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Freshford Cottage Nursing Home Good

Inspection Summary

Overall summary & rating


Updated 17 March 2018

The inspection at Freshford Cottage Nursing Home took place on 30 January and 1 February 2018 and was unannounced.

Freshford Cottage Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide nursing, personal care and accommodation for up to 20 older people, over 65 years of age, who have chronic physical health care needs, such as diabetes, and who also may be living with dementia. At the time of the inspection there were 17 people living at the home. The premises is a converted older building, with an extension to one side, on two floors. Lifts enable people to access their rooms and there are communal rooms on the ground floor, with access to the garden for people using walking aids and wheelchairs. Freshford Cottage Nursing Home is one of three care homes within the registered organisation.

A registered manager was in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

At the last inspection on 24 October 2016 the service was rated as Requires Improvement overall. We found that improvements were needed under key questions of safe and well led. We asked the provider to take action to make improvements to guidance for ‘as required’ medicines, the medicine administration records, daily records and quality monitoring of the care and services provided. This action has been completed and the rating for each key question and the overall rating for Freshford Cottage Nursing Home is ‘Good’.

From August 2016 all organisations that provide NHS care or adult social care are legally required to follow the Accessible Information Standard. The standard aims to make sure that people who have a disability, impairment or sensory loss are provided with information that they can easily read or understand so that they can communicate effectively. At this inspection we have made a recommendation that the provider seeks advice and guidance from a reputable source, about Accessible Information Standards (AIS) to ensure staff are aware of their responsibilities.

Staff managed medicines safely. Staff responsible for giving out medicines had attended training and their competency was assessed to ensure they understood ‘as required’ medicines and completed the medicine administration records. The provider had identified where improvements were needed in record keeping through the quality assurance system. Staff had been allocated to review care plans to ensure they were up to date. People, and their relatives if appropriate, had discussed their needs with staff; they were involved in writing their care plan and had signed them to show their agreement

The care plans were person-centred. They included people’s individual support and care needs and assessment of risk; with clear guidance for staff to follow to ensure safe and appropriate care was provided. For example, if people were at risk of falls or unable to move around the home independently, the most appropriate aid, such as a hoist or wheelchair, was recorded. Staff asked people how and where they wanted to spend their time and used the aids to assist people to and from the lounge or to sit comfortably in their own room. People took part in one to one and/or group activities of their choice. These included bingo, manicures, quizzes, trips into town shopping and the seafront and, there were with regular visits from external entertainers.

Staff were knowledgeable about people’s individual needs. Staff had attended essential training as well as

Inspection areas



Updated 17 March 2018

The service was safe.

Staff used relevant guidance to give out ‘as required’ medicines safely.

People said they felt safe and staff had attended safeguarding training and knew how to protect people from abuse.

The staffing levels were sufficient to meet people’s needs and effective recruitment procedure ensured only suitable people worked at the home.

Staff reviewed risk and produced guidance to provide safe care and support for people.



Updated 17 March 2018

The service was effective.

Staff had received relevant training and they were supported to develop professionally through supervision and appraisals.

Staff had attended training on the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards and they supported people to make decisions about the care they received.

People had sufficient to have enough to eat and drink, choices were provided and people could ask for something different if they wanted to.

People had access to appropriate healthcare professionals as required.



Updated 17 March 2018

The service was caring.

People were treated with kindness and respect.

Staff promoted people’s independence and encouraged them to make decision about the care provided.

People were encouraged to maintain relationships with relatives and friends.



Updated 17 March 2018

The service was responsive.

People's needs were assessed before they moved into the home to ensure they could be met.

People and relatives or representatives were involved in writing and review the care plans, which were personalised and reflected their needs.

People's preferences and choices were used to develop the activity programme and people spent time as they wished.

People and relatives were aware of the complaints procedure and were confident they would use it if they needed to.



Updated 17 March 2018

The service was well-led.

Quality assurance and monitoring systems were in place. Audits had identified areas for improvement and action had been taken to address these.

There were clear lines of accountability and staff were aware of their roles and responsibilities.

Yearly questionnaires and regular meetings enabled people, relatives, staff to provide feedback about the services and care provided.