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Florence Nursing Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 26 August 2020

During an inspection looking at part of the service

About the service

Florence Nursing Home is a care home accommodating up to 30 older people, some of whom may be living with dementia, in one adapted building. At the time of the inspection 20 people were using the service.

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

Some risks in relation to the premises were not always identified or safely managed. The provider’s system to manage the quality and safety of the service was not consistently effective. Staff had received training, but they did not always have appropriate guidance to refer to on how to manage some possible risks in relation to Covid 19. Records of people’s care were not always accurate and up to date.

The registered manager took swift action to address the issues we found with the premises and records. They told us they would take action to address other areas of concern found.

People’s relatives told us they thought their family members were safe and well looked after. People were protected from abuse and neglect. There were enough staff to meet people’s needs and medicines were managed safely. Risks in relation to people’s health care were assessed and plans were in place to reduce risks.

We saw staff had received training on infection control, wore appropriate PPE and supported people to socially distance as far as possible. There was guidance displayed on how to manage visitors safely during the pandemic.

Staff received regular training and support to carry out their roles. 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. People’s nutritional needs were supported, and they had access to appropriate advice from health professionals.

Relatives told us they were happy with the way the home was run. However, they told us they would like more communication from the home during the pandemic, when visits were limited.

The registered manager understood their responsibilities as registered manager. Staff told us they felt well supported and worked well as a team. The provider sought people’s and their families views about the service, although meetings had not been held for some time due to the restrictions of the pandemic.

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 report published (5 December 2019).

Why we inspected.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We undertook this targeted inspection to follow up on specific concerns which we had received about the service. The inspection was prompted in part due to concerns received about people’s nursing care needs. A decision was made for us to inspect and examine those risks.

We inspected and found areas of concern had been acted on but there was a concern with some risks in relation to the premises, the provider’s system to manage the quality and safety, and people’s records. So, we widened the scope of the inspection to become a focused inspection which included the key questions of Safe, Effective and Well-Led.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

We have found evidence that the provider needs to make some improvements.

The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection. You can see what action we have a

Inspection carried out on 18 November 2019

During a routine inspection

Florence Nursing Home is a care home that provides accommodation and nursing care for up to 30 older people some of whom may be living with dementia in one adapted building. At the time of the inspection 25 people were using the service.

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

The home had safeguarding procedures in place and staff had a clear understanding of these procedures. Appropriate recruitment checks had taken place before staff started work and there were enough staff available to meet people’s care and support needs. Risks to people had been assessed to ensure their needs were safely met. People’s medicines were managed safely. The service had procedures in place to reduce the risk of infections.

People’s care and support needs were assessed when they moved into the home. Staff had the skills, knowledge and experience to support people appropriately. Staff were supported through induction, training, regular supervision and annual appraisals of their work performance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People were supported to maintain a healthy balanced diet and they had access to health care professionals when they needed them. The registered manager was in the process of improving the environment for people living with dementia.

People and their relatives had been consulted about their care and support needs. People were supported to take part in activities that met their needs. The home had a complaints procedure in place and people and their relatives said they were confident their complaints would be listened to and acted on. There were procedures in place to make sure people had access to end of life care and support when it was required.

The registered manager and staff worked in partnership with health and social care providers to plan and deliver an effective service. The provider took people and their relatives views into account through satisfaction surveys and meetings. There were systems in place to monitor the quality and safety of the service and any learning was identified and acted on. Staff enjoyed working at the home and said they received good support from the registered manager and deputy manager.

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 18 July 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 20 June 2017

During a routine inspection

This inspection took place on 20 June 2017 and was unannounced. Florence Nursing Home was registered with the Care Quality Commission in August 2016. This was the first inspection of the home. Florence Nursing Home provides residential and nursing care for up to 30 people and is located in the London Borough of Bromley. At the time of our inspection the home was providing support to 25 people.

The home had a registered manager in post. 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 registered manager also managed another care home run by the registered provider. The provider was in the process of recruiting a full time registered manager to run the home.

There were appropriate safeguarding adults and whistle-blowing procedures in place and staff had a clear understanding of these procedures. Procedures were in place to support people where risks to their health and welfare had been identified. There were safe staff recruitment practices in place and appropriate numbers of staff were deployed throughout the home to meet people’s needs. Medicines were managed, administered and stored safely.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. Staff had completed an induction when they started work and they had received training relevant to the needs of people using the service and supervision. People’s care files included assessments relating to their dietary support needs. People had access to health care professionals when they needed them.

People’s privacy was respected. People using the service and their relatives, where appropriate, had been consulted about their care and support needs. People received appropriate end of life care and support when required. Care plans and risk assessments provided guidance for staff on how to support people with their needs. There was a range of appropriate activities available for people to enjoy. People and their relatives knew about the home’s complaints procedure and said they were confident their complaints would be fully investigated and action taken if necessary.

There were appropriate arrangements in place for monitoring the quality and safety of the service that people received. The provider took into account the views of people using the service, relatives and staff through surveys. The results were analysed and action was taken to make improvements for people living at the home. The provider carried out unannounced visits to the home to make sure people where receiving appropriate care and support. Staff said they enjoyed working at the home and they received good support from the registered manager and the provider.