La Fontana

Updated 29 October 2022

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can 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 and an Expert By Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

La Fontana is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. La Fontana is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 4 October 2022 and ended on 17 October 2022. We visited the service on 11 October 2022 and 17 October 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We met people who lived at the home and spoke with nine of them about their experience of the care provided. We also spoke with two relatives visiting the home.

We spoke with 18 members of staff including the provider’s quality and compliance manager, the deputy manager, the head of care, registered nurses, care workers, activity staff, the chef, the administrator and housekeeping staff.

We reviewed a range of records. This included nine people's care records and medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, including fire safety, maintenance records and a wide range of monthly audits were also viewed.

An Expert by Experience contacted people’s relatives by phone to gain their views on the quality of the service. They spoke with eight relatives.

Following our inspection visits, we continued to seek clarification from the provider to validate evidence found. We looked at the information sent by the provider. This included quality assurance audits, the fire risk assessment, minutes of staff meetings, staff training records, staff rotas, compliment and complaint records and the infection prevention and control policy.

Updated 29 October 2022

About the service

La Fontana is a nursing home providing personal and nursing care to people aged 65 and over. At the time of the inspection there were 68 people using the service. It accommodates people in three separate units, each of which has separate adapted facilities. Each unit specialises in providing care to people living with dementia.

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

Risks relating to infection prevention and control (IPC), including in relation to the COVID-19 pandemic, were assessed and managed. Staff followed recommended IPC practices and safe visiting was supported. Daily cleaning of the home was being improved and the importance of wearing facemasks at all times emphasised to staff.

People's medicines were generally well managed and administered safely. Minor improvement was needed in the management of topical creams to ensure people had them applied as prescribed. Staff needed to ensure there was always prompt action when changes were needed in medicine administration.

People said they felt well cared for, listened to and were happy living at La Fontana. People told us they felt safe. Systems, processes and practices safeguarded people from abuse. Staff knew how to identify and report safeguarding concerns.

Risks to people were assessed and reduced as much as possible. Risk assessments for people who expressed feelings or an emotional reaction were being improved. Equipment was safe for people and staff to use.

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.

Staff were recruited in a safe way. People said there were enough staff to support them.

Staff told us morale, teamwork, training and communication were good. Staff culture was positive and proactive. We observed many positive, kind and caring staff interactions with people.

There were thorough reviews of all accidents, incidents and near misses. Actions were taken to prevent reoccurrence to ensure people were safe.

The current management team (supported by the provider’s quality and compliance manager and operations manager) had clearly worked hard to manage the home well since the last manager had left. There were effective systems in place to monitor and review the quality of the service and to make sure improvements were carried out.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 28 April 2020).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed to good based on the findings of this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.