A single inspector carried out this inspection. The focus of the inspection was to answer five key questions: is the service safe, effective, caring, responsive and well-led? Below is a summary of what we found. The summary describes what people told us, what we observed and the records we looked at.
Although we spoke with some people who lived in the home during our inspection, they were not always able to tell us about their experience. This was because most of the people in the home had dementia. Therefore we spoke with six people's relatives who were visiting the home and observed people receiving support from staff to make our judgements.
If you want to see the evidence that supports our summary please read the full report.
Is the service safe?
Relatives of people who used the service were confident that their family members were in safe hands. They told us that they were kept informed of incidents that occurred and felt assured that staff would take appropriate action to look after people and keep them safe.
We saw that there were moving and handling plans in place to help ensure people were supported with moving in a safe way. Staff were aware of these plans. We saw that mobility equipment was checked on a regular basis to ensure it was in good condition and safe to use. These checks meant that that people were not placed at unnecessary risk by the equipment used to help them mobilise.
Care plans were also in place to minimise the risk of people developing pressure sores. We saw that staff ensured that the care plans were followed in order to protect people from skin breakdown.
Staff were not always aware of people's needs in relation to drinking safely. Some people needed their drinks thickened so they could swallow them safely. This was stated in their care plans. However, it was not clear from talking with staff that their care plans were always followed. This potentially put people at risk of not having their drinks in a safe way. A compliance action has been set for this and the provider must tell us how they plan to improve.
Improvements were also needed in relation to some aspects of record-keeping to ensure that there were accurate records about people's care and how to meet their needs. We found that some records were stored away from where care was delivered which meant there was a risk of delays in staff being able to locate people's records when required. A compliance action has been set for this and the provider must tell us how they plan to improve.
Is the service effective?
Relatives spoke highly about the care provided at Foxes Moon. For example, one relative told us, "I don't think they could do any more. I'm quite happy." Another person commented, "I really can't fault the care...they look after her very well." People told us that staff understood their family member's needs. One relative described how their family member had been much more settled since coming to live at the home because staff had taken the time to get to know them.
We found that staff were able to tell us about people's interests, likes and dislikes. They were able to understand what was important to them and respected their wishes.
There was a range of activities available for people including quizzes, arts and crafts activities and music sessions which helped ensure they had things to do in the home. People were also supported to maintain relationships with their friends and family who were welcomed into the home at any time and involved in planning and delivering their care.
We looked at how the home met the specific needs of people with dementia. It was not always clear that people fully understood the meal choices they were being offered and received the support they needed. Meal time arrangements needed to be reviewed in order to take into account the specific needs of people with dementia. A compliance action has been set for this and the provider must tell us how they plan to improve.
Improvements were also needed in relation to providing a care environment that was always dementia-friendly. For example, during our inspection, we observed an activity going on in the lounge while other people watched television, spent time with their relatives or enjoyed a visit from a therapy dog. This created a busy and noisy environment which may be difficult and confusing for some people with dementia. The provider told us that they were planning to convert another room in the home into a quiet lounge which would provide people with more space.
Is the service caring?
We observed people receiving support from staff who spoke with them in a kind, patient and respectful way. Staff were observed to communicate with people as they supported them which helped them understand what was happening.
Relatives told us that people's privacy and dignity were upheld and that their family members were treated well. For example, one relative told us, 'They're very good'they have a chat with people. They are always polite'always very nice to people', while another person commented, 'They've got the right attitude.'
Is the service responsive?
The home responded to people's changing needs. Where staff had concerns about people's health, we saw that this had been reported to their GP and professional advice was sought to ensure they received the right care.
Relatives had confidence that the home was able to meet their family members' needs. They gave us examples of how the home had responded to changes in their health, for example by caring for them in bed and calling the doctor out when they were unwell. They had confidence that staff knew what they were doing and had a flexible approach to people's care.
Is the service well-led?
There was a clear management structure in the home.
The provider carried out regular checks on the quality of the service by asking people for their views. They made improvements to the service based on the feedback they received.
Checks were also carried out to ensure that staff followed safe procedures and understood their roles and responsibilities in the home.
The provider had systems in place to monitor accidents and incidents which meant that they were able to identify emerging risks and take appropriate action.
Relatives of people who lived in the home told us that they felt able to approach staff or management with their comments or concerns. They felt sure that staff would listen to them and the provider would take action to resolve any issues.