Fitzwilliam House Care Home

We found the following examples of good practice.

The service was only receiving essential visitors at the time of our inspection. Any person entering the building had their temperature taken and wore full personal protective equipment (PPE) including a face visor.

People were supported by staff in full PPE, whether that person was COVID-19 positive or negative. This is called barrier nursing. This is to protect both staff and people living in the service from spreading infection.

The registered manager told us that they had changed systems within the service to reduce the spread of infection. Staff entered through a back entrance immediately into a staff changing area where they changed into clean uniform and PPE.

Staff worked in set groups in units known as 'cohorting' and did not mix between the units they were allocated to. This approach also applied to domestic staff. Kitchen staff entered the kitchen through a separate entrance and did not mix with other staff.

The building was clean and free from clutter. During our inspection we observed staff cleaning communal areas. The registered manager told us that frequently touched areas were cleaned more often.

All staff had received training in the use of PPE, and how to put it on, take it off and dispose of it safely. The registered manager had organised role play sessions at the beginning of the COVID-19 pandemic to give staff the opportunity to practice what they had learnt.

The registered manager and provider ensured staff had regular well-being, monitoring and support meetings. The provider was arranging counselling to be offered to staff in recognition of how the current COVID-19 pandemic may have affected staff’s well-being.

Fitzwilliam House Care Home is a care home that provides personal care to 40 older people, some of whom are living with dementia. Each of the two floors is a self-contained unit, with bedrooms, lounge and dining areas, a kitchenette and bathrooms. There were 24 people living there when we visited.

People’s experience of using this service:

People who lived at Fitzwilliam House Care Home received outstanding care from a staff team who were passionate about delivering a high-quality, person-centred service. People were truly valued and staff knew each person well. People’s views were respected and they were involved in everything that happened in the home. People were happy to be living there and relatives trusted the staff team to look after their family members.

Staff delivered care and support that was exceptionally personalised and responsive to people’s likes, dislikes and preferences. Staff were kind, caring and motivated and people, their relatives and external professionals described them in glowing terms. Staff respected people’s privacy, dignity and independence and encouraged people to lead their life in the way they wanted to.

Everyone praised the registered manager who led by example and provided extremely good management and leadership. The staff team worked towards continually improving their practice based on the provider’s values and good practice guidelines. Fitzwilliam House Care Home was part of the local community and admired by external professionals for the homely, caring atmosphere that staff created and their professional approach to all aspects of care.

People were safe at Fitzwilliam House Care Home, protected by practices and procedures that put their safety and well-being at the heart of the care provided. There were enough staff to meet people’s care and support needs. Staff had been recruited well and understood their responsibility to keep people safe. Staff were creative in engaging people in activities of their choice, based on their interests and hobbies.

The provider was committed to ensuring staff developed their competence and knowledge and that they felt valued and supported. External healthcare professionals supported people to maintain their health and people were offered a wide choice of nutritious and appetizing food. Staff asked people’s consent to deliver their care and supported them to make decisions so that they were cared for in the least restrictive way possible.

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

Rating at last inspection:

At the last inspection we rated this service Good (report published on 12 August 2016).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we might inspect sooner.

This unannounced inspection took place on 11 July 2016.

There was a registered manager in place during this inspection. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Where people had been assessed as lacking capacity to make day-to-day decisions, decisions were made in their best interest. Applications had been made to the local authorising agencies to lawfully restrict people’s liberty where appropriate. Staff demonstrated to us that they respected people’s choices about how they wished to be supported. Staff were able to demonstrate a sufficient understanding of the MCA and DoLS to ensure that people would not have their freedom restricted in an unlawful manner.

Plans were in place to minimise people’s identified risks and to assist people to live as independent and safe a life as possible. Records were in place for staff to monitor people’s assessed risks, and their support and care needs. People’s nutritional and hydration needs were met.

Arrangements were in place to ensure that people were supported with their prescribed medicines safely. People’s medicines were managed, stored and disposed of appropriately. When required, people were referred to and assisted to access a range of external healthcare professionals. People were supported to maintain their health and well-being.

People were supported by staff in a caring and respectful manner. People’s support and care plans gave prompts and guidance to staff on any individual assistance a person may require. This included the person’s wishes on how they were to be supported, their likes and dislikes and what was important to them. Staff supported people with their interests and activities and promoted social inclusion. People’s family and friends were encouraged to visit the home and staff made them welcome.

Staff were trained to provide care and support which met people’s individual needs. The standard of staff members’ work performance was reviewed during supervisions, competency checks and appraisals. This was to make sure that staff were deemed confident and competent by the registered manager to deliver people’s care and support needs.

Staff understood their responsibility to report any suspicions of harm or poor care practice. There were pre-employment safety checks in place to ensure that all new staff were deemed suitable to work with the people they supported. There was a sufficient number of staff to provide people with safe support and care.

The registered manager sought feedback about the quality of the service provided from people, their relatives and stakeholders. People who used the service and their relatives were able to raise any suggestions or concerns that they had with the registered manager and staff and they felt listened to.

Staff meetings took place and staff were encouraged to raise any suggestions or concerns that they may have had. Quality monitoring processes to identify areas of improvement required within the home were in place and formally documented any action required.

People were asked for their consent when considering care offered to them. Staff had received training in the Mental Capacity Act and deprivation of liberty safeguards so they were aware of how to protect people who could not make decisions for themselves.

We found that there were enough staff on duty, with right set of skills, to ensure that people's needs were met effectively and in a timely way.

We found that people's needs had been reviewed regularly and information about them had been kept up to date by staff. People's relatives had been involved in their care where appropriate, and were kept informed by staff of any changes to their family member's care.

Is the service effective?

We found that procedures were in place to ensure that people who could not make decisions for themselves were protected.

We spoke with relatives during the inspection and all agreed they had been consulted regarding their family member's care plan and were confident that alterations made were always in the best interests of the their family member's care goals. Advocacy services could be accessed for people if necessary.

Is the service caring?

The provider advocated a person centred approach towards people who used the service. Consideration to people's personal preferences and life history were seen throughout their care goals. Staff were observed to be polite and respectful towards people and had a clear awareness of people's needs.

People using the service, their relatives and other health professionals were given the opportunity to express their views and opinions regarding the service through meetings and questionnaires. The provider demonstrated how these views had been implemented to change and improve the service.

Is the service responsive?

We spoke with staff and relatives during the inspection. All stated that if they had concerns regarding the provider they would feel able to raise them and that their concerns would be taken seriously and, where necessary, appropriate action would be taken.

The service had good links with other health professionals required to meet the individualised needs of the people who used the service. These included GPs, district nurses, diabetic nurses and social workers.

Is the service well led?

We found that staff received a range of training which gave them the skills and knowledge to support people with specific needs such as diabetes and dementia.

The provider demonstrated they had ongoing plans for improvement. Incident reports were completed and reviewed as required by the provider's policy alongside on-going improvement plans detailed in a business plan.

We received consistently good feedback about the home from a range of health and social care professionals who visited frequently. One GP told us that staff managed people's long-term health conditions well and that he would be happy to have a relative in the home. One social worker described the staff as, 'Very conscientious and caring' and was impressed by the input and care that had been shown by them when someone had to be transferred to a nursing home. One dietician told us that staff worked very hard to maintain and improve people's nutrition with great success.

We found that the provider was compliant in all the outcomes we assessed: evidence showed that this was a well run, clean and happy home staffed by caring workers who respected the people they supported.