Freshfields - Care Home with Nursing Physical Disabilities

Updated 12 July 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 carried out by 2 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.)

Service and service type

Freshfields Care Home with Nursing Physical Disabilities (Freshfields) 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. Freshfields 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 on the first day, and announced on the second day.

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 and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We carried out an inspection of the home to ensure it was safe and suitable to meet people's needs. We also observed the delivery of care and support at various times throughout the day. We spoke with 6 people who lived at the home, 3 relatives, the registered manager, the regional quality director, the administrator, a team leader, 2 activity co-ordinators, the kitchen assistant and 3 members of care staff.

We looked at records in relation to people who used the service including 4 care plans, medication records and systems for monitoring the safety and quality of the service provided. We also looked at staff training and quality assurance records.

Updated 12 July 2023

About the service

Freshfields Care Home with Nursing Physical Disabilities (Freshfields) provides accommodation and nursing and/or personal care to up to 35 people. At the time of our inspection there were 23 people living at the home.

The service is purpose built and all accommodation and facilities are ground floor level.

People's experience of using the service and what we found

The service had made significant improvements since our last inspection. Systems and processes had been overhauled to address the breaches of regulation and to help improve the safety and quality of care provided. Further time was required to evidence these improvements were embedded through sustained governance.

Medicines were managed safely. People received their medicines as prescribed by staff who were competent to administer them.

Risks to people's health, safety and well-being were assessed and care plans had been re-written to ensure staff had access to information about how to manage people's identified risks and support them in a safe way.

Since the last inspection, the reliance on agency staff had decreased, a more stable team structure was in place. People received care by staff they knew and who were familiar with their needs and preferences. There were enough staff on duty to meet people’s needs in a timely manner.

Staff were recruited in a safe way and underwent an induction to help prepare them for working at the service.

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. Consent for care and support was being obtained in line with the principles of the Mental Capacity Act (MCA) 2005.

People's needs were assessed and planned for in line with best practice. Staff had access to information about how to support people based on their current needs, helping to ensure people received care based on their individual needs and preferences.

Since the last inspection, improvements had been made to the environment to help better support people with dementia or cognitive impairments to navigate the home.

We received consistently positive feedback from people and their relatives about the care and support provided by staff.

Governance systems had been overhauled to ensure they were effective at identifying issues and driving necessary improvements to the quality and safety of the service.

Since the last inspection, the former registered manager had returned to the service and had been instrumental in taking the appropriate action to address the issues we found. They and the provider had worked closely with the Local Authority to make positive changes and enhance the daily living experience of people using the services of Freshfields.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service has been in Special Measures since 10 January 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection. This also included to check whether the Warning Notice we previously served in relation to Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met (in relation to using medicines safely.)

We also 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 inadequate 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 Freshfields Care Home with Nursing Physical Disabilities 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.