Background to this inspection
Updated
19 February 2022
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.
As part of CQC’s response to care homes with outbreaks of COVID-19, we are conducting reviews to ensure that the Infection Prevention and Control (IPC) practice is safe and that services are compliant with IPC measures. This was a targeted inspection looking at the IPC practices the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 10 February 2022 and was announced. We gave the service one days' notice of the inspection.
Updated
19 February 2022
About the service
Fleetwood Hall is a residential care home providing personal and nursing care to 41 people at the time of the inspection. The service is registered to support up to 53 people.
People’s experience of using this service and what we found
There was a manager in post. They already worked for the organisation and had submitted their registration forms to CQC. There was a temporary manager who had been managing the home for the last few months with support from senior managers and a registered manager from another home. Most people knew who the new manager was and told us they had introduced themselves. Other people said there had been different managers and they were not sure who was who. Staff we spoke with said they felt well supported by the management. The temporary manager and the supporting managers worked well together to ensure the service was running as well as possible and information was up to date and actions and audits were being completed.
People told us they felt safe. There were some mixed comments around staffing, which we raised with the manager at the time of our inspection. They assured us they would look into this. Medication was stored and administered correctly. People told us they received their medication on time. Risk assessments were detailed and informative and gave clear and accurate instruction on how to minimise risk of harm occurring. Checks and maintenance were routinely carried out, and infection control procedures were robust.
People’s capacity had been assessed and recorded. Their ability to contribute to important decisions regarding their care and support had been considered, and best interest meetings were held if required. Rationale for any decisions made on someone’s behalf was recorded in their plan of care and more formally in the DoLs authorisations. Care plans did not always evidence involvement, however people told us their care was discussed with them. The food had improved in the last few weeks, and they were able to choose what they ate. Where people needed support with specialist diets, this was clearly documented and guidance from Speech and Language Therapy (SALT) teams was written into their care plans.
We observed staff treated people kindly, and the comments we received from people confirmed this. People's personal items were treated with care and the staff kept inventories of people’s possessions. Equality and diversity needs were considered, and people had freedom to choose how they spent their day. Some activities were tailored around people’s hobbies and interests. People told us staff respected their privacy and knocked on doors.
On day one of our inspection we raised some concerns with the managers which people had discussed with us. We saw on day two of our inspection these concerns had been dealt with appropriately. People’s care plans were personalised and contained a good level of information around their likes, dislikes and backgrounds. There was a complaints procedure in place, and people told us they knew how to complain. We tracked some complaints through and saw they had been responded to in line with the policy. Staff were trained in end of life care and support. People told us there were activities on offer and we saw people being support with activities during our inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (Published 21/02/2019)
Why we inspected
The inspection was prompted in part due to some anonymous concerns we received about the environment, infection control, staffing concerns, and management not addressing issues. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from these concerns.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.