Four Seasons

Updated 13 December 2022

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.

Inspection team

2 inspectors, a medicines inspector, a specialist advisor nurse and an Expert by Experience carried out this inspection. 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

Four Seasons 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. Four Seasons 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 not a registered manager in post. A new manager joined the service in November 2022, just before our inspection.

Notice of inspection

This inspection was unannounced.

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 spoke with 13 people and 4 relatives about their experience of the care provided. We reviewed a range of records. This included 8 people's care records and 13 medicine administration records, with accompanying documentation. We spoke with 13 members of staff, including the manager, the provider, care, kitchen and domestic staff. We also spoke with 1 visiting professional.

Updated 13 December 2022

About the service

Four Seasons is a residential nursing home providing personal and nursing care to older people and people living with a dementia. It can support up to 72 people across 3 purpose-built buildings, one of which accommodates people requiring nursing care. There were 56 people using the service when we visited.

People’s experience of using this service and what we found

Medicines had not always been managed safely. People had not always been safeguarded from abuse or from risk. Effective support with eating and drinking was not always in place. Care plans did not always reflect people’s needs, and people and relatives had limited involvement in these. Governance systems had not always identified or addressed issues at the service.

People received kind, caring support and spoke positively about their care. Staff treated people with dignity and respect.

The provider was acting to improve infection prevention and control standards at the service. Staffing levels were monitored and recruitment of new staff was ongoing. Recruitment practices had been inconsistent, but improvements were being made.

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. The service was adapted for the comfort and convenience of people living there.

Staff supported people to access a range of activities. The provider had a clear complaints process in place.

The provider was working with external professionals to stabilise and improve the service. Staff reported that morale was improving and that they could see improvements taking place.

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

Rating at last inspection

The last rating for this service was good (published 9 January 2020).

Why we inspected

The inspection was prompted in part due to concerns received about medicine management, risk management and staffing. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to medicine management, safeguarding and risk management, eating and drinking support and governance.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.