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Archived: Florence House Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 20 April 2016

This inspection took place on 10 and 11 February 2016 and was unannounced. Florence House is a care home providing nursing care for 30 people with a variety of conditions including people living with dementia. On the day of our inspection there were 26 people using the service.

The overall rating for this service is ‘Inadequate’ and the service is being placed into ‘Special measures’. Services in special measures will be kept under review and will be inspected again within six months.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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 2008 and associated Regulations about how the service is run.

We inspected the home on 22 and 29 May 2015 and followed up some of our concerns on 17 August 2015. We asked the provider to take action to make improvements in relation to the management of people's medicines, systems to protect people from harm, records relating to people who were unable to consent to care, supporting staff, quality assurance systems, security and accuracy of people's records. At this inspection we found improvements had been made in relation to the management of people's medicines, supporting people who were unable to consent to care, knowledge of staff relating to their responsibilities to identify and report concerns relating to safeguarding and support for staff.

However we found improvements had not been made in relation to the security of people's personal information, the accuracy of people's care records and systems to monitor and improve the service. We found additional concerns relating to the care and support people were receiving.

The service had not completed the actions stated on the action plan they sent to us following the May 2015 inspection. People's personal information was still stored in an unlocked office which visitors could enter freely throughout the day. People's care records contained information that did not reflect their current needs. Systems introduced to monitor the quality of people's care records had not identified these concerns.

People were not always fully assessed and care plans did not always contain accurate up to date information to ensure people's needs were met. Risk assessments were not always completed and where they were there were not always care plans in place that showed how the risks would be managed. People did not always receive care that met their needs and staff were not always clear about the specific care needs of some people. People had access to activities when the activity coordinator was on duty. However people spent long periods of time with no social interaction on the first day of our inspection when the activity coordinator had a day off.

Throughout the day we saw many caring interactions, however we found that people's rooms were not always personalised and did not have a homely feel. People's rooms were not always tidy and were left in a condition that did not promote a caring culture.

People and their relatives were positive about the registered manager and proprietor. Relatives told us they were approachable and supportive. However, there were no formal methods to communicate information to people and their relatives. The service did not have systems in place to enable people to provide feedback on the service.

Staff were supported and felt confident to raise any concerns with the registered manager or provider. Staff had regular one to one meetings with the registered manager and there were regular staff meetings where staff were encouraged to share ideas and raise any concerns.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the re

Inspection areas

Safe

Requires improvement

Updated 20 April 2016

The service was not always safe.

Risks to people were not always assessed and where risks were identified there were not always plans in place to manage the risks.

Medicines were managed safely.

Staff were knowledgeable about their responsibilities to identify and report concerns relating to safeguarding people using the service.

Effective

Good

Updated 20 April 2016

The service was effective.

People were supported in line with the Mental Capacity Act 2005 (MCA). Staff understood the principles of the MCA and how to act in people's best interest.

People enjoyed the food and had a choice of meals. People's dietary needs were met.

Staff felt supported. Staff had access to regular supervisions and development opportunities.

Caring

Requires improvement

Updated 20 April 2016

The service was not always caring.

People's personal information was not stored securely.

People were supported by staff who were kind and caring.

People were involved in their care.

Responsive

Inadequate

Updated 20 April 2016

The service was not responsive.

People's care records did not contain accurate, up to date information.

People were not always assessed to identify their needs and care plans did not detail how care needs would be met.

Where people had specific needs these were not being met. Deterioration in people's condition was not always identified and action was not taken as a result.

Well-led

Inadequate

Updated 20 April 2016

The service was not well-led.

Actions required as a result of our previous inspection had not been completed.

Quality assurance systems were not effective as they had not identified the issues we found during this inspection.

Systems to enable the provider to seek feedback in order to monitor and improve the service had not been implemented.