Fen House

We found the following examples of good practice.

There was an area outside (gazebo) where visitors visited people by appointment. Visitors were expected to wear Personal Protective Equipment (PPE) and this would be made available. There were gaps between each visit to prevent people encountering other visitors, staff or people from the home.

On arrival into the building, external visitors including a health or social care visitor were asked to wait to enter and complete a series of checks in line with government guidelines.

Pictorial and large type easy read posters were on display to prompt people/staff on social distancing, COVID-19, handwashing etc.

Group activities such as mealtimes, physio sessions and arts and crafts had been organised into smaller groups and staggered to promote social distancing.

People were asked to isolate in their rooms for fourteen days if they had been recently admitted into the home. Rooms for new admissions had been zoned into one corridor to reduce the risk of any potential spread of infection. The Registered Manager told us the building could be zoned into different areas should an outbreak occur, and these plans had already been considered should the need occur.

Staff were asked to socially distance when on their break. Staff changed into their work clothes and put on their PPE before starting work.

There was an infection control champion within the home.

Fen House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At our last inspection on 24 February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in post at the time of this inspection. 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 were supported by staff who knew about safeguarding and its reporting processes. Risk assessments were in place as guidance for staff to support and monitor people’s assessed risks. People’s care records were held securely to ensure confidentiality. Technology was in place to help staff assist people to receive safe support and care.

Recruitment checks were in place before new staff began work at the service. People’s needs were met as there were enough staff with the right skills and knowledge to support people. Staff were trained to meet people’s care and support needs. Actions were taken to learn lessons when things did not go as planned.

People’s medicines were administered as prescribed and managed safely. Medication errors were recorded, reviewed and action taken to reduce the risk of recurrence. Systems were in place to maintain good infection prevention and control.

People were involved in their decisions about their care and staff promoted people’s independence and helped them maintain their life skills as far as practicable. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

People were supported with their eating and drinking to promote their well-being.

Staff supported people to access external healthcare services. Staff worked with other organisations to help ensure that people's care was coordinated. Staff also worked with other external health professionals to make sure that peoples end-of-life care was well managed and dignified.

People received a caring service by staff who knew them and their needs well. Staff maintained people’s privacy and dignity. Activities were in place to support people’s interests and well-being, including links and trips out to the local community.

Compliments were received about the service and people’s complaints were responded to and resolved where possible.

The registered manager led by example and encouraged an open and honest culture within their staff team. Audit and governance systems were in place to identify and drive forward any improvements required. The registered manager and their staff team worked together with other external organisations to ensure people’s well-being.

Further information is in the detailed findings below.

There were 22 people living at the home at the time of this visit. There are internal and external communal areas, including lounge areas, separate dining rooms, an activities room, a gym, two communal bathrooms and court yards for people and their visitors to use. The home is made up of two floors which can be accessed by stairs or a lift. All bedrooms are on the ground floor have en-suite facilities including a toilet, basin and shower. There are two smaller kitchens for people to use to support and maintain their independence. There is also a self-contained flat for a person to live in with the support of staff prior to them moving back into the community.

During this inspection there was some work being undertaken on the building. This was being managed to make sure that there was little or no impact on people living in the home. This unannounced inspection took place on 24 February 2016.

There was a registered manager in place during this inspection. 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Where people had been assessed as lacking capacity to make day-to-day decisions, decisions were made in their best interest. Applications had been made to the local authorising agencies to lawfully restrict people’s liberty where appropriate. Staff demonstrated to us that they respected people’s choices about how they wished to be supported.

Records were in place for staff to monitor people’s assessed risks, support and care needs. Plans were put in place to minimise people’s identified risks and to assist people to live as safe a life as possible whilst supporting their rehabilitation and independence.

Arrangements were in place to ensure that people were assisted with their prescribed medicines safely. People’s medicines were managed and stored appropriately. People’s nutritional and hydration needs were met.

When needed, people were able to access a range of internal and external health care professionals. People were supported to maintain their health and well-being. Staff supported people with their interests and hobbies and to maintain their links with the local community to promote social inclusion. People’s friends and families were encouraged to visit the home and staff made them feel welcome.

People were supported by staff in a compassionate and respectful manner. People’s care and support plans gave guidance to staff on any individual assistance a person required. Records included how people wished to be supported, what was important to them and their rehabilitation goals.

Staff understood their responsibility to report any poor care practice or suspicions of harm. There were pre-employment safety checks in place to ensure that all new staff were deemed suitable and safe to work with the people they supported. There was a sufficient number of staff to provide people with safe support and care.

Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions, spot supervisions, competency checks and appraisals. This was to ensure that staff were confident and competent to provide people’s support and care.

The registered manager sought feedback about the quality of the home provided from people, and their relatives as they were able to raise any suggestions or concerns that they had with the registered manager and staff and they felt listened to.

Staff meetings took place and staff were encouraged to raise any concerns or suggestions that they may have had. Quality monitoring processes to identify areas of improvement required within the home were in place and formally documented any action required.

We found that care records were current and reflected the needs of people who lived at Fen House. Staff demonstrated a good understanding and knowledge of the care and support people required.

The premises were well maintained and records showed that appropriate safety checks had taken place on systems and equipment which meant it was safe for people to live in.

There was a recruitment procedure in place to ensure that only people suitable to work with vulnerable people were employed. Staff received a wide range of training to equip them for their role.

There was an effective system in place to deal with any complaints or concerns people who lived at Fen House or their relatives might raise.

People received a service from a team of clinicians led by a clinical psychologist. The clinical team and the 'care/support' team worked well together to provide a rehabilitation service based on people's individual assessed needs. Regular reviews of people's programmes took place with changes made as required.

The organisation had a quality assurance system in place which meant that the service was regularly monitored and areas for improvement identified with action taken to address issues.