Archived: Fonthill House

There were 57 people living at the service on the day of our inspection. There was a registered manager in post. They were registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run. The registered manager at Fonthill House was also the provider (owner).

When we last inspected the service on 12 August 2014 we found them to be meeting the required standards. At this inspection we found that they had continued to meet the standards.

People told us they felt safe and secure living at Fonthill House. Staff were knowledgeable in recognising signs of potential abuse and knew how to report concerns both within the organisation and externally if required. Assessments were undertaken to identify any risks to people who received a service and to the staff who supported them. There were plenty of staff available to meet people’s individual support and care needs at all times, including during the night and at weekends. People received appropriate support from staff to enable them to take their medicines.

People received care and support that was based on their individual needs and preferences. There was a ‘people first’ culture within the home and people were central to everything the manager put in place. People’s care and support plans were reviewed regularly in consultation with the person and, where appropriate, family members to ensure the service continued to meet their changing needs. People and their relatives felt confident to raise any concerns and told us they were confident any concerns would be resolved without delay. People received their care and support from a staff team that were both competent and extremely knowledgeable with regard to people’s health and care needs and demonstrated that they were skilled and experienced to meet them. People who used the service were treated with dignity and respect, and their privacy and confidentiality was maintained.

People were offered a range of innovative and diverse activities and were supported to pursue hobbies and pastimes that were of interest to them, and that were suited to their varying abilities.

Safe and robust recruitment practices were followed to make sure that all staff were of good character, and were suitable to work in a care home environment as well as being fit for the roles they were being employed to carry out. Staff records confirmed checks had been made which ensured they were safe to work with vulnerable adults before a position was offered to them. They also told us that they had been encouraged to spend time with people who lived at the home as part of the recruitment process.

Staff were well supported by the registered manager and received an induction when they started working at the home. They received on-going training and support to enable them to perform their roles effectively. Staff had regular individual supervision meetings, team meeting and had an annual appraisal to review their development and performance.

People’s views about the service were gathered using several methods, including a comments and suggestions box, a comments book, survey and verbal feedback.

Feedback was used in a positive way to improve the quality of the overall service. People we spoke to were positive and complimentary about all aspects of the service.

The manager was creative and innovative in how the service was operated. People were encouraged and supported with a focus on what they could do and they were not restricted by health or physical conditions. People were supported to take risks and make their own informed decisions. The manager had developed excellent links within the local community which enhanced the quality of life for people who lived at Fonthill House. For example they had regular high profile and inspirational speakers who came to the home to give a talk on a variety of issues and current affairs. People told us repeatedly that the management and staff consistently strived to improve the quality of lives of everyone who passed through their doors.

This is a summary of what we found:

Is the service safe?

We saw that people's medication was managed appropriately so they received the right medication at the correct time.

People told us they felt safe. Safeguarding vulnerable adults from abuse procedures were robust and staff understood how to safeguard people they cared for. Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints and whistleblowing investigations. This reduced the risks to people and helped the service to continually improve.

The service had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put into place to ensure that people's human rights are protected should their liberty be restricted in any way. Staff had been trained to understand when an application should be made and knew how to submit one.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

The service was safe, clean and hygienic. Environmental audits were carried out regularly therefore not putting people at unnecessary risk.

The provider had safe and effective staffing rotas. Policies and procedures were in place to make sure that unsafe working practice was identified and people were protected.

Is the service effective?

People's health and care needs were assessed with them. Specialist dietary, personal care and psychological needs had been identified in care plans where required. People told us that they had been involved in writing their care plan and that they reflected their current needs.

Is the service caring?

People were treated with respect and dignity by the staff. People were supported by kind and attentive staff. We saw that support workers showed patience and gave encouragement when supporting people. People we spoke with told us, 'The staff are excellent here and nothing is too much trouble. We are very spoilt with the high calibre of staff."

People who used the service, their relatives, friends and other professionals involved with the service completed a yearly satisfaction survey. People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

People knew how to raise a concern or complain if they were unhappy.

The service worked well with other agencies and services to make sure people received care in a joined up way.

People completed a range of activities in and outside of the service regularly.

Is the service well-led?

The service had a quality assurance system in place. Records seen by us showed that identified shortfalls were addressed promptly. We were therefore assured that the provider had taken steps to continually improve the service.

Staff told us they were clear about their roles and responsibilities and staff demonstrated a good understanding of the ethos of the service.

People we spoke to told us that the staff in the home were 'kind and caring' and the atmosphere in the home was that of a 'big family' and that they were 'free to do what they want'. People told us that their personal care needs were met and staff were always on hand to provide them with anything they needed.

We found that the provider was meeting the essential standards because they treated people with dignity and respect and allowed them to make choices around their daily care routines. We saw that through the use of their coffee shop they were promoting community involvement and people's independence. We found that people who used the service were happy and we were told by one person that before they came to the home they were 'lonely' and now they had 'good friends' around them.

The staff we spoke to told us that the provider was 'understanding' and listened to staff suggestions and acted on them. Staff said that Fonthill house was a 'lovely place to work' and that the 'standard of care is unbelievable'. Staff told us that it was their perception that people 'lived their lives as they would at their own home'. Staff told us that the care they provided was 'not about us (the carers) it's about the people who lived at the home'.