Faversham House Nursing Home

Faversham House is a nursing home in the Urmston area of Trafford, Greater Manchester. Accommodation is provided in single and double rooms spread over 2 floors, with access to the upper floor provided by a passenger lift. Faversham House Nursing Home is registered to provide nursing and personal care for up to 20 people. At the time of our inspection there were 20 people living at the home.

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

People and relatives were complimentary about the service and were very happy with the care and support given at Faversham House Nursing Home. There were effective safeguarding systems in place. Staff understood how to recognise signs of abuse and were aware of their responsibility to raise concerns should they arise. There were enough suitably qualified staff working at the service to meet people's nursing and care needs and robust staff recruitment practices were in place. Medicines were stored, managed and administered safely. The home was clean and well-maintained and staff followed good infection control practices.

Staff had received appropriate training and supervision and nurses maintained their clinical skills. Staff were encouraged to take additional qualifications to enhance their roles. People were complimentary about the food and were provided with a balanced diet. People were helped to maintain their health, and referrals to specialist professionals for advice and support were made when required. 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.

People were supported by kind, caring staff who respected their privacy and dignity and helped them be as independent as they could. People were helped and encouraged to maintain relationships with family and friends and to engage in meaningful activities.

People were supported with care that was person-centred. Leaders were visible and experienced; they promoted a positive staff culture in the service which helped achieve good outcomes for people. Quality assurance systems ensured all aspects of the service were reviewed and checked regularly. There was a system for dealing with any complaints, although none had been received recently.

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 23 November 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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

We found the following examples of good practice.

Visitors and professionals were screened for COVID-19, tested and supported to perform hand hygiene and put on personal protective equipment (PPE) prior to staff escorting them directly to the visiting room via the home garden. It was designed to reduce the amount of footfall through the service.

The service was clean throughout, and there were procedures to ensure any infection control risks were minimised. Additional cleaning schedules had been introduced since the beginning of the coronavirus pandemic. Areas that were frequently touched, such as door handles and light switches, were cleaned several times a day. Hand sanitiser was readily available on the premises.

Staff understood the importance of using PPE, they had received training and were confident in their knowledge of PPE and how to dispose of it safely. Staff were observed wearing correct PPE and promoting hand hygiene.

The registered manager was visible and supportive to staff. The registered manager sought support and advice from external agencies including the local health protection team and CQC and was open to all advice and guidance offered.

The provider had a range of policies relating to COVID-19 and infection control practices. Policies were up to date and showed amendments made to reflect changes in government guidance or the care homes individual circumstances.

Further information is in the detailed findings below.

Faversham House Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Faversham House is a nursing care home in the Urmston area of Trafford and can accommodate 20 people. At the time of this inspection, there were 20 people living at the service, some of whom were living with dementia.

At our last inspection on 2 February 2016 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a manager in place at Faversham House Nursing Home, who was also the owner of the service. They were in the process of registering with CQC to become the 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 2008 and associated Regulations about how the service.

Risk assessments were in place for people who lived at Faversham House Nursing Home. Risk assessments were tailored around the needs of the person, support measures were in place to mitigate risks and assessments were regularly reviewed and updated. Staff were familiar with people's risks; they received daily updates on people's health and well-being and if their circumstances had changed.

There were safe recruitment procedures in place to ensure staff were of the right character to support vulnerable people. However, we found no evidence of medical statements. Medical statements enable new starters to declare any health condition or disability. The manager said this had been overlooked and confirmed they would review this as a matter of urgency.

Accidents and incidents were routinely recorded and analysed. There was an accident and incident reporting policy in place and staff routinely completed accident and incident documentation. The manager analysed monthly accident and incident reports and established trends that were emerging as a measure of mitigating risk.

Medicines were stored safely and securely, however two people prescribed PRN medicines (medicines to be given 'as and when' needed) did not have protocols in place. The manager was responsive to our feedback and ensured that all protocols were reviewed and updated during the inspection.

The home was acting under the principles of the Mental Capacity Act and people were asked for their consent before support was given. Where people lacked the capacity to make decisions for themselves, appropriate processes were in place to identify the person's best interests.

Staff received regular supervision and told us they received support on a day to day basis. Staff were supported with training, learning and development opportunities.

Confidential information was securely stored and protected in line with General Data Protection Regulation (GDPR). This meant that people's sensitive and personal information was not unnecessarily shared with others.

We observed the mealtime experience and found this to be relaxed and well organised. People received any help, support and encouragement they required to eat and drink promptly.

A person-centred approach to care was evident. Records were tailored around the needs of the person and staff were familiar with the likes, dislikes, preferences and wishes of people they supported.

People were sensitively supported with end of life wishes and preferences. Records we checked contained end of life documentation (where required) and staff were familiar with any specialist support that was needed.

People had the opportunity to engage and participate in a range of different activities arranged by the dedicated activity co-ordinator. We received positive feedback about the different activities that were taking place.

There was good day to day management of the service. The management team were respected, visible and supportive to both staff and the people who used the service, ensuring standards of care were maintained.

There was a well-developed performance framework which assessed the safety and quality of the service. The electronic care management system, further enhanced robust quality assurance procedures.

