We carried out a review of the data available to us about Fleming House Care Home with Nursing on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Fleming House Care Home with Nursing, you can give feedback on this service.
Fleming House Care Home with Nursing is a residential care home providing personal and nursing care to 53 people aged 65 and over at the time of the inspection. The service can support up to 55 people some who may be living with dementia.
People’s experience of using this service and what we found
People felt safe living at Fleming House Care Home with Nursing and they were very much at the heart of the service. We received positive feedback from people, their relatives and health professionals about the care provided.
Staff knew people well and were responsive to people’s needs. People were able to choose what activities they took part in and suggest other activities they would like to complete. The impact this had on people was outstanding and had resulted in people living an active life with choice evident throughout.
The service had introduced a tea room which was a popular meeting place throughout the day. People told us it was a great addition to the home and enjoyed get togethers held in the venue.
The Fleming Arms pub remained a popular destination and we observed many people enjoying themselves throughout the inspection and looked forward to planned events in the pub.
Staff were passionate about making a difference to people’s lives and had raised funds for improvements to the service and enjoyed working at the service.
People received excellent care that was based around their individual needs and that ensured care was personalised and responsive.
People were cared for by a motivated and well-trained staff team, who always put people first. Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. Staff informed us they completed a wide range of training and felt it supported them in their job role. New staff completed an induction programme before being permitted to work unsupervised.
Staff had developed positive and caring relationships with people and their families. Staff were highly motivated and demonstrated a commitment to providing the best quality care to people in an individualised and compassionate way. People’s privacy and dignity was always maintained.
People received outstanding end of life care by a team of staff that were passionate about providing high quality care during people’s final stages.
Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.
The registered manager developed and promoted community involvement within the home. In the summer the home involved the national citizenship scheme which involved local children tidying the garden.
People were supported with their nutritional needs when required. People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Regular audits of the service were carried out to assess and monitor the quality of the service. There were appropriate management arrangements in place.
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 good (published 04 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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.
There was a registered manager in place. 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.
People felt safe living at Fleming House Care Home with Nursing and they were very much at the heart of the service. People received excellent care that was based around their individual needs and that ensured care was personalised and responsive. Staff understood and were able to meet people’s needs. People’s support was planned proactively in partnership with them to ensure it met their individual needs.
The home was designed to create a suitable environment for people living with dementia. Walls were painted with outside scenery including hanging baskets, windows, bicycles and animals and wall lights in the hallway were enhanced with a painting of a lamppost underneath. People’s rooms had the appearance of an authentic front door and people were asked what colour door they would like. This meant that the doors provided a sense of home and ownership as well as assisting people remember where their room was located promoting independence.
The home had introduced its own pub called ‘The Fleming Arms.’ People were very happy with the pub and its appearance was outstanding and was used to provide many activities and gave a great opportunity for social interaction. The pub was well used and created a high degree of engagement and people clearly enjoyed themselves when they attended the pub.
The home was responsive to people’s needs and wishes. People were able to choose what activities they took part in and suggest other activities they would like to complete. The home had introduced a ‘Gentlemen’s group’ focused on the needs of the men within the home. The home were in the process of raising funds to be able to provide a professional nail bar for people in the home to enhance their experience while having their nails painted.
The registered manager developed and promoted community involvement within the home. In the summer the home involved the national citizenship scheme which involved local children completing a makeover for the garden and home. When this was completed an afternoon tea party was held on the last day for people and their families to view the changes. The registered manager told us, “It was lovely seeing the young people interacting with the residents and the residents really enjoyed it.”
Relevant recruitment checks were conducted before staff started working at Fleming House to make sure they were of good character and had the necessary skills. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. There were enough staff to keep people safe.
The risks to people were minimized through risk assessments. There were plans in place for foreseeable emergencies and fire safety checks were carried out.
People received varied meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu choice of the day.
People were cared for by a motivated and well trained staff team, who always put people first. Staff received regular support and received regular one to one sessions of supervision to discuss areas of development. Staff informed us they completed a wide range of training and felt it supported them in their job role. New staff completed an induction programme before being permitted to work unsupervised.
People received personalised care from staff who understood and were able to meet their needs. Care plans provided comprehensive information to guide staff and were reviewed regularly by their key workers. People had a choice and access to a wide range of activities and were able to access healthcare services.
People felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of the Mental Capacity Act (MCA) and were clear that people had the right to make their own choices. Staff sought consent from people before providing care and support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights were protected and their liberty was not restricted unlawfully.
The registered manager maintained a high level of communication with people through a range of newsletters and meetings. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service. People felt listened to and a complaints procedure was in place.
Regular audits of the service were carried out to asses and monitor the quality of the service. Staff felt supported by the registered manager. There were appropriate management arrangements in place.
This inspection took place on 09 & 15 October and was unannounced. The home provides accommodation for up to 55 older people. Some people may be living with dementia or have mental health care needs. There were 45 people living at the home when we carried out our inspection.
The home had a registered manager who had been registered since August 2011. 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 brought this inspection forward, due to safeguarding concerns raised by the local council safeguarding team about people living in the home. We looked at the concerns raised and found these were not confirmed at the time of our inspection.
We found people’s safety was compromised in some areas. People and staff felt there was not enough staff at mealtimes and there was a potential risk of people not receiving personal care if required during meal times.
People and staff did not have confidence in the emergency call bell system. People told us they sometimes had had to wait a long time for the bell to be answered. There weren’t enough pagers available at the time of our inspection. However the registered manager informed us that new pagers were on order.
Care plans were not always representative of people’s current needs and although some contained a lot of individual detail others did not have the current information. Where care plans had been reviewed, the information in them had not always been updated.
Risks assessments had been completed for the environment and safety checks were conducted regularly of gas and electrical equipment. People felt safe. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse.
People were supported to receive their medicines safely from suitably trained staff. Relevant checks were conducted before staff started working at Fleming House to make sure they were of good character and had the necessary skills. Staff received regular supervision and appraisals where they could discuss their training and development needs.
Staff sought consent from people before providing care or support. The ability of people to make decisions was assessed in line with legal requirements to ensure their rights and liberty were not restricted unlawfully. Decisions were taken in the best interests of people.
People received varied and nutritious meals including a choice of fresh food and drinks. Staff were aware of people’s likes and dislikes and offered alternatives if people did not want the menu of the day. However, people did not always have their fluid intakes recorded appropriately.
People were cared for with kindness, compassion and sensitivity. We observed positive interactions between people and staff. The home had been recognised by a national agency because they had demonstrated they provided high quality and effective end of life care.
People and their families (where appropriate) were involved in assessing, planning and agreeing the care and support they received. People were encouraged to remain as independent as possible. Their privacy and dignity was protected.
People were supported and encouraged to make choices and had access to a wide range of activities tailored to their specific interests. ‘Residents meetings’ and surveys allowed people to provide feedback, which was used to improve the service.
There was an open and transparent culture at the home. There were appropriate management arrangements in place. Staff and people were encouraged to talk to the manager about any concerns. Regular audits of the service were carried out to assess and monitor the quality of the service.
We observed that staff worked knowledgeably and sensitively to meet people's needs. People and their relatives we spoke with gave positive comments about the staff. For example: 'Everybody takes time to say hello as they pass, or pop into their rooms to see if they're O.K'. Some had commented that there had been times when there appeared to be too few staff. Others indicated that this had improved. A relative told us 'In almost four years of daily visits I have rarely found management and staff wanting, under sometimes difficult circumstances'. Another person's relative said 'We as a family are happy with the care our father gets' and 'If we do have a problem we go and talk about it, to get it sorted'.
The majority of people confirmed that they felt involved in making decisions about their care and that their views and experiences were taken into account. One person told us that they were encouraged to attend regular residents meetings, where they were given information and able to give feedback. Another person said they were 'always involved in everything going on' and 'given support to be as independent as possible'. People we spoke with confirmed that their care and welfare needs were being met and that they were satisfied with the way staff provided support. They confirmed that staff responded promptly to requests for assistance. They made positive comments about the staff, for example describing them as 'great, very helpful and pleasant.' People knew what to do if they had any concerns about the service they received. One person told us that if they had any concern or cause for complaint, then they would speak to staff and they were confident their concerns would be dealt with promptly.