We carried out a review of the data available to us about The Fleet 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 The Fleet, you can give feedback on this service.
The Fleet is a residential care home that provides personal and nursing care for older people. The Fleet is registered to accommodate 39 people, at the time of the inspection 37 people lived at the service.
The Fleet provides accommodation across two floors. The ground floor accommodates people who require residential care. The first floor accommodates people who need nursing care which is provided by the service.
People’s experience of using this service and what we found
Staff had received training in recognising safeguarding, and knew the actions to take to protect people from harm. There were recruitment processes in place and checks were carried out before staff were appointed.
People’s medicines were managed safely, and people received their medicine’s as prescribed. Staff followed infection control guidance and had access to Personal Protective Equipment (PPE).
People received person-centred care based on their individual needs, choices and preferences. Staff who supported them were aware of their individual preferences and were knowledgeable about people’s needs and how these should be met.
People’s needs and choices were assessed, and their care was reviewed regularly. Care records identified people’s individual risk and how these should be managed to reduce the risk of harm.
People confirmed they were well cared for by staff that had the skills and knowledge to meet their needs. Staff understood their roles and responsibilities and felt well trained. Staff communicated with other health and social care providers to ensure people’s health and care needs were met.
People were supported to have maximum choice and control of their lives and supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff felt supported in their role and felt confident any concerns they raised would be acted on promptly. The provider had a complaints process in place to manage and respond to any concerns or complaints they may receive.
People were supported to maintain relationships with their families.
Regular audits were completed by the management team to check the safety and quality of the service delivered. This included competency checks of staff practice.
Rating at last inspection and update
The last rating for this service was requires improvement (published 7 September 2021) and there were 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 improvements had been made and the provider was no longer in breach of regulations.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Fleet on our website at www.cqc.org.uk.
Why we inspected
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 Safe, Responsive and Well-led which contain those requirements.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from Requires Improvement to Good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The Fleet accommodates people across two floors. The lower floor accommodates people who need residential care. Here nursing care is provided by the community nursing team. A further floor provided accommodation and in-house nursing care.
People’s experience of using this service and what we found
People told us staff were kind and caring, responsive to their needs and effective in ensuring they experienced good outcomes. Family members were also positive about the care and the staff.
People told us staff listened to them and made sure they were involved in planning and consenting to their care. We found people had their needs met but the records and, how the service evidenced the care of people and demonstrated people were involved in planning their care, needed to improve.
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 in the service supported this practice. Staff knew how the Mental Capacity Act 2005 applied to their role however, people's records could improve to evidence when staff were acting in people's best interests.
The provider was in process of restructuring and recognised in a recent audit that improvements at The Fleet were needed. The manager and staff demonstrated they were aware that improvements were needed and were in process of actioning this. Further audits by the provider and manager were planned to review each area of the service and act on any recommendations. This would ensure infection control practices, for example, are checked.
People, family, staff and professionals were all positive about the manager and their abilities and openness.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 17 April 2020. We inspected the service’s infection prevention and control measures in March 2021 and found no concerns. This is the first inspection of all key questions which provides a rating for the service..
Why we inspected
The inspection was prompted in part due to concerns received about the management of medicines, people’s skin care, staffing and systems the provider and manager had in place to oversee the quality and, the clinical governance of the service. A decision was made for us to inspect and examine those risks.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
We have found evidence the provider needs to make improvements.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified a breach in relation to how the service is governed at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Fleet was registered with us in April 2020 and this was their first inspection
We found the following examples of good practice:
People and staff were being supported emotionally to come to terms with the emotional impact of the outbreak and, there was an activity co-ordinator who supported people who needed to be in their room due to isolation or because of risks to their health.
People and staff were tested in line with the guidance and more often, if this meant everyone was emotionally reassured or checked to be free of the disease. Everyone was engaging with the vaccination programme.
People coming to live at the service first had to have a negative test for Covid-19. People were then isolated in their rooms for 14 days. This was achieved discreetly with rainbows placed on their door to signify to staff that they need to take extra precautions with their personal protection equipment (PPE) and people’s clothes and personal items.
Visiting by families was presently being supported for those whose loved one’s were at their end of life. Visiting for everyone was to resume on the 15 March 2021. Communications with families had taken place to enable one family member to be identified who could then visit in line with the new government guidance for visiting in care homes.
Visiting professionals were supported to enter the service safely and were checked for symptoms and whether they had had a recent test.
Staff were trained in safe infection control practices and this learning was refreshed at regular intervals. There was a morning 'huddle' and competency checks that were used to reinforce practice. Staff had the facilities available to shower and change into their uniforms on site. Their uniforms were being washed and prepared for them. This reduced the possibility of infection being taken home or into the community.