Francis House

Francis House is a residential care home providing accommodation and personal care for up to 8 older people with mental health needs. At the time of this inspection there were 8 people receiving care at the service within one adapted, accessible, single level building. This included individual bedroom accommodation, with some en-suite facilities and a choice of communal bathing, lounge, dining and kitchen areas.

People’s experience of using this service and what we found

Risks to people's safety were effectively assessed and managed. People’s medicines were safely managed to ensure people received their medicines when they should.

The provider was meeting key principles for infection prevention, control and cleanliness at the service, including for COVID-19. Environmental and equipment safety was ensured.

The provider's safeguarding, emergency contingency planning and staffing measures, helped to ensure people’s safety and protect them against the risk of harm or abuse.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The provider operated effective governance arrangements, to ensure the quality and safety of people's care and timely, sustained improvements when needed.

The service was well managed. The registered manager and staff understood their individual role and responsibilities for people’s care. Regulatory requirements were being met. Staff management measures, communication, reporting and record keeping procedures for people’s care, helped to ensure this.

There was an open, positive and inclusive culture at the service, where people and others who were important to them, felt they mattered. Staff were highly motivated and effectively supported, to provide people’s care in the right way.

The provider worked in partnership with people, relevant authorities, care partners and others with an interest in people's care at the service, to help achieve good care outcomes. Feedback from all parties, was used to help inform or improve people’s care, when needed.

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

Rating at last inspection

The last rating for this service was good. (Published 30 August 2018).

Why we inspected

We undertook this inspection due to length of time since our last comprehensive ratings inspection. We undertook a focused inspection to review the key questions of Safe and Well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains good, based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Francis House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At our last inspection we rated the service as Good. At this inspection we found the evidence continued to support the rating of Good. 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 in October 2015. There were seven people accommodated.

People continued to receive safe care in a clean, well maintained and adapted environment, which they were comfortable and happy with. People and staff were informed and confident to raise any safety concerns relating to people’s care, if they needed to. People felt safe at the service and staff knew how to keep them safe from any abuse or harm associated with their assessed health, environment or care equipment needs.

Staffing measures, emergency contingency planning and related safety procedures, helped to ensure people’s safety at the service. Management action was agreed, to review staff lone working and deployment arrangements at night, to further ensure people’s safety.

Risks to people’s safety associated with their health conditions, medicines, environment and any care equipment, were assessed before people received care and regularly reviewed in consultation with them. People’s medicines were safely managed.

Staff were trained, knew how and provided people’s care in a way that ensured their choice, involvement and least restrictive care. People’s consent or appropriate authorisation was obtained for their care, to ensure their rights and best interests.

Safety incidents were monitored, analysed and used to inform any care improvements needed. Care and service improvements, including any lessons learned from this; were shared with staff and followed to reduce any further risks to people’s safety.

People continued to receive effective care. Staff helped people to maintain and improve their health and nutrition. People were supported to access external health professionals when they needed to and staff followed their related instructions for people’s care when required.

People’s health and personal care plans were devised in consultation with them and regularly reviewed. Staff consulted with people to optimise their inclusion, understanding and ownership of their agreed care; and to ensure effective information sharing with external care providers when required. People were provided with care and service information in a format they could understand.

People continued to receive individualised care from staff, who were kind, caring and fostered good relationships with them and their families. Staff understood and followed people’s preferred daily living routines, lifestyle and care preferences. This was done in an individualised way that helped to ensure people’s choice and independence.

Staff knew how to communicate with people in the way they preferred and understood. People were informed to help them understand their rights, what they could expect from their care and how to access relevant advocacy, if they needed someone to speak up on their behalf. People’s views were regularly sought about their care and they were informed, confident and knew how to make a complaint if they needed to.

The service continued to be well led. The provider operated effective systems to ensure the quality and safety of people’s care, ongoing service improvement and partnership working to enhance people’s care experience.

Staff understood their roles and responsibilities for people’s care. People’s care was effectively informed, lawful and well led. The provider met their legal obligations, to share relevant information with us about people’s care, and to inform others with an interest about our judgements.

Further information is in the detailed findings below.

All people using the service had capacity to make decisions about their care at the time of our inspection. Where people may not have the capacity to make some decisions about their care, the provider's arrangements were not fully adequate to meet legal requirements.

During our inspection we observed staff taking time to sit with and talk with people receiving care. Some people were involved in crafts and others were watching television. One staff member we spoke to told us, "We always make time to talk with people using the service."

We found appropriate arrangements were not in place in relation to managing people's medicines.

There were enough qualified, skilled and experienced staff to meet people's needs.

We found staff records and other records relevant to the management of the service were generally accurate and fit for purpose.

People's views and experiences were taken into account in the way their care and support was delivered at Francis House. People's consent was also generally being sought for the care they received at the home.

We found that staff were trained to provide appropriate support for people, and received support from managers in supervision and team meetings.

We saw that a range of different ways were used to assess and monitor people's care and safety at Francis House, and that people's views were taking into account when assessing quality.

Although we saw that some positive support strategies were used at the home, care planning and risk management systems did not fully describe people's needs or personalised ways of providing support. Because of this we found that people were not fully protected from receiving inappropriate or unsafe care at Francis House.