Archived: Finchley House

Finchley House is a care home run by Community Integrated Care. It is a detached bungalow set in a mainly residential area with good access to shops and local amenities. Six people can live there and it has good access both into and outside of the property. It is registered to provide accommodation for people and their nursing needs are met by the local community nursing services. At the time of the inspection five people were living at Finchley House.

There was an established registered manager in post at the time of the 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.

During this inspection we found some ongoing concerns in relation to the completion of some training. Some staff had not attended training such as health and safety, infection control and food hygiene but were booked to attend. Staff had had no recent training in epilepsy or diabetes and were supporting people who lived with these conditions. Staff had not attended training in mental capacity and Deprivation of Liberty Safeguards (DoLS).

Care records and risk assessments were in place but reviews had not always been completed to the specified timeframe. When reviews had taken place they were dated and an entry was recorded as ‘no change.’ Where care plans had been updated following a review additions were handwritten and were not signed or dated and the out of date information was crossed out.

Quality assurances systems and audits had not been effective in improving the concerns noted during the inspection. An internal audit had rated the location requires improvement and had identified areas to improve but a detailed action plan covering all areas was not available. There was an action plan in relation to medicine management which had been developed on 15 May and needed to be completed within four weeks. This had not identified concerns in relation to a failure to temperature check medicine storage cupboards, gaps in the recording of the administration of prescribed creams or a failure to complete weekly medicines audits, as required by the provider.

Team meetings had not been held regularly and this had been identified as an area for improvement.

People were supported in a respectful and warm manner by staff. We observed lots of smiles, laughter and people instigated lots of appropriate touch and warmth with their staff.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff supported people with their nutritional and health needs. A health champion was in post.

People enjoyed one day a week where they were supported to have one to one time with staff to participate in activities of their choosing. On other days people were supported with activities in the house, or attended group activities.

Safe recruitment practices were in place and staff told us there were enough staff to meet people’s needs. On the majority of days there were four staff to support five people.

There had been no safeguarding concerns or complaints raised since the last inspection but detailed procedures were in place for staff to follow should they arise. Accidents and incidents were recorded and analysed for any triggers or actions required to minimise the risk of reoccurrence.

Staff attended regular supervision and all staff who had been in post for over a year had received an annual appraisal. Newer staff had completed a thorough induction and had attended a probation review meeting to discuss their performance.

Staff told us they thought the service was well managed and they worked together as a team to achieve positive outcomes for the people they supported.

The registered manager was open and transparent about the areas needing improving and told us the organisation was going through a transitional phase with new senior staff being employed and new documentation and quality assurance systems being implemented.

You can see what action we told the provider to take at the back of the full version of the report.

We saw how people engaged with staff as they were being supported in their day to day lives. We saw this was a positive exchange, people looked relaxed and content. One person showed us their bedroom and indicated they were happy with how it was decorated and personalised to their taste.

Staff were assisting people with their usual daily activities, including helping with domestic tasks, watching television, going out to a day centre and visiting the hairdresser. Staff responded to their needs in a professional and pleasant way, and when we spoke with them they were clear about how each person was supported. These activities maximised people's independence while maintaining their safety and wellbeing. The atmosphere in the service was quiet and calm and the staff were focused on the people they were supporting.

Staff had appropriate training to make sure they could meet people's needs and were supervised and supported in the role they were carrying out. The training included epilepsy, nutrition and hydration, and challenging behaviour.

There was an effective programme of quality assurance to make sure the standards were maintained and where improvements were identified they were planned and carried out.