help out on the ‘floor’.”

At the time of the inspection, rota reviews and our observations confirmed that staffing levels were sufficient to meet people’s assessed needs. The registered manager described how staffing was continually reviewed and adjusted in response to individual needs and the overall requirements of the service.

Staff undertook regular training to maintain the knowledge and skills necessary to perform their duties effectively. Staff also confirmed they received regular support and supervision. Relatives commented that staff had the training needed to provide good care. A relative told us, “I have witnessed examples when it is evident they are trained e.g. supporting at mealtimes, supporting to safely navigate from a chair to a frame.” Another relative said, “The staff seem to be trained into [repositioning] and [caring for] all types of [people] with regards to mobility. The come across as confident and caring.”

The provider had appropriate recruitment procedures in place, which ensured staff were suitable to support people who lived at the service. Disclosure and Barring Service (DBS) checks had been undertaken. A DBS check is a criminal record check on a potential employee's background. The provider checked potential staff's previous employment history, their identity and obtained references about them.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading or share concerns with appropriate agencies promptly.

There was a lack of cleanliness in several areas of the building, including on some items of furniture and carpets. These concerns had not been identified or addressed by staff or leaders, indicating shortfalls in monitoring and oversight of environmental hygiene. This placed people at risk of potential harm through cross‑infection and demonstrated a failure to maintain the high standards of cleanliness required to ensure a safe care environment. During our inspection visit, the provider took immediate action to address these concerns, replacing the necessary furniture, cleaning carpets and making improvements to support people’s well-being and comfort and reduce the risk of infection. They also advised they would be making changes to strengthen their IPC checks and audits as part of lessons learnt/prevent re-occurrence.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

There were robust and well‑established systems in place to ensure that medicines were managed safely within the service. This included structured processes for ordering, storing, administering and auditing medicines, which helped staff maintain consistent standards of safe practice. During the inspection we reviewed a sample of training records, which demonstrated that staff responsible for administering medicines had completed appropriate medication training that was relevant to their roles. We also examined competency assessments, which were designed to test both knowledge and practical skill. These assessments took place after training and involved direct observations of staff practice, alongside formal knowledge checks, to ensure that only staff who were competent and confident were permitted to administer medicines independently.

Although the majority of competency records were up to date and appropriately completed, we identified that some documentation was missing or incomplete at the time of the inspection. The deputy manager responded promptly once this was highlighted, taking immediate steps to update the outstanding paperwork and ensure all staff had fully documented competency assessments.