Background to this inspection
Updated
14 May 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.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was undertaken by two inspectors and an Expert by Experience. 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
Florence House 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. Florence House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with two people who used the service and we spoke with seven relatives. We spoke with nine members of staff including the registered manager, the deputy manager, senior members of care staff and care staff.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at four files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found such as training data.
Updated
14 May 2022
About the service
Florence House is a residential care home providing personal care to up to 36 people, some of whom may be living with dementia, a sensory impairment or mental ill health. The service accommodates people in a single adapted building, over two floors. At the time of the inspection 29 people were living at the service.
People’s experience of using this service and what we found
Some care records needed reviewing to ensure they were up to date and contained the most accurate information about people’s assessed needs. Care plan audits needed to be completed more frequently.
There were however other systems in place to measure and monitor the quality and safety of the service and other audits had been completed regularly. There was a clear staff structure in place and staff understood their roles and responsibilities. Staff felt valued by the management team and told us Florence House was a good place to work.
Since the last inspection, risk management had improved, and people had risk assessments in place. Staff understood how to recognise and respond to concerns of abuse and supported people to keep safe. There were enough staff to support people and there was an on-going recruitment drive. Medicines were managed in a safe way. There were effective infection prevention control measures in place. The management had improved systems and practices, demonstrating they were able to learn lessons when things went wrong and improve care for people living at Florence House.
People had their needs assessed and planned for and were supported by staff who were suitably trained to meet people’s needs. 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. Staff worked alongside other agencies and professionals to ensure people had access to healthcare as required. People had their dietary needs met.
Staff supported people in a dignified way and upheld people’s privacy. People were supported to remain as independent as possible.
People’s likes and dislikes were considered, and activities were tailored to people’s preferences. There was a complaints process in place and people and their relatives knew how to make a complaint. People were supported at the end of their life.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 26 November 2020) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
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.
We carried out an unannounced comprehensive inspection of this service on 19 October 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve. The provider was required to send us monthly updates as per the conditions on their registration, which we imposed due to the breaches of legal requirements.
This inspection was carried out to follow up on action we told the provider to take at the last inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Florence House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.