Finch Manor Nursing Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed. The service was in continued breach of legal regulation in relation to the ways people’s medicines were managed safely.

This service scored 56 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Systems which had been put in place to record and report events had improved since the last assessment. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, information recorded demonstrated the actions taken in response to individual events which had occurred. The provider supported the manager to look at trends and lessons learnt. Family members told us they were kept informed about events which occurred. One family member told us, “It’s been so good. [Staff] ring me if [Name] falls.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Appropriate care records were maintained to record transition between services, for example if a person went into hospital. One person who received care in bed told us they were uncertain how they would be safely evacuated from the service in an emergency. We checked the emergency processes and equipment in place and found there was a safe plan of evacuation. The deputy manager told us they would speak to and assure the person.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. However, we received feedback reflecting effective partnership working was a very recent improvement. A professional who worked with the service told us, “When I originally got involved, communication was quite poor. The new manager is good to communicate and responds well to requests for information. I have seen some improvements in recent weeks.” As there had been a further change in the management team since our last assessment, we could not yet be sure this was a sustained improvement.

Staff protected people’s right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. People told us they felt safe. One person said, “The staff are friendly, and I have no complaints.”

The provider shared concerns quickly and appropriately. A safeguarding policy was in place to support this process.

Several people were being deprived of their liberty following decisions which had been made in their best interests. This process is known as an authorisation under deprivation of liberty safeguards (DoLS). Systems to record and monitor this were appropriate and in line with the Mental capacity Act 2005.

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. For example, people had detailed risk assessments and care plans in place to mitigate risk, there were some shortfalls in the accurate recording of daily monitoring of care. For some people, planned monthly reviews of care needs were not fully up to date. We raised these findings with the manager who told us they were aware further improvements were needed.

We observed staff using safe practices when assisting people to mobilise.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care. The service was generally well maintained; however, we observed piles of discarded cigarette butts in some areas of the internal gardens. These were agreed smoking areas for people however, these areas also contained seating which, at some times, blocked access to others using the garden. These were cleared and tidied when raised however had clearly built up over time.

Bedrooms were personalised to people taste. Some bedrooms showed areas of wear and tear and required fresh redecoration. Planned maintenance and redecoration of the service was ongoing.

Routine checks on the environment and equipment were up to date and certificates were in place to demonstrate this. We observed people had the equipment they needed to keep them safe. Since our last assessment, the service had received a reinspection from the local authority environmental health department. The food safety rating had improved.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. We observed staffing levels and staff were available throughout our assessment in communal areas to respond to people. However, some staff told us additional staffing would be beneficial in parts of the service where people were cared for in bed. Other staff said domestic staffing levels should be increased to ensure high cleaning standards could be maintained.

Staff worked well together to provide safe care that met people’s individual needs, however, some people told us they had to wait for staff to assist if they had, for example a particular preference of staff gender. One person described ‘peak times’ of the day such as mealtimes when staff were busier, and they had to wait longer for assistance when they needed it.

We shared all this feedback with the management team. The regional manager told us they would review staffing levels.

Staff were recruited safely. Appropriate checks were in place to ensure staff were suitable for their role. Staff, including agency workers, received an induction when they commenced employment. Regular staff confirmed they received ongoing training to enable them to undertake their role effectively.

The provider did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. Some equipment needed deep cleaning, for example, a chair in one bedroom and some wheelchairs. In one area of the home a nailbrush was found in the bathroom and hairbrushes were stored in the same area as personal protective equipment (PPE). Immediate action was taken to rectify these shortfalls when raised.

Other systems were more effective in protecting people from the risk of infection. We observed the home to be generally clean and tidy. Cleaning rotas were maintained. Supplies of PPE were readily available and appropriately worn by staff.

The provider involved people in planning but did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Following the last assessment, the provider received a Warning Notice relating to the management of medicines. At this inspection we found significant improvements had been made, however more improvements were still needed.

Thickening agents are prescribed to reduce the risk of choking for people who are unable to drink thinned fluids. Staff were not consistently recording the administration of thickener so we could not be assured that this was always done safely.

Temperatures of fridges used to store medicines were taken however action was not taken when these were recorded to be outside of a safe range. As a result, some medicines had to be disposed of, people had been put at risk of receiving medicines that were not safe to use.

Medicines audits were not fully completed. Audits had not noted the findings at this inspection.