Freshford Cottage Nursing Home

Updated 8 March 2023

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 undertaken by 1 inspector.

Service and service type

Freshford Cottage Nursing Home 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. Freshford Cottage Nursing Home 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 provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

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 sought feedback from the local authority. 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

During the inspection we reviewed a range of records. These included 3 recruitment records, accidents and incidents and quality assurance audits. We looked at medicine administration charts, 4 care plans and risk assessments along with other relevant documentation to support our findings.

We spoke with 7 people who lived at the home. We also gathered feedback from the relatives and representatives of 6 people. We spoke with 9 staff members; this included the registered manager and nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also received feedback from 3 health and social care professionals.

We observed people in areas throughout the home and could see the interaction between people and staff. We watched how people were being supported by staff in communal areas, this included the lunchtime meals.

Updated 8 March 2023

About the service

Freshford Cottage Nursing Home is a residential care home providing personal and nursing care to up to 20 people. The service provides support to older people who were living with a range of health care needs. Some people had memory loss associated with their age and physical health conditions. The service also provided care and support for people who were at the end of their lives. At the time of our inspection there were 17 people using the service.

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

People were not supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

The quality of the service was regularly monitored through audits, however we identified areas where further improvements were needed in relation to mental capacity and people’s records.

Staff understood how to support people safely, risk assessments provided further guidance about individual risks.

People were supported to have enough to eat and drink throughout the day. We identified that improvements were needed to the delivery of the lunchtime meals. The registered manager told us this would be addressed.

Staff received regular training and supervision and individual support was provided to ensure staff had the knowledge and skills to support people. People were supported to maintain and improve their health with support from health care professionals.

The home was clean and tidy throughout. Systems were in place to help ensure people were protected from the risk of infection. Staff understood safeguarding risks and procedures and knew what to do if concerns were raised. People were supported to receive their medicines when they needed them. There were enough staff, who had been safely recruited, working in the service.

People were happy living at the home. They told us staff were kind, they were given choices and able to do what they liked throughout the day. There was a positive culture at the service. People, relatives and staff were asked for their feedback through meetings, discussions and feedback surveys.

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 16 March 2018).

Why we inspected

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

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

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

We have found evidence that the provider needs to make improvements. Please see the effective and well-led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement

We have identified breaches in relation to need for consent 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 continue to monitor information we receive about the service, which will help inform when we next inspect.