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Finch Manor Nursing Home Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 13 April 2021

During an inspection looking at part of the service

About the service

Finch Manor is a care home providing personal care for up to 85 older people. The service is purpose built and the accommodation is in five units over one floor, although at the time of the inspection, only four units were in use. Each of the units supports people living with different conditions such as dementia and nursing needs. There were 55 people living at the service at the time we inspected.

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

At the last inspection, we found concerns with the safety and quality of care being provided at this service. People living at Finch Manor did not benefit from a service that was safe or well-led and we found multiple breaches of regulation.

As this inspection, we checked to see whether improvements had been made and found they had.

Since the last inspection, a new registered manager had joined the service, and the management team had been restructured. Both people and staff spoke positively about the new manager and the changes they had made.

We found that the service had improved their systems and processes to ensure that care provided to people was safe, and the quality of care and support was consistently monitored.

People spoken with and their relatives told us they were happy with the care being provided and valued the staff.

Parts of the service had been reconfigured and we observed people were calm and at ease in their environment as a result. People were supported to have maximum choice and control of their lives, and staff supported people in line with preferences.

The appearance of the physical environment had improved since the last inspection. New bathrooms, satellite kitchens and flooring had been installed and most areas had been newly painted.

Although significant improvements had been since the last inspection, further time was required to ensure that new systems were fully embedded, and consistency of improved practice was evidenced.

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 11 September 2020) and there were multiple breaches of regulation. In line with our enforcement procedures, we issued Warning Notices in respect of Regulation 12 and 17.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found enough improvement had been made and the provider was no longer in breach of regulation and the Warning Notices had been met.

This service has been in Special Measures since 19 October 2019. 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

We carried out an unannounced focused inspection of this service on 23 July 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from Inadequate to Requires Improvement. This is based on the findings at this inspection.

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

We looked at infection prevention and control measures under the Safe key question. We look at this in

Inspection carried out on 23 July 2020

During an inspection looking at part of the service

About the service

Finch Manor is a care home providing personal care for up to 85 older people. The service is purpose built and the accommodation is in five units over one floor. Each of the units support people living with different conditions such as dementia and nursing needs. At the time of the inspection there were 78 people living at the service.

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

People living at Finch Manor did not benefit from a service that was safe or well-led.

People did not always receive their medicines safely. Medication was not managed, stored and administered in a safe way.

Care plans were not consistent and did not contain the most up to date information about people's health care needs and requirements. Care records lacked person centred detail. Risk assessments were not always in place or adequate to minimise risks to people. Care records were not maintained so people’s care, support and treatment had not always been accurately documented and monitored.

The service did not always identify and report accidents and incidents appropriately and refer incidents to safeguarding for investigation when necessary. Incidents were not analysed effectively meaning that people were exposed to a risk of harm.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. There were no assurances that people made their own decisions about their care and treatment.

Assurance and auditing processes did not assess, monitor and drive improvement in the quality and safety of the service being provided. Governance systems were ineffective and did not mitigate risk to the health and welfare of people living at the service.

Systems in place to monitor the physical environment had improved since the last inspection, although it was not evident that a major recommendation made by the fire service had been implemented.

The appearance of the physical environment had improved since the last inspection. New bathrooms and flooring had been installed and corridor walls had been newly painted. It was recognised that the service was still in the process of a full refurbishment.

Safe recruitment practices were in place for staff. People's relatives spoke positively about the staff and care received by their loved one.

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 21 October 2019) and there were multiple breaches of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found not enough improvement had been made and the provider was still in breach of regulation. We also identified new breaches of regulations, meaning that the service had further deteriorated.

Why we inspected

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Inadequate. The service is therefore in 'Special measures'. This is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional

Inspection carried out on 16 September 2019

During a routine inspection

About the service

Finch Manor is a care home providing personal care for up to 85 older people. The service is purpose built and the accommodation is in five units over one floor. Each of the units support people living with different conditions such as dementia and nursing needs. At the time of the inspection there were 78 people living at the service.

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

People did not always receive their medicines safely. Medication was not managed and administered in a safe way.

Care plans were inconsistent and did not contain the most up to date information about people’s health care needs and requirements. Care records lacked person centred detail. Risk assessments were not always in place or adequate to minimise risks to people.

The safety of the environment was not routinely monitored or assessed. Many areas of the service appeared worn and tired. Bathrooms were not maintained and appeared unclean. The service was in need of a full refurbishment.

Systems in place to monitor, assess and improve the safety and quality of the service being provided were not effective. The safety and oversight of the service was inadequate.

Not all staff had received the necessary training to help them carry out their role in a safe and competent manner.

Safe recruitment practices were in place for staff. People and relatives spoke positively about the registered manager and the staff. We observed some positive interactions between staff and people living at the service.

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.

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 requires improvement (published March 2019) and there were multiple breaches of regulation.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection, we found not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating. You can see what action we have asked the provider to take at the end of this full report.

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

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe, and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.

Inspection carried out on 5 March 2019

During a routine inspection

About the service: Finch Manor is a care home providing personal care for up to 89 older people. The home is purpose built and the accommodation is in five units over one floor. One of the units within the home is designed to support people living with dementia and one unit is designed to support people with nursing needs. At the time of the inspection there were 69 people living at the home.

People’s experience of using this service: People living in the home told us they felt safe. Most people felt there were enough staff to meet their needs. However, two people and some relatives told us there was not always enough staff and during these times response to call bells was slow. During the inspection we observed staffing levels to be adequate, with staff able to support people in a timely way.

People were not always receiving their medicines safely. Staff were not following the service medication policy when administering medicines. Staff had not been appropriately checked for competence with administering medication.

The service was not compliant with the Mental Capacity Act (MCA) 2005 and the associated Deprivation of Liberty Safeguards (DoLS). People had not always had an appropriate assessment when they were deemed to lack capacity for a specific decision. People were being restricted without the lawful process being followed.

Care plans were inconsistent and lacked detail.

The service failed to ensure staff were suitably trained and supervised in their roles.

Risk assessments were not fully completed or adequate for the management of people’s risks. Environments risks were also not well managed. We found medicine rooms, maintenance rooms and other areas that posed a danger to people, unsecured. We also found concerns with hot water temperatures. These issues were addressed during the inspection.

People told us they had enough to eat and drink. We saw snacks being offered throughout the day. However, we raised concerns with the lack of drinks offered throughout the day. We also raised concerns with the lack of monitoring for people's fluids. Although fluid consumption was recorded in people's notes, there was no oversight of this to ensure people were having adequate fluids. The provider has since put new governance systems in place to address this.

Safe recruitment practices were in place for staff. People were complimentary about the staff that supported them. We observed caring, familiar interactions between staff and people living in the home.

Standards of cleanliness were poor in some parts of the home. Some communal areas appeared dusty and dirty. The home was in need of a refurbishment as it was ‘tired’ looking in parts..

The service did not have robust and effective systems in place to monitor, assess and improve the safety and quality of service being provided. Management oversight of the service was inadequate.

You can see more information in the Detailed Findings below.

Follow up: Following the inspection, we asked the provider to detail how they planned to deliver the required improvements. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme.

Rating at last inspection: This is the first inspection for this provider.

Why we inspected: This was a planned comprehensive inspection.

Enforcement: Please see the ‘action we have told the provider to take’ section towards the end of the report.