Archived: Footherley Hall

Updated 10 November 2017

We carried out this inspection visit under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Our inspection was unannounced and the team consisted of two inspectors.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information that we had received from the public. We also spoke with the local authority who provided us with their current monitoring information. We used this information to formulate our inspection plan.

We spoke with five people who used the service and three relatives. Some people were unable to tell us their experience of their life in the home, so we observed how the staff interacted with people in communal areas.

We also spoke with five members of care staff, the cook, the deputy, the family liaison and the registered manager. We looked a range of information, which included the training records to see how staff were trained, and care records for four people who used the service. We also looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 10 November 2017

This inspection visit was unannounced and took place on 17 September 2017. At our last inspection visit on December 2015 we asked the provider to make improvements to the medicine auditing process and for the manager to compete their registration with us. At this inspection, we found improvements had been made, however in our effective section we require the provider to make some further improvements. The service was registered to provide accommodation for up to 50 people. People who used the service had physical health needs and/or were living with dementia. At the time of our inspection 46 people were using the service. The home is situated in a small village and is adjoined to a convent with a small working chapel; sisters support the management and running of the home.

There was a registered manager in post. 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.

People were supported to make choices, however the assessments did not always reflect the person’s level of understanding in different situations. We saw that staff knew how to keep people safe and raised any concerns if necessary. Risk assessments had been competed to reduce risks or provide guidance. There was enough staff to support people’s needs and this was supplemented by the sisters from the adjoining convent. People received their medicine to support their health conditions.

Staff had received a range of training for their roles and this enabled them to provide care in a supported and enabling way. There was a friendly atmosphere and staff had established relationships with people. People enjoyed a positive meal experience and their nutritional needs had been catered for. When required health care professionals advice had been sought had their guidance followed.

Peoples care plans were individual and recorded preferences in relation to their daily routine and their interests and hobbies. We saw these had been reflected in the stimulation on offer. People’s dignity was respected and this included their choice of faith.

Staff felt supported by the provider and the manager. A range of audits and quality measures had been implemented to consider improvements and ongoing developments to the home. People had an opportunity to comment on the service they received and their comments had been reviewed and considered. Complaints had been acknowledged and responded to. We saw that the previous rating was displayed in the reception of the home as required. The manager understood their responsibility of registration with us and notified us of important events that occurred at the service; this meant we could check appropriate action had been taken.