Fourways

Updated 20 July 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we could understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors who visited Fourways on the 22 June 2021. Off site, one inspector undertook telephone calls to relatives who consented to us calling them on 22 June 2021.

Service and service type

Fourways is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager. This means the registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave short notice of the inspection because of the risks associated with COVID-19. This meant that we could discuss how to ensure everyone remained safe during the inspection.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority who work with the service and provider and used any information the provider had sent us from their annual Provider Information Return. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During our visit we spoke with four people living at the home, although these were not full conversations. We spoke with one visiting relative. We spoke with six members of care staff, one laundry assistant, the registered manager, a regional manager, a health and safety manager and a director of quality and compliance.

We reviewed a range of records. This included examples of five people's care records and examples of medication records. We also looked at one staff recruitment file and records that related to the management and quality assurance of the service, especially around managing risk, environmental risks, medicines management, complaints and compliments and infection control.

Post our visit, we spoke with four relatives about their experience of the care provided to their family member.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 20 July 2021

About the service

Fourways is a residential home providing accommodation and personal care to 40 older people at the time of the inspection. Some of these people were living with dementia or a cognitive impairment. The service can support up to 47 people.

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

At our last inspection, we found people’s risks and environmental risks were not always managed. Medicines were not always managed and kept safely, and the quality of audits and checks were ineffective. At this inspection, we found improvements had been made.

Environmental risk management was improved since our last inspection. Fire checks were completed, but we found some outstanding actions needed to be completed. Following the inspection, the provider confirmed this work would be completed by 30 June 2021.

Medicines management had improved following our last visit. Medicines were managed safely by trained and competent staff.

People’s individual risks related to their health and wellbeing had improved and plans were in place to manage those identified risks. People's changing needs were responded to promptly by staff and other healthcare professionals were contacted when needed. People were treated with respect by staff. Where complaints had been made the provider had investigated and responded.

There were enough staff on duty to meet people’s needs and to respond to people’s requests for assistance.

Staff understood their responsibility to safeguard people from harm and report any concerns they had to the management team.

People were involved in pursuing their own interests and hobbies. Staff helped encourage people to share some of their interests with other people in the home. The pandemic and government restrictions had limited external and internal visits over the last 12 months, however staff continued to keep people occupied and stimulated.

Audits and checks were completed. People and staff provided their feedback which helped ensure the quality of service continued to improve. People and staff were complimentary of the management and staff felt the care provided at the home had improved since our last inspection. Relatives we spoke with confirmed the quality of care was much better and communication had also improved. Relatives we spoke with felt well informed and engaged in how their family members were supported. The provider’s care record system had a facility for family members to review what care had been provided each day which helped them to keep in touch.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 12 September 2019).

Why we inspected

The inspection was prompted in part to follow up concerns from the previous rated inspection in July 2019. As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice was safe and the service was compliant with IPC measures. We looked at the IPC practices the provider has in place.

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 coronavirus and other infection outbreaks effectively.

We reviewed the information we held about the service. No immediate areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Fourways on our website at www.cqc.org.uk.

Follow up

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.