Frances Bolitho Care Home

Updated 2 September 2022

Inspection team

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

The inspection was carried out by one inspector.

Service and service type

Frances Bolitho is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and we looked at both during this inspection.

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. However, they had not visited the service since May 2022. The registered manager was also registered at another service within the Cornwallis Care Group.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed information we held about the service and the provider which included any statutory notifications sent to the CQC. A notification is information about important events which the service is required to send us by law. 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 of this information to plan our inspection.

During the inspection

During the inspection we reviewed two people's care plans and risk assessments. We looked at two staff files in relation to recruitment. We reviewed staff training and supervision. We also reviewed other records relating to the management of the service, including medicine records, complaints and compliments received. We spoke with five staff including the clinical lead and the registered manager. We spoke with three people at the service.

We spoke on the phone with one relative of a person who was living at Frances Bolