• Care Home
  • Care home

Freshfields Residential Home

Overall: Requires improvement read more about inspection ratings

265 Corbets Tey Road, Upminster, Essex, RM14 2BN (01708) 226362

Provided and run by:
May Residential Homes Limited

All Inspections

7 January 2020

During a routine inspection

About the service

Freshfields Residential Home is a residential care home registered to provide personal care, support and accommodation for up to 36 people in one adapted building over three floors. At the time of our inspection the care home accommodated 34 people, many whom were living with dementia.

People’s experience of using this service

There were risk assessments in place to monitor risks to people. However, these were not always holistic. Recruitment procedures at the service were not always robust, there were gaps in people’s employment histories which were not explained. People were not supported to have maximum choice and control in their lives and staff did not support them in the least restrictive way possible. The policies and systems in the service did not support this practice. Mental capacity assessment forms were not always completed with people. There were no consent to care forms, although people told us, and observations confirmed that staff always sought consent. Some staff had not completed their mandatory training. The provider gave us assurances this training would be completed in the months following our inspection. People’s information was not always kept securely. Quality assurance processes did not identify the issues we found at inspection.

The service decoration was not dementia friendly and we have made a recommendation about this.

Although some people had mixed views about staff numbers, the management team were able to demonstrate with dependency tools and rotas there were enough staff to meet people’s needs. Staff understood people can be at risk of abuse and knew who to report it to if they suspected it. There were infection control measures in place and staff understood infection prevention. Medicines were managed safely. Lessons were learned when things went wrong.

People’s needs were assessed before using the service to ensure they could be met. Staff received an induction before starting employment. Staff received supervision and appraisals. People were supported with their healthcare needs and the service worked with other agencies to the benefit of people. People mostly enjoyed the food they were provided and were supported to eat and drink healthily.

People and their relatives told us they were treated well. Staff understood equality and diversity. People could express their views and be involved with choices around their care and treatment. People told us their dignity was respected and their independence promoted.

People’s needs and preferences were recorded in care plans. The service provided activities for people. The service made information accessible to people with communication needs. People were able to make complaints and when doing so these were responded to appropriately. The service worked with people who were at the end of their lives and recorded their wishes before this occurred.

People told us they thought highly of the management team. The management team were responsive to inspection findings and wanted to improve the service to the benefit of people who lived there. People and staff held meetings and were engaged with the service. People and staff were able to complete surveys to assist with improving the service. The service had a presence within the local community.

Rating at last inspection

The last rating for this service was Good (published 14 July 2017.)

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to good governance and people providing consent. 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 for 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.

20 June 2017

During a routine inspection

This unannounced inspection took place on 20 June 2017. Freshfields provides accommodation and personal care to a maximum of 36 people, some of whom may be living with dementia. On the day of our visit there were 35 people using the service.

At our previous focused inspection on 22 July 2015, the service was meeting the legal requirements.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was well led with evidence of effective quality assurance systems in place to ensure the quality of care delivered was monitored and continuously improved.

There were safeguarding systems in place which were known and understood by staff. Staff demonstrated an understanding of the incident and accident reporting procedure and were able to explain any learning that had taken place following some falls resulting in injuries.

People and their relatives told us they felt Freshfields was a safe place to live. They thought there were enough staff to meet people’s needs.

People told us their privacy and dignity was respected. They were involved in how the service was run and told us they were asked their views on issues such as meals and how they spent their time. They told us they were able to make a complaint if they were unhappy with any aspect of their care.

Care plans were person centred and were completed after consulting with people and their relatives. They included peoples religious, emotional and physical support needs and preferences.

People were enabled to maintain a balanced diet that met their individual needs. Food and fluid charts and regular weight checks were in place for people at risk of malnutrition.

Staff were supported by an approachable management team that ensured monthly staff meetings took place and supervision. There was a comprehensive induction and training program which ensured staff were up to date with practice and able to deliver evidence based care.

Recruitment systems were robust and included appropriate checks to ensure that only suitable staff were employed.

The service worked according to Mental Capacity Act to ensure that where people lacked capacity decisions were made in their best interests following appropriate guidance and involvement of relevant professionals. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

22/07/2015

During an inspection looking at part of the service

We visited this service on 10 and 11 November 2015 and found the provider was in breach of the regulation that related to medicines. People were not protected against the risks associated with the unsafe use and management of medicines. Systems were not in place to ensure that people safely received all of their medicines when they needed them. The provider sent us an action plan stating the steps they would take to address the issues identified.

We undertook this focused inspection on the 22 July 2015 to check that the provider had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Freshfields Residential Home on our website at www.cqc.org.uk.

Freshfields is a 36 bed care home providing accommodation and personal care for older people, including some living with dementia. Most of the 36 single bedrooms have ensuite facilities. There was a lift to each floor and accessible bathrooms to assist those with mobility difficulties.

At the time of the inspection 36 people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At this inspection we found that the provider had followed their plan and the legal requirement relating to medicines had been met. Systems were in place to ensure that people received their prescribed medicines safely and appropriately. Information was in place to ensure that staff knew how and when to administer medicines that were prescribed on an ‘as required’ basis or that should only be given under specific circumstances. Controlled drugs were securely stored and accurately recorded.

10 to 11 November 2014

During a routine inspection

This unannounced inspection took place over two days on 10 and 11 November 2014.

We found that the arrangements for administering medicines were not always safe. Staff did not have information to enable them to make decisions about when to give certain medicines to ensure that people received these when they needed and in a way which protected them against the risks associated with the unsafe use of medicines. You can see what action we told the provider to take at the back of the full version of this report.

Freshfields is a 36 bed care home providing accommodation and personal care for older people, including some living with dementia. Most of the 36 single bedrooms have ensuite facilities. There was a lift to each floor and accessible bathrooms to assist those with mobility difficulties. When we visited 34 people were using the service. People lived in a clean, comfortable, safe and well maintained environment that was suitable for their needs.

The registered manager for the service had recently left. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run. The provider was in the process of recruiting another manager and the interim management arrangements were robust. People told us that were very happy with the way in which the service was managed.

People told us they felt very safe and secure and that they were supported by kind, caring staff who treated them with respect. One person told us that they felt secure because staff checked them regularly at night.

Staff had received Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) training. Deprivation of Liberty Safeguards is where a person can be deprived of their liberties where it is deemed to be in their best interests or their own safety. Staff were aware that on occasions this was necessary. There were not any DoLS in place at the time of the inspection.

People were happy with the quality of food provided. Their dietary needs were met in a way which promoted and maintained their health and wellbeing. A healthcare professional told us, “They tell you if a ‘resident’ is eating enough now and no longer needs supplements. They are good at providing appropriate diets when needed.”

Staff received the support and training they needed to provide a safe service that met people’s needs.

People told us they were happy with the management of the home and felt comfortable raising any concerns with management as and when they arose. They were confident that these would be dealt with.

6 December 2013

During a routine inspection

People's needs were assessed and care was planned and delivered in line with their individual care plan. People we spoke with told us they were satisfied with the care and support they received. Comments included 'the attention and help is extremely good' and 'the staff have great friendliness and care.' We found that care plans and risk assessments were in place which set out how to meet people's needs in a safe way. People had access to health care professionals including GP's and opticians.

We found that medications were stored securely and administered safely. The home's physical environment was well maintained and various safety checks were carried out, such as checking fire alarms. Checks were carried out on staff before they began working at the service, including obtaining two employment references. The service had a complaints system in place and people we spoke with knew who they could complain to if they wished. One said 'I would tell one of the workers if anything was wrong.'

17 January 2013

During a routine inspection

We spoke to four people using the service who were all very pleased with the service they received and said the staff were all attentive and caring. Many people said that they had seen their health improve greatly after being at the home for a few weeks. One person said "I would recommend this place-everything is good."

We saw that staff treated people using the service with respect and care. Personnel and training records we reviewed showed that staff were suitably skilled and qualified.

The standard of food was good and people were encouraged to eat full meals, without being unnecessarily pressured.

The provider had an effective system in place to measure the quality of the service.

14 September 2011

During a routine inspection

The people we spoke with were very happy with the care that they received. People said, 'I am very happy with the care and nothing is too much trouble. Staff do whatever you want. They will bring you tea at any time of the day or night. They are kind and patient. The staff seem to get on well with each other and they have a laugh and a joke. No complaints, could not fault the place'. 'It's very good to have someone here when you need them. Everything is good, the staff are good. They look after you well'. 'The girls are wonderful. I looked at lots of homes and thought Freshfields was the best. Everyone said the same. I would recommend it. They do all they can for you'.

Relatives we spoke with were also happy with the quality of the service. One said, 'Staff have been very helpful. They spend time with my father, talk to him and take him out for coffee. He is happy with the food and said it's a nice balanced diet. I have seen that there are enough staff to spend time chatting to people and there's always a lot going on'. Another said, 'This is an excellent home and my mum is well looked after. She was very ill earlier this year and they gave her good care and dedication and got her through it. I can only speak well of the service, staff are caring and it's run very well'.

A healthcare professional told us, 'The service is excellent and staff are willing to learn. They treat residents well and with respect. There is a good rapport and they do things above and beyond, particularly when supporting people at the end of their life'.