Faith House Residential Home

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

The provider had failed to identify or act to mitigate the risks to people. We identified through our inspection that the home did not have safe staffing levels during the night. Some people the staff cared for required two staff to safely support them. Only one night staff worked during the night with one staff member on call.

Systems to monitor and audit the home were not effective and had not identified the improvements that were required. The provider visited the home, but no formal audits had been completed which would have helped to identify any shortfalls and to monitor any actions identified. Quality assurance systems were not robust.

Staff were trained to recognise signs of abuse or risk and understood what to do to safely support people. People had risk assessments in place which meant peoples' safety and well-being was promoted. The home was clean and tidy. There were enough staff to meet people's needs. Safe recruitment practices had been followed before staff started working at the service. Accidents and incidents were recorded, and lessons learnt to prevent reoccurrences. Medicines were safely administered to people by appropriately trained staff, who had been assessed as competent.

Staff received regular support to help them carry out their role. The annual training programme equipped staff with essential skills and knowledge. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. 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.

Staff were caring, and people were treated with kindness and respect. Staff knew people well and understood how to communicate with them. People's privacy was respected, and their dignity and independence promoted. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner.

Rating at last inspection

The last rating for this service was good (published 13 August 2021). At this inspection the rating had changed to requires improvement.

Why we inspected

This service was registered with us on 21 January 2020 and this was the first full inspection of the five key questions to formally rate the home. We undertook a focused inspection of the home 17 June 2021 to check the service was safe and well-led which we rated good.

We have found evidence that the provider needs to make improvements. We have identified some shortfalls relating to managing risks to people’s safety, the staffing levels at night and around good governance. Please see the safe and well-led sections of this report.

You can read the report from our last inspection, by selecting the ‘all reports’ link for Faith House Residential Home on our website at www.cqc.org.uk

Follow up

We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There was a clear process for visitors, which included a temperature check and the wearing of PPE. They were required to take a lateral flow COVID-19 test with a negative result before entering. Where people were isolating the use of phone calls were utilised to promote contact with family members.

Visitors were required to leave their contact details as part of a track and trace. They were required to complete a risk assessment and had to show a negative lateral flow test. The vaccination status was checked for health and social care professionals and contractors. This was in line with legislation that had come into effect in November 2021.

People were supported to see friends and family in accordance with government guidance. People and their relatives had been asked who their named visitors would be. The registered manager kept a list of these names. We asked people if they had regular contact with loved ones. People told us, “Yes my family visit me” and “My daughter visits me. I can also use the phone to speak to her if she cannot visit”.

There was ongoing enhanced cleaning of the home, this included of high touch point areas. A daily cleaning schedule was in place along with a deep cleaning schedule.

The home took part in regular testing for COVID-19. The registered manager maintained an audit of the dates staff and people were last tested. The registered manager showed us a spreadsheet they had in place with the dates staff had received vaccinations. This showed the director, registered manger and staff were double vaccinated. Some staff had received booster vaccinations and others planned to have this when they were able to. Two staff had showed proof of vaccine exemption. Risk assessments were in place.

The deputy manager told us they had experienced some workforce pressures due to unplanned sick leave of staff. This was not related to illness caused by COVID-19. The home was recruiting for three 21 care hours posts. This had not had an impact on the home or people's care as staff were willing to pick up overtime. We spoke with the three staff on duty. They told us, “We are a good team and pick up extra hours to help” and “We plan rotas and muck in to get everything covered”.

Faith House Residential Home is a residential care home providing accommodation and personal care for up to 10 people. At the time of the inspection there were eight people living at the home. The home is a converted bungalow and extended building with rooms over two floors. There was one communal lounge with a dining area. The kitchen also had a dining area where people could socialise around the table at mealtimes. People also have access to a garden area.

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

Staff understood how to keep people safe and knew how to identify potential abuse. Where concerns were identified, staff understood their role to report concerns to protect people from future potential harm. Care records included risk assessments to mitigate the risks of harm.

There were suitable numbers of staff supporting people, who had been recruited safely to ensure they could work with people. There were systems in place to ensure people received their medicines as prescribed. Where improvements were needed, the provider had recognised and learnt from any mistakes.

The provider ensured infection control procedures were in place and there was guidance for people, staff and visitors during the COVID-19 pandemic to keep them safe. The provider welcomed relatives and visitors to the home in accordance with the latest government guidance.

The management team and staff were responsive and worked in partnership with other agencies to meet people's needs.

Quality assurance systems were in place to identify shortfalls and take prompt action to ensure people always received safe care. The quality and standard of the home was checked by the manager and other members of the management team. The provider was meeting regulatory requirements and notifications of incidents were submitted to us.

Rating at last inspection

The last rating for this home was good. (28 November 2020).

Why we inspected

The inspection was prompted from an individual safeguarding investigation carried out by the local authority. We had also received intelligence from a whistleblower. The inspection was to check the home had safe levels of staff and that people were safe.

This was a focused inspection where we looked at the key questions, is the service safe and well led. As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the home in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

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

Follow up

We will continue to monitor information we receive about the home until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

• The home had designated entrance with posters displayed which explained the safety procedures in place. Due to the COVID-19 outbreak the only visitors to the home were professionals. They were asked to adhere to the home’s infection control procedures. On arrival visitors were asked to sign in, complete a risk assessment and have their temperature checked. They were provided with personal protective equipment (PPE) that included gloves, aprons and a facemask. They were then shown to the area of the home they were visiting. Staff used a separate entrance at the side of the building. A dedicated room beside the entrance was used where staff changed their clothing before and after their shift. PPE was donned before they entered the building. Clinical waste bins were in place for staff to safely remove and dispose of their PPE.

• Staff supported people to maintain contact with their family and friends, by phone, social media and video calling, when they were unable to visit. The registered manager and staff remained in contact with people’s loved ones. They provided regular updates in relation to people’s wellbeing. We were told that people’s family and friends were thankful for all that the staff and the manager were doing.

• At the time of our inspection all 10 people were self-isolating in their rooms. The staff monitored people’s wellbeing and provided one to one care to people. When people were well enough to do so the staff team encouraged them to participate in one to one activities in their rooms. Some people chose to knit, watch sports, use their personal laptop, read books, magazines and newspapers.

• From the onset of the pandemic staff had put people’s best interests at the heart of these difficult times. During these circumstances they had sacrificed their own personal lives in order to protect people. Due to the recent outbreak of COVID-19 two staff had moved into the home. All staff recognised their responsibility to protect the people they cared for. The registered manager was very proud of all staff.

• The home had a seated area of the garden beside the patio door. People were able to sit in the lounge area with the patio door open. People's loved ones were able to sit in the garden the other side of the door. Visits were pre booked with social distancing measures adhered to. Visits had been temporarily halted until further notice due to the COVID-19 outbreak.

• The registered manager told us if people were admitted to the home, risk assessments were completed, and people were isolated for 14 days. Staff would be allocated to people on a one to one basis, to provide personal care and support.

• There were enhanced cleaning of surfaces and people were supported to wash and sanitise their hands regularly. The registered manager completed regular walk rounds of the home and monthly infection control audits were undertaken. They were in the process of making changes to the infection control audit that was being used.

• The home took part in regular testing for COVID-19. Staff were tested weekly, and people who lived at the home were tested monthly. The registered manager maintained an audit of the dates staff and people were last tested. They were aware of when people and staff’s isolation period had finished.

• Furniture had been moved around in the lounge and dining areas to support social distancing. This meant people could still spend time in communal areas which supported their wellbeing and reduced the risk of isolation.

• Faith House Residential Home had policies and procedures in place. Staff had received infection control training and were kept up to date with any changes in guidance and information. Staff were given practical training on how PPE should be used.

• The registered manager told us they were well supported by the local GP. The home had a dedicated community nurse who supported the home. We were told she contacted the home weekly by phone to offer support.