Background to this inspection
Updated
3 August 2022
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. We checked whether the registered provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
Three inspectors, a pharmacy inspector and an expert by experience carried out the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Finney House 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.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was no registered manager in post however a manager was employed and in the process of registering with CQC.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we received about the service, including information from the registered provider about important events that had taken place at the service, which they are required to send us. We sought feedback from the local authority. The registered provider was not asked to complete a registered provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
During the inspection
We spoke with six people who lived at the home about their experiences of the care provided. We spoke with 12 members of staff including the two managers, regional manager and the nominated individual on the inspection. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with 14 relatives. We reviewed a range of records. This included 12 people’s care records, multiple medication records, accident and incident records, three staff recruitment records. We looked at a variety of records relating to the management of the service.
After the inspection
We continued to seek clarification from the managers and nominated individual to validate evidence found. We looked at training data and quality assurance records and sought feedback from health and social care professionals.
Updated
3 August 2022
About the service
Finney House is a nursing home providing accommodation and personal care for up to 96 adults. There were 41 people living at the service at the time of the inspection. Some of the people lived with mental health needs, dementia and required support with their physical needs.
People’s experience of using this service and what we found
People and their relatives told us they felt safe and protected from the risk of abuse and avoidable harm by staff who understood how to recognise, respond and report concerns. While some improvements had been made to the management of medicines, practices were not always safe and further improvements were required. The provider and their manager had improved their systems to ensure people’s clinical needs were identified, monitored and safely met. Risk assessments were in place to monitor and minimise the potential risk of avoidable harm to people during the delivery of their care. People were supported by staff who had been safely recruited. Staff had received training and guidance in the prevention and control of infections including COVID-19.
Arrangements for staff supervisions needed to be improved to follow best practice guidance. We made a recommendation about staff supervisions.
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. People’s consent was sought however some improvements were required and the manager took immediate action to address them. People's care and support had been planned in partnership with them, their specialist professionals and their relatives where possible. Staff had received training that was suitable to meet the needs of people in the home and the induction and support of new staff had improved.
People and their relatives shared positive comments about the caring nature of the staff team. They said staff were kind and caring. People were treated with dignity and respect and their right to privacy was upheld. There had been a focus on monitoring and supporting people’s personal care, hygiene and dignity.
People received person-centred care, which was responsive to their needs. Care records reflected people’s needs and had been reviewed when people’s needs changed. Staff supported people with meaningful activities. People's individual communication needs had been assessed. The registered manager dealt with people's concerns and complaints appropriately. People received dignified end of life care.
The provider made improvements to the quality monitoring, governance and leadership arrangements which contributed to driving improvements at the home. The provider and staff worked hard to improve people’s experiences and to address shortfalls found at the last inspection. Comments from relatives included; "They seem to be heading in the right direction for sure we can see a difference". The provider audited various areas of people’s care however, they needed to sustain the changes they made and to continue to monitor areas of improvement including medicines management and seeking consent. The service worked in partnership with a variety of agencies to ensure people received the support they needed. Staff were positive with how the service was managed and the culture and morale within the staff team had improved.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update:
The last rating for this service was inadequate (published 27 October 2021) and there were multiple breaches of regulation. At this inspection we found improvements had been made and the provider was no longer in breach of regulations 9, 10, 11,13, 17 and 18. The provider remains in breach of regulations in relation to medicines management.
This service has been in Special Measures since 27 October 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This was a planned inspection based on our inspection scheduling.
Enforcement and Recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to medicines management at this inspection. Please see the action we have told the provider to take at the end of this report.
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.