We carried out a review of the data available to us about Fonthill House 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 Fonthill House, you can give feedback on this service.
We found the following examples of good practice.
¿ The service was receiving professional visitors to the service with robust infection control procedures in place. Visitors were received into the reception area on arrival where they were provided with guidance, personal protective equipment (PPE) and a health screening was completed. Each visitor had their temperature checked by staff.
¿ At the time of our inspection, visits had been temporarily suspended due to an outbreak of COVID-19 at the service. This suspension was lifted shortly after our visit. Plans were in place to facilitate garden visits in designated areas. Visits were to be by appointment only, with times allocated to avoid potential infection transmission with other visitors and to enable the visiting area to be cleaned between visits. Visitors were to be provided with a rapid test for COVID-19, guidance and personal protective equipment (PPE). The provider was in the process of assessing communal areas within the service, following recent government guidance, to facilitate indoor visits.
¿ PPE donning and doffing stations were available throughout the service, with PPE supplies available outside each person’s bedroom. The provider had made the decision to use enhanced PPE (above levels in current guidance) following their assessment of risk at the service. Guidance and information for staff, with detailed safe systems of work, were in place. Staff had received training on how to don, doff and dispose of the additional items of PPE they were wearing. In addition, a ‘PPE Champion’ had been identified in the staff team who, alongside ‘PPE buddies’, ensured that staff were supported to safely use the enhanced PPE.
¿ The service was engaged in the routine testing scheme, with all staff and people living at the service being tested for COVID-19 on a regular basis.
¿ The provider had developed policies and procedures in response to the COVID-19 pandemic. Management oversight and daily checks, alongside regular infection prevention and control audits were in place.
We found the following examples of good practice.
¿ The service had been facilitating ‘window visits’ for relatives. Visits were by appointment only, with times allocated to avoid potential infection transmission with other visitors and to enable the visiting area to be cleaned between visits. Visitors were provided with guidance, personal protective equipment (PPE) and a telephone to communicate with the person living in the service. Staff were available to facilitate and support all visits. The provider was in the process of making adaptations to the outside space for visitors with a view to making the area more comfortable for visitors and being able to ensure that future visits would not be weather dependent.
¿ The service had taken steps to alleviate the negative impact of the pandemic on people. People had been provided a wide variety of in-house activities to support wellbeing. A newsletter was compiled by the provider which was shared with people, family and friends. The provider had also activated all telephone lines into people’s bedrooms, offered an online communication channel for families and staff had supported videos calls with family and friends.
¿ Staff were provided with a designated preparation area on arrival to and departure from the service. PPE donning and doffing stations were available throughout the service, with PPE supplies available outside each person’s bedroom. Staff were seen to be maintaining social distance and adhering to the guidance and protective measures in place.
¿ The service was clean and hygienic. Additional cleaning tasks and schedules had been implemented by housekeeping staff, which were methodically completed throughout the service. Robust techniques and systems for waste disposal and management were in place.
¿ Risks to people and staff in relation to their health, safety and wellbeing had been thoroughly assessed. There was a comprehensive support package for staff in place which included provision of training, uniform and laundry service, access to an online communication channel, the support of clinical colleagues and financial assistance should they become unwell.
¿ The provider and clinical team had developed robust policies, procedures and guidance for the service which had been fully implemented.
Further information is in the detailed findings below.
Fonthill House is a purpose built nursing and residential care home, that specialises in end of life care. The nursing home accommodates up to 64 people in one adapted building. At the time of the inspection 64 people were receiving care and support.
Peoples experience of using this service:
Fonthill care home has been recognised as a leader in end of life care, they achieved “Beacon” status which demonstrated innovation and outstanding end of life care and support. We looked at thank you letters regarding the end of life support and without exception these told a story of outstanding kindness and care that remained with and left a positive feeling for the families going forward. The staff provided great care during and after with families receiving support during these difficult times.
People received care and support at a time they wanted. The providers ethos was person centred care that was personalised and in line with people’s needs and preferences. At a time, people wanted, where they wanted. People were not gathered together in one room to be managed in one space, they were encouraged and supported to live as they wished.
There were no set times for care, people chose when to get up, eat, wash and dress. There were many options available for entertainment. People could choose where to eat and could change their mind any time, nothing was too much trouble. There were no rigid meal times, people could request food throughout the day, when they wanted.
People and relatives told us the environment was lovely, clean and homely. People had developed great relationships with the staff. For example, a member of the hospitality staff arranged a shopping trip with one person who ‘just wanted to go shopping’. The person uses a wheelchair with a palliative diagnosis and complex health needs this did not deter the hospitality staff member. They talked to the nursing team about how best to facilitate the persons wishes.
People's concerns were dealt with and acted on quickly and to the person’s satisfaction. We saw lots of thank you letters and cards. People felt listened to and their opinions and ideas were valued.
Peoples interests, dietary requirements and independence were promoted and supported daily.
Skilled staff were provided with the necessary training and support. Staff received regular supervision and felt valued and supported by the provider. Staff loved working here, they all told us they would gladly have their loved ones cared for at Fonthill House. One staff member said, “I would gladly come here myself this is a wonderful place to be.”
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff were caring and were passionate about providing great care. People told us staff were kind, caring and promoted their dignity and independence. Staff knew people well and they promoted people’s cultural needs. One person told us, "This place is fantastic and it's all because great staff."
Governance and oversight of the quality of the service was highly effective in driving improvements this included regular clinical meetings with the highly skilled multidisciplinary team (MDT) to support people with providing good outcomes. For example, due to appropriate specialist equipment, one person’s independence was promoted. The person told us their outlook on life had dramatically improved and they were enjoying their life. The team met weekly to discuss people’s needs to ensure people’s changing needs were being met.
Risks to people were identified and managed well. Appropriate steps had been taken to safeguard people. The provider ensured good staffing levels with the required skills had been recruited to safely and deployed to keep people safe. Lessons were learned when things did not go quite so well. Infection control systems promoted good hygiene standards.
The last rating for this service was outstanding in responsive and well-led (report published 22 June 2016). Since this rating was awarded the provider has altered its legal entity. We have used the previous rating to inform our planning and decisions about the rating at this inspection. At this inspection the service had improved to outstanding in caring and effective and maintained outstanding in responsive and well-led
Why we inspected: This was a planned inspection based on the previous rating.
Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.