Archived: Fosse House Nursing Homes

Updated 18 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector, a Specialist Advisor 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. The expert by experience’s area of expertise was older people.

Service and service type:

Fosse House Care Home is a care home. People in care homes receive accommodation and nursing or personal care. 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 they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced on the first day and announced on the second day.

What we did:

We reviewed information we had received about the service since the last inspection in March 2018. This included details about incidents the provider must notify us about. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.

We used a number of different methods such as undertaking observations to help us understand people’s experiences of the service. As part of our observations we used a pathway tracking. This is a method of reviewing people’s care and the associated records to check their health and social care needs are met.

During the inspection we spoke with eight people living at the service and four relatives. We spoke with five members of staff, including the registered manager. After the inspection we received feedback from one relative. We reviewed nine people’s care and support records and five staff files. We also looked at records relating to the management of the service such as incident and accident records, meeting minutes, recruitment and training records, policies, audits and complaints.

Updated 18 May 2019

About the service: Fosse House Nursing Home is a care home. It provides accommodation and personal care for up to 37 older people. At the time of the inspection there were 33 people living at the service.

People’s experience of using this service: The service has on two previous occasions been rated as requires improvement. Some improvements were made in ensuring people who were not able to make a choice were assessed and treated in their best interest. Medicine management had also improved.

• People were supported by a consistent staff team who were kind and caring. Staff had good relationships with people and knew them well. People were encouraged and supported to maintain their independence.

• People received their medicines safely and as prescribed except for prescribed creams which required more direction for staff to follow. Medicine management practices were safe. However, medicine policies did not effectively cover the administration of concealed covert medicines and PRN protocols were not always in place. Handwritten medicine administration records had not been signed by two staff.

• Care plans and risk assessments did not always contain accurate and complete information, particularly in relations to people’s specific health conditions. There was a lack of guidance in how risks should be managed safely.

• Recruitment procedures ensured all relevant checks were completed before new staff began work.

• Audits had not always identified shortfalls we identified.

• An activities time-table was provided to all. An activities coordinator was in post and people were engaged if they wished.

• People spoke positively about the food provided at the service.

• Relationships were supported both within and outside the service. Visitors were welcomed. The service was clean and tidy.

• Feedback was sought from people through direct contact with people and their relatives and staff through meetings and questionnaires. Relatives said the service communicated well with them. People felt comfortable in raising any concerns or issues.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection: Requires Improvement (19 December 2017 and 9 January 2018). This service has been rated as requires improvement at the previous two inspections (November 2016 and March 2018).

Why we inspected: This was a planned inspection based on the previous rating.

Enforcement: We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and we made one recommendation into guidance for specific health conditions. Please see the ‘action we have told the provider to take’ section towards the end of the report

Follow up: We will review the report on actions the provider intends to take following the inspection. We will continue to monitor the service through the information we receive. We will inspect in line with our inspection programme or sooner if required.