Fessey House

Updated 8 May 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection team consisted of three inspectors and an Expert by Experience. 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:

Fessey House is registered to provide accommodation and personal care for up to 39 older people who require nursing or personal care. 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.

Fessey House is divided in to four units. Two units provide support to people requiring short term support in 'discharge to assess' or crisis beds, the other two units provide long-term care for people living with dementia.

The service had a manager registered with the Care Quality Commission. 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.

What we did:

Before the inspection we reviewed the information we held about the service and the service provider. The provider completed a Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern. We reviewed the action plan which the provider had submitted following the last inspection. We received feedback from two social and health care professionals who regularly visited people who received care from the service. We also reviewed the provider’s previous inspection report.

We spoke with 11 people and four relatives. We looked at five people’s care records and six medicine administration records (MAR). We spoke with the registered manager, the service manager, the nominated individual, the deputy manager and eight staff which included, carers, kitchen staff and activities coordinator and a volunteer. We reviewed a range of records relating to the management of the home. These included five staff files, quality assurance audits, staff communication letters, incident reports, complaints and compliments. In addition, we reviewed feedback from people who had used the service and their relatives.

After the inspection, we received additional evidence from the service.

Updated 8 May 2019

About the service:

Fessey House is care home that was providing personal and nursing care to 32 people at the time of the inspection.

People’s experience of using this service:

• The provider demonstrated they had made significant improvements since our last inspection. We found the service had improved and met the characteristics of an Outstanding service in caring domain and a Good service in safe, effective, responsive and well-led. We received exceptional feedback on how staff supported people and went the extra mile to get care just right for people.

• The service was designed around people’s needs and wishes and used innovative ways to help people to be as independent as possible. Fessey House was divided into four colour coded units. Each unit had a kitchenette, dining area and sitting area. These units were decorated to a high standard with an emphasis on the building being people’s homes. Colour coordination was used to enable people to find their way in the home and to promote their independence. We saw people easily and freely navigating around the home independently.

• People were valued and respected as individuals allowing them to be partners in their care. There was an exceptionally strong ethos within the service of treating people with dignity and respect. People were at the forefront of the service delivery and the provider was committed to and passionate about providing a high-quality service.

• We received exceptionally positive feedback from all people and relatives. The feedback reflected staff were very kind, caring and committed. People complimented the continuity of care provided by regular staff which contributed to building of meaningful relationships. Staff exceeded in recognising what was important to people and ensured individually tailored approach that met people's personal needs, wishes and preferences was delivered. There was evidence the staff often went 'the extra mile' to meet people's needs.

• People were supported by exceptionally caring staff that knew them well and understood how to maximise their potential. People were supported to maintain relationships with their families and friends and the value of relationships was central to the success of the service. People's independence was highly promoted and they received support to achieve their goals.

•The service had a holistic approach to assessing, planning and delivering care and support. They looked for and encouraged the safe use of innovative and pioneering approaches to care and support, and how it is delivered. New evidence-based techniques and technologies were used to support the delivery of high-quality care and support. For example, the service was taking part in a pilot project called ‘My Sense’ which used technology to maximise safety to people whilst they were at the service as well as when they went back to their own homes.

• There was a thorough approach to planning and coordinating people’s move to other services, which was done at the earliest possible stage. Fessey House supported people requiring short term support in 'discharge to assess' beds which aimed at rehabilitating people back into their homes. This was a tailor-made service which consisted of dedicated care staff, social workers physiotherapists and occupational therapists.

•Staff were committed to working collaboratively and had found innovative and efficient ways to deliver more joined-up care and support to people. The provider worked collaboratively with the local hospital, GPs and community teams. Fessey House had been recognised in the Health Service Journal (HSJ) Value awards and won both last year’s categories for improving value in the care of frail older patients as well as Improved partnerships between health and local government.

• People living at Fessey house received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.

• Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely and people received their medicines as prescribed.

• People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.

• Fessey House was well-led which resulted in provision of good care. The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service. The provider had effective systems in place to monitor the quality and safety of the service.

• The service was an integral part of the local community. The team developed various community links that reflected the changing needs and preferences of the people who used the service.

Rating at last inspection:

• At our last inspection we rated the service requires improvement. Our last report was published on 9 March 2018.

Why we inspected:

• This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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