Fourways Residential Home

Updated 31 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Fourways Residential Home provides care and accommodation for up to 21 people. At the time we visited, 20 people lived at the home. The comprehensive inspection took place on 16 and 18 May 2018. The first day was unannounced; the inspection was carried out by one adult social care inspector.

Prior to the inspection we reviewed the Provider Information Record (PIR) and previous inspection reports. The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service and notifications we had received. A notification is information about important events which the service is required to send us by law.

We met people who lived at the service and received detailed feedback from six people who were able to tell us about their experiences. We spent time in communal areas observing staff interactions with people and the care and support delivered to them. We spoke with four visitors and six staff to ask their views about the service. We also reviewed the service’s own quality assurance system and feedback from questionnaires.

We reviewed information about people’s care and how the service was managed. These included three people’s care records; along with other records relating to the management of the service. This included three staff files, staff training records and a selection of policies, procedures and records relating to the management of the service. We also looked at people’s medicine records and the systems in place for managing medicines, and we checked how they were administered to people. We contacted the GP surgery and the community nurse team; two professionals responded.

Updated 31 July 2018

Fourways Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Fourways Residential Home is registered to provide personal and nursing care for 21 people. There are two floors and a passenger lift by the front door. The front door is accessible to people using wheelchairs as is the garden.

At our last inspection we rated the service Good. At this inspection we found the service remained Good overall, with one key question now being rated as ‘Outstanding’. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager working at the home. A registered manager is a person who has registered with the 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 2008 and associated Regulations about how the service is run. The registered manager is also one of the directors of the company that owns the service. They have delegated the day to day to running of the home to a home manager and two deputies. However, the registered manager visits the home on most days and is actively involved in the running of the home.

People visiting, living and working at the home spoke highly of the quality of the care, the calibre of the staff and the well maintained environment, including an accessible garden complete with a range of seating areas and a summer house. One visitor said they regularly visited people living at other care homes in the area and said “this is my favourite.” Another visitor said “we knew the moment we walked in that Fourways was the right place.” People told us they were treated as equals and enjoyed the social life of the home as there were a wide range of activities and opportunities to learn and participate in different events. A newsletter kept people informed and the investment of a television, which showed pictures from events and activities at the home, had proved popular with people living at the home and their visitors.

Staff were quick to respond to people’s changing needs, providing high quality end of life care with professionalism and compassion. Families praised the support they received from staff to cope with this experience. They said staff comforted them and they gained immense reassurance knowing the staff members’ commitment to make their relative feel safe, at peace and pain free. The provider always provided transport to medical appointments, as well as company during these journeys and support, if needed, during appointments. People were positive about this type of support as the stress of planning of appointments was reduced as they were not reliant on organising their own transport. People told us staff were attentive and varied their support depending on how they were feeling.

People praised the high standard of food, the choice and the responsiveness of staff to make alterations to the menu based on feedback and suggestions. Many people chose to eat in the dining room; meals were a social occasion with people staying to chat over a drink after the meal. The provider shopped for all the food on a weekly basis to ensure the quality was of a high standard. They had invested in a dessert trolley so that a range of fresh fruit and desserts could be taken to people who chose to eat in their rooms as well as proving a clear choice for people in the dining room.

People said they could speak with any of the staff if they had a concern and were confident actions would be taken, if required. There was a strong commitment to staff training, which included recognising and reporting abuse, and increasing the staff team’s knowledge and skills. Staff said they would recommend working at the home and felt supported to learn; a visiting professional confirmed the service’s commitment to train their staff and encourage them to aspire to a career in care. People said they felt safe and “settled” at the home. There were sufficient numbers of suitable staff to keep people safe and meet their needs. Recruitment practices ensured people were supported by appropriate staff. Medicines were well managed.

Staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (2005) (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. Staff supported people to be involved in making decisions and planning their own care on a day to day basis and through care plan reviews.

Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. Care plans were individualised. People were referred promptly to health care services when required and received on-going healthcare support. Staff worked in partnership with other agencies and visitors complimented the staff on a well-run and caring service, as well as their professionalism.

The premises were well managed and maintained to keep people safe. There were emergency plans in place to protect people in the event of a fire. A quality monitoring system at the service ensured people’s views were sought through meetings, reviews and questionnaires with the aim to continuously improve the service.

Further information is in the detailed findings below.