Folkestone Nursing Home

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Although quality assurance and monitoring systems were in place, these were not always effective. Further, many of them had only recently been introduced by the new manager and had not yet had sufficient time to imbed and take effect. This was breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The provider worked in partnership with other agencies and there were systems for people, relatives and staff to voice their opinions and they were free to speak up.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We saw team meeting minutes held in August 2024, which amongst many things discussed kitchen hygiene, timekeeping, maintenance, training and development and health related issues. We noted that the staff meeting minutes had been signed by staff to acknowledge the notes being read and understood.

We saw evidence of many changes the new management of the home were making. We saw how they were holding meetings to share information which included meeting between Managers and the staff team. We saw evidence of meetings with families and dates for proposed family meetings up to August 2025.

The staff we spoke to all talked about the improvements made since the new Manager started in July 2024. Staff told us how the Manager had implemented many positive changes in a short space of time. They also told us how approachable the Manager was and how the home feels different since they arrived.

As part of the daily checks by the management team they were checking that staff have everything they need to be able to do their job and were receptive to any of their colleagues who need help. We heard that on the daily checks through the building the managers ensured that staff were treating people with dignity and respect by knocking on people’s doors and that people were receiving choices.

The Manager told us that since taking up post within the organisation they felt that the person they reported to was supportive and could be approached whenever there were problems. The staff we spoke to talked about the positive differences since the management had changed and how the Manager was both approachable and was consistently available to talk to.

Processes were in place to enable staff, people who used the service and their relatives to speak up. There was a whistle blowing policy in place which provided guidance to staff about how to raise concerns. There was also a complaints policy and we saw complaints had been dealt with in line with the policy. In addition, various meetings were held including for staff and people who used the service, which gave them the opportunity to raise issues of importance to them. A relative told us, “There is a meeting tomorrow for all the relatives. They emailed us all the date. It’s on Teams and you can call in for it [or attend n person]. There is going to be 1 every month. Staff supervision was still a work in progress the time of our visit. Prior to the new manager taking up their role, there had only been one staff supervision in the previous 12 months. Since then, all staff have had a limited supervision session with the manager. Limited in the sense that the agenda was entirely drawn up by the manager and was the same for all staff. The manager told us this was just an initial meeting where they wanted to set out their plans for the home and expectations of staff. The added that going forward they planned that all staff should have regular supervision meetings, where both parties could raise issues of relevance to them.

We learnt as part of out assessment that many of the care staff are part of sponsorship schemes coming to work in the UK from overseas. The Manager told us that they used recruitment agencies for Nurses and kitchen staff to ensure they attracted people with the right skills and qualifications. This care home was reflective of the diverse cultures that are part of the local community.

The provider had processes in place to promote workforce equality, diversity and inclusion. For example staff recruitment practices reflected good practice in relation to equality and diversity. Staff told us they were treated fairly by the provider, without discrimination.

The Manager told us about the meetings and systems now in place since their appointment in July 2024. We heard about the meetings across the staff team that were taking place and of the range of checks that are now happening. However, we observed that the Managers had implemented a daily visual inspection of the premises that they had commenced, but we saw consecutive days where this had not happened. We acknowledged the Manager had implemented a host of positive changes in a short space of time, however, these need time to be embedded and the good practice needs to be sustained.

The provider had various quality assurance systems in place. However, these were not always effective. For example, although risk assessments were subject to monthly review, these reviews had failed to identify the shortfalls we found with risk assessments in relation to diabetes and epilepsy. Likewise, medicine audits were in place, and although they had found areas in need of improvement, the necessary action had not yet been taken to make those improvements. This was a breach of Regulation 17 of The Health and Social care Act 2008 (Regulated Activities) Regulations 2014.

People told us they were able to work in partnership with the service. A relative told us, “I can talk to the nurses and the carers, they are all very friendly.. They talk to me about what’s happening.” The added that they would, “Talk to the manager if I had a complaint."

The Manager told us about the referrals they had made to other professional bodies since taking up their position in July 2024. They had referred people to the services of speech and language therapy, dietician’s, GP to review medication, including those on antipsychotic medication and covert medication. They had liaised with the Deprivation of Liberty Safeguards team to apply for extensions on any restrictions. They had made referrals to specialist’s teams for those who are living with Parkinson’s disease. There had been referrals to professionals who supported people and teams around falling, looking at support including the use of technology to reduce the number of falls. There were also referrals made with regards to the physical support people required which resulted in referrals to occupational and physiotherapy services. We heard that the home was liaising with colleagues in the local authority to acquire voluntary services to come into the home and provide activities for people within the home.

We spoke with staff from the host local authority who commissioned care with the service. They told us they had a number of concerns about the service and were working with team to make improvements. The told us some improvements had been made since the new management team was put in place, but there was still more to do.

The Manager told us about links they had made with a range of local resources in recent months. As well as referring people to clinical services to meet specific needs we heard about external training staff were now accessing to provide them with a health and social care qualification.

We heard from the Manager about the new electronic care planning system that was being introduced. This would replace the current paper based system in the home and the staff team were in the process of transferring information to the new system. We were shown how the home had already written the plans of those people who they believed were high risk through such health conditions as, epileptic, diabetic, people who have guidelines in place for eating and drinking. etc. The plans were written for the people who lived on the ground floor of the home and work had started on the plans for the people who lived on the first floor. The aim was to have all plans written by the end of September with a view of having staff trained to use them by the end of October 2024 which includes a overhaul of the home’s WiFi system to ensure staff are able to use their mobile devices in all areas. The plans covered comprehensively a person’s life, who they are, all of the things that are important to them and all aspects of their life. We were given access to what had been completed to date. The plans were well written with a clear indication of how to support the person. The notes were person centred and respectfully written. Following both visits it was clear that both the Manager and the person nominated to write the plans understood the importance of writing the plans which would best reflect the holistic needs of the people living in the home. The manager shared a template with us which created the standard of how they wanted the care plans written to ensure they are all of the same level of quality across the home.

A relative told us record keeping had improved since the new manager took over. They said, “They [care staff] are writing down every time they go in the room what they are doing, which is a new thing."