Ford Place Nursing Home

We found the following examples of good practice:

The provider had clearly communicated their contingency plans and risk assessments around the management of the pandemic with the Care Quality Commission, (CQC) the local authority and Clinical Commissioning Group. They had ensured that the service was carefully planned particularly in regard to staffing levels and no agency staff had been used since the beginning of the pandemic.

Staff have had access to regular testing following current government guidelines for COVID-19, and additional checks were in place for anyone visiting the service such as outside contractors.

All staff and service users received their vaccines. There has been minimal impact from the virus with two staff testing positive and the correct procedures had been put in place to help prevent the spread of the virus.

Stringent no visitors’ policies were put in place early on to protect staff and service users and a gradual reintroduction of visitors has been meticulously planned to ensure everyone’s ongoing safety. A conservatory at the back of the service had been set up with protective screens and robust use of protective personal equipment, (PPE) and enhanced cleaning between visits.

The service has always supported service users approaching the end of their lives and visiting in these circumstances have been managed sensitively according to service users’ individual needs.

Staff were observed wearing PPE in line with current government guidance.

Donning and doffing of PPE was completed appropriately and disposed of safely to reduce the risk of cross contamination. There were strict isolation procedures for all new service users or those returning from another setting and this was clearly communicated across the staff team.

Clear policies and procedures were implemented by the provider detailing what to do if an individual displays signs or symptoms of COVID-19. These ensured that staff knew how to promote the safety of those using the service and themselves and these policies were clearly communicated with relatives.

There was evidence of strong teamwork and staff taking individual responsibility to ensure hygiene practices were maintained and the service upheld excellent standards of infection control and levels of cleanliness.

Service users had regular opportunities to engage in social interaction and communication with others to help maintain positive mental health and sustain relationships which were important to them. As well as designated activities the service had invested in technologies to support service users as holistically as possible. We observed service users relaxing in a calm environment.

Ford Place is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided. The care home accommodates up to 49 people in one adapted building. The building has both downstairs and upstairs accommodation. The home in a prominent position in the town of Thetford, Norfolk and has created additional parking for the ease of visitors. The home is a listed building, which had been sensitively restored creating a spacious and airy environment.

The service has a registered manager who was a registered nurse. There was also a deputy manager who is a registered nurse and nurses working on each floor. 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.

At this inspection we met with one of the directors of the company who has been referred to as the provider throughout the report.

During our inspection, we found exceptional standards of care. A committed and well-trained group of staff who demonstrated the right values and attributes provided this.

Staff provided seamless care working together to ensure they met people’s needs. We observed kind, compassionate staff spending time with people and their families to ensure peoples well-being and offering support around their individual needs. People were able to retain their interests, routines, and staff fitted in around these. There was good stimulation for people and plenty of opportunities to stay connected to their pasts.

Staff encouraged people to retain their independence and up hold people’s dignity. End of life care was exceptional and demonstrated the value staff placed on people in their care.

People were consulted and their views and experiences shaped the service they were provided. Feedback was acted upon in a positive way which gave people confidence in the service they received. It was responsive to people’s individual needs and the needs of the wider service. The staff survey showed improving results as staff gained more confidence in the provider who was proactive and hands on.

There was documentation recording people's individual care needs and how staff should meet these. This helped to ensure they could continue with their preferred routines and have their choices and preferences met. Staff managed risks to people’s safety well because they identified risk and put plans in place to reduce them as far as possible. Staff monitored people’s health to ensure they did not develop preventable conditions like pressure ulcers.

The home supported people to have positive mental health by encouraging people to stay active and socialise with others. There were planned and spontaneous activities, which took into account people’s individual interests and hobbies. Activities were provided every day of the week and helped prevent social isolation.

Families were involved in the care of a loved one and kept up to date by staff about their well- being. Community engagement was important and the home did a lot of intergenerational engagement between old and young recognising the benefits and potential of doing so. The home reflected the values of an extended family.

Complaints where received were viewed as providing an opportunity to get things right and the staff responded to complaints in a timely constructive way. Outside the process, there were regular opportunities for people and their families to discuss any aspects of their care, which they had, concerns about and wanted changes without the need to raise a formal complaint.

The service was extremely well managed and run in the interest of people using it and in consultation with families, staff and stakeholders. The registered manager was strong and provided clear leadership, direction and support to their staff. Staff said they felt well supported by the provider and Stow Healthcare. They had the opportunity to develop themselves and their practices. Staff were dedicated and motivated to be the best they could be. This meant people were supported by staff motivated to get things right, learn from mistakes and prevent things happening in the first place.

There were robust quality assurance systems, which took into account constant feedback about the service and people’s experiences. There were audits to determine the safety and well-being of people, the premises and equipment used.

Staff said they received good training organised by the manager, which supported them to do their job. They were able to keep up to date with new guidance, and best practice through regular training and familiarisation with policy and procedure.

Staffing levels met people’s assessed needs and the shift was well planned and organised to help ensure people had their needs met promptly.

Staff received comprehensive training and understood the importance of promoting people’s safety and well-being. Staff knew how to recognise abuse and knew what actions they should take if they suspected someone to be at potential or actual risk of abuse. Staff assessed people’s safety and risk assessments were in place describing the measures put in place to reduce risk. This helped to reduce the risk of avoidable harm. Staff helped ensure the environment was fit for purpose and equipment safe to use. The service recorded incidents/accidents, near misses, and reported these accordingly. As part of their investigation log, they had lessons learnt to help reduce a reoccurrence. This meant the service was continuously learning and trying to improve its service by reviewing its practices.

People received their medicines as intended. Staff had the necessary competencies and skills to deliver medicines safely. There were good systems in place to ensure medicines were available as intended. Regular medication audits helped to identify if medicines were available and administered as intended.

Staff recruitment was robust. This helped ensure the staff employed had the right credentials to work in care and a favourable care ethos. The home had full staff recruitment and agency staff kept to a minimum.

Staff had the right skills and competencies and had the opportunity to complete enhanced training in care. There was a good induction process for new staff as well as on-going training, formal and informal support. The provider kept up to date with changes in the care industry and best practice and the service had won some awards for its innovative practices and innovative staff.

People were encouraged to eat and drink sufficient to their needs. Food was home cooked and served in an ambient environment, which was conducive to people’s well-being. Staff received timely support and encouragement to eat and drink. This was checked by staff to help ensure people did not become dehydrated or malnourished. People were encouraged to stay active and healthy and staff monitored health care conditions to ensure people got the treatment they needed to stay well. The service had a good rapport with other health care professionals to help ensure people had their health care needs met as holistically as possible.

Staff understood and effectively applied the principles of the Mental Capacity Act, 2005 and the Deprivation of Liberty Safeguards. People were involved in decisions about their care so their human and legal rights upheld. People had maximum choice and control of their lives and staff assisted them in the least restrictive way possible.

The environment was conducive to people’s wellbeing, providing ample space, being light and airy with access to outside space, and far reaching views.