Foxleigh Grove Nursing Home

Updated 7 March 2020

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 Care Act 2014.

Inspection team

This inspection was carried out by one inspector and an assistant inspector.

Service and service type

Foxleigh Grove Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We looked at feedback and any notifications that we received. Notifications are reports of events the provider is required by law to inform us about. We used all of this information to plan our inspection. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke to 10 people who use the service and three relatives about their experience of the care provided. We spoke to nine members of staff including the registered manager, head of care, nurses, health care assistants, activity coordinator, house keeper and chef. We observed people’s dining experience at lunchtime and dinner time. We observed people being administered their medicines. We reviewed a range of records. These included eight people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. We looked at a variety of records relating to the management of the service, including policies and procedures, accidents and incidents, complaints, audits and quality assurance records were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and additional quality assurance records. We contacted eight professionals who regularly have contact with the service. We received four responses.

Updated 7 March 2020

About the service

Foxleigh Grove Nursing Home is a residential care home providing personal and nursing care to older people with a range of needs such as physical disabilities and cognitive impairments. The service is registered to accommodate a maximum of 39 people. On the day of our inspection there were 35 people using the service.

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

People told us they felt happy with how their medicines were managed, however, guidance was not in place for ‘as required’ medicines and therefore staff did not have all the information necessary when administering these medicines. Staff responsible for people’s medicines had not always had their knowledge and competency of medicines management checked in line with national guidance and best practice. We observed staff administering medicines in a person-centred way, taking time with each person and ensuring they knew what each medicine was for.

The provider had undertaken criminal records checks with staff to support them in making decisions on staff suitability. However, some checks had not been made in line with the fundamental standards. We have made a recommendation that the provider further seeks guidance on safe recruitment checks. Robust quality assurance procedures were not always in place to monitor and improve care.

People had access to healthcare services, however, we found that staff had not acted in a timely way when a person required medical attention. We have made a recommendation that the registered provider ensures they have an appropriate falls pathway in place for staff to follow when a person falls.

The atmosphere of the service was homely. The service was clean and free of malodours. We have made a recommendation that the provider considers best practice on making the home more dementia friendly.

People residing in the home on a permanent basis had their needs assessed prior to receiving care and this informed their care plans. However, we found that people who were in the home on a temporary basis for respite care did not always have a robust assessment in place. We have made a recommendation that the provider ensures assessments of people's needs are comprehensive and expected outcomes are identified.

People felt safe living at the service and able to raise any concerns they had. Staff were aware of their responsibility to safeguard people from abuse, and steps were taken to prevent the reoccurrence of accidents and incidents. Staff adhered to safe infection control practices.

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.

People were supported to eat a well-balanced diet and were offered a variety of meals and snacks. People's social and recreational needs were met through a varied activities programme, which included regular access to the local community.

People felt staff were well trained and competent in their roles. People and relatives were complimentary about staff's kindness towards them and told us staff treated them with dignity and respect and enabled them to be as independent as safely possible.

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 27 July 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.