Faversham House is a nursing home registered to provide accommodation, nursing and personal care for up to twenty people. On the day of our inspection the home was fully occupied.

The provider had a registered manager in place as required by the conditions of their registration with the Care Quality Commission (CQC). 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 registered manager was responsible for all the services delivered by the provider.

People who used the service told us they felt safe with staff who supported them. They told us staff were available to support them in the activities they wished to do. People were encouraged to make their own decisions and told us staff always promoted their independence. During the inspection we observed staff were caring and respectful in their interactions with people who used the service.

Recruitment processes were robust and should help protect people who used the service from the risk of staff who were unsuitable to work with vulnerable adults.

Staff had received training in the safe administration of medicines. The competence of staff to administer medicines safely was regularly assessed.

Systems were in place to help ensure the safety and cleanliness of the environment.

Staff told us they received the training and support they needed to carry out their role effectively. There were systems in place to track the training staff had completed and to plan the training required. All the staff we spoke with told us they enjoyed working in the service and felt valued by both the registered manager and the rest of the team. Staff felt able to raise any issues of concern in supervisions and in staff meetings.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005. We saw that appropriate arrangements were in place to assess whether people were able to consent to their care and support.

People who used the service had support plans in place. Records were stored electronically and were easily accessible by staff. Records reviewed showed that, where necessary, people were provided with support from staff to attend health appointments. People were also supported by staff to maintain a healthy diet as far as possible.

Care records we looked at showed people who used the service had been involved in developing and reviewing their care and support plans. However some people’s care records were not up to date.

All the people we spoke with told us they felt able to raise any concerns with the registered manager and were confident they would be listened to. We noted systems were in place to encourage people who used the service to provide feedback on the care and support they received.

One inspector carried out the inspection. We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask:

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found.

Is the service safe?

We saw people were being cared for in an environment which was clean. Processes for the prevention and control of infection were in place. For health, safety and security reasons, visitors were asked to sign in and out. There were enough staff on duty to meet the needs of the people living at the home at the time of our visit. A qualified member of staff was on duty on each shift.

The people we spoke with who used the service told us they felt safe. One person said 'I'm quite safe and I am very well looked after.'

Discussion with staff and examination of records confirmed a programme of training was in place for all members of staff.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS). DoLS are part of the Mental Capacity Act 2005 (MCA). The aim is to make sure people in care homes and hospitals are looked after in a way which does not restrict their freedom inappropriately. Staff had all received training about the Mental Capacity Act and Deprivation of Liberty Safeguards so they understood when an application should be made and how to submit one.

Is the service effective?

People's health, social and care needs were assessed with them and they were involved in writing and reviewing their care plans. Specialist needs had been identified in care plans, for example, ways to communicate. Care plans were reviewed every month and when people's needs changed. The manager carried out a full re-assessment of people's needs every six months.

The people we spoke with told us they were happy with the care they received and said their needs were met. They spoke positively about the staff who supported them. From what we saw and from speaking with staff it was clear they had a good understanding of the care and support needs of the people who used the service.

One person told us 'When I first came here I couldn't stand up. They encouraged me to use the frame and I can walk now.' A relative of another person said 'They spot changes early on and they act on it.'

An electronic system was in use throughout the service by all staff, on which everything was recorded and which flagged up when things were due or had not been carried out. This included for example, care records, training and supervision records, environment records and equipment records.

Is the service caring?

People we spoke with told us they liked living at the home. Comments included 'I love living here' and 'Nothing is too much trouble.'

We saw the staff showed patience and gave encouragement when they were supporting people so people were able to do things at their own pace and were not rushed.

In July 2014, the home had received the Dignity in Care award from the local authority. Dignity in Care is a national initiative designed to put dignity and respect at the heart of care services to enable a positive experience of care. Achieving the award is evidence the organisation is striving to provide the best possible health and social care services.

Is the service responsive?

The records we saw confirmed people's preferences and diverse needs had been recorded and care and support had been provided in accordance with people's wishes. People had access to activities which were important to them and had been supported to maintain relationships with their friends and relatives.

Is the service well-led?

We saw documentary evidence which showed the service worked well with other agencies and services to make sure people received their care in a joined up way.

From speaking with staff we found they had a good understanding of the home's values. They told us about their roles and responsibilities and they were clear about these. We saw quality assurance processes were in place to make sure the provider monitored the care provided and made improvements where necessary. For example, people who used the service had the opportunity to express their opinions through meetings and questionnaires. One person told us 'M (the manager) is on top of everything.'

We walked around the building and found all areas to be clean and tidy. We saw there was liquid soap and paper towels available in bathrooms and toilets. Hands free sanitising hand gel dispensers were seen affixed to walls around the building and throughout the course of our inspection we observed staff and visitors using them.

We spoke with five members of staff about what training and support they received. Comments included: "You can talk to X at anytime he will discuss any issues." "We have a team meeting every couple of months and supervision every eight weeks." "Training is good; we do lots of training."

We looked at the maintenance file and saw that equipment was regularly serviced. Checks of the fire systems including fire extinguishers were carried out and fire drills were well attended.