We carried out a review of the data available to us about Felix Holme RCH on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Felix Holme RCH, you can give feedback on this service.
Felix Holme RCH provides accommodation for up to 20 older people in one adapted building. At the time of the inspection 17 people were living there. Some people lived at the home permanently whilst others were there for short stays, for example following a period of ill health. This is known as respite.
People were living with a range needs were associated with old age and frailty. Accommodation is provided over three floors with a passenger lift and stair lift that provides level access to all parts of the home.
There was a registered manager, however they no longer worked at the service, but had not yet de-registered with the Care Quality Commission. The provider was currently managing the service and was in the process of registering with Care Quality Commission to become the registered manager. 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.
Felix Holme RCH had been previously inspected in November 2017 where we found the service was meeting all the regulations. However, we asked the provider to make improvements to achieve a ‘good’ rating. At this inspection we found improvements had been made and a rating of ‘good achieved.
People were supported by staff who knew them well and treated them with kindness, respect and understanding. Staff understood people’s support needs and ensured care provided was person-centred and met people’s individual needs and choices. People were enabled to make decisions and choices about what they did each day and their dignity and privacy was respected. People had enough to do each day. There was an activity programme which people enjoyed participating in as they wished.
There were systems in place to assure quality and safety and to identify if any improvements to the service were needed. The provider had good oversight of the service and what was needed to improve and develop the service. Where improvements were needed work had started to address these.
People’s medicines were ordered, stored administered and disposed of safely. People received their medicines in a way that reflected their personal preferences.
There were enough staff working to provide the support people needed. Recruitment procedures ensured only suitable staff worked at the home. Staff had a good understanding of safeguarding procedures. This meant people were protected from the risks of harm, abuse or discrimination.
Staff had a good understanding of the risks associated with the people they looked after. Individual and environmental risk assessments were in place. There provided the guidance staff needed. Fire procedures had been developed to help keep people safe in the event of a fire.
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. There was a training programme for staff and they received regular supervision and appraisals.
People were supported to eat and drink a choice of food that met their individual needs and preferences. People’s health and well-being needs were met. They were supported to have access to healthcare services when they needed them.
There was a complaints policy and people told us they would discuss any concerns with the provider or staff. The provider was well thought of and supportive to people and staff. Systems were in place to gather feedback from people and staff and this was used to improve the service.
Felix Holme is situated in Eastbourne and provides accommodation and personal care for up to twenty older people. Some people lived at the home whilst others were there for short stays, otherwise known as respite. There were 14 people using the service at the time of inspection; 12 living there and two staying for respite. This is the first rating under the new provider, however the management structure remains the same in the service.
Bedrooms are located over three floors and can be accessed via stairs. Communal bathrooms and toilet facilities are available throughout. There are several communal areas; a dining room, main lounge and quiet lounge. A front garden contains a seating area which we observed people sitting in during inspection.
The service had a registered manager. ‘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.’ There was also a Head of Care who is being trained to be the registered manager and was therefore an integral part of the inspection. For the purposes of this report, the head of care will be referred to as the trainee manager.
The provider did not demonstrate safe practises with regard to fire safety. There were no clear protocols or evacuation plans for supporting people in an emergency and actions identified in a previous Fire Safety report had not been completed. The information on the main handover form regarding support that people required in a fire was also inaccurate. We saw that weekly fire tests were carried out however the service was not completing fire drills. On the second day of inspection, these concerns had already been addressed and fire protocols were much clearer.
Overall medicines were managed safely and staff observed to be professional when supporting people. However there were aspects of giving people ‘as required’ medication that needed further clarification to ensure they were effective for people. Staff were also not consistently receiving medication competencies to ensure that they were giving people their medicines safely. On the second day of inspection, the trainee manager had sought guidance for what was required and documentation had been improved. The provider also had an action plan for ensuring medicine competencies would be completed in a timely manner.
Staff told us that they received a wide variety of training and people and their relatives were equally confident that staff had the right skills and knowledge to support people effectively. However, records for staff failed to identify whether they had received training and when it was due for renewal. Certificates used to inform this process were either missing or lacked dates for completion which made it difficult for the registered manager to have clear over sight on whether staff have the skills and knowledge to support people. Since the inspection, we have seen some improvements to the training records.
Staff had the opportunity to meet with their manager’s for supervision and had regular staff meetings where they could discuss any concerns.
People were not consistently given opportunities to engage in a variety of social activities. There were limited activities on offer during our visits. Some people were independent in going out or happy to partake in their own activities, however other people and relatives felt more could be on offer. The registered manager acknowledged that activities offered could be better and has since identified actions to improve this.
The registered manager and trainee manager told us that they regularly assess the quality of the service by auditing and reviewing. However areas where records were inaccurate or issues identified during inspection were missed, suggests the auditing process was not always effective. Quality audits that we did see were detailed and in-depth however the trainee manager was not always able to complete them. It was acknowledged that delegation of tasks was important to ensure responsibility did not fall on one person. The provider also has plans to ‘up-skill’ staff so that they can take responsibility for people’s support plans.
Staff treated people with kindness, compassion and respect and promoted people's independence and right to privacy. People and their relatives spoke highly of the staff team who demonstrated their understanding of people’s preferences dislikes and support needs. Staff also felt supported and cared for by their manager’s and employer’s. However encouraging people’s independence and setting personal goals was not always identified, particularly for those people on respite.
Staff had a clear understanding on how to safeguard people and protect their health and well-being. Risk’s for people were identified in their support plans and actions taken to minimalize this risk. There were sufficient numbers of suitable staff to ensure peoples safety.
We saw that staff had access to Personal Protective Equipment (PPE) to minimalize the risk of cross infection. We observed staff using PPE regularly throughout inspection.
The registered manager, trainee manager and staff had a good understanding of the Mental Capacity Act and how to promote choice in decision making. People at Felix Holme were mostly independent and able to make decisions about their care and safety. Regardless of this, the registered manager and staff understood their responsibilities under the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be deprived of their liberty for their own safety.
People’s nutritional needs were met. People told us that they enjoyed the food and that there was a lot of choice with meals. Any risks that were identified for eating and drinking were highlighted in care plans and also displayed in the kitchen.
Records showed that the provider sought guidance from health professionals where additional support needs were identified. A health professional spoke highly of the service and felt they were responsive to people’s changing needs. Care plans were tailored to individual’s and highlighted areas where additional support was required.
People, their relatives and staff spoke highly of the management team and felt that an open, transparent and supportive culture was promoted. Staff felt that good practise was recognised and celebrated, which meant they felt valued by the provider.
Further information is in the detailed findings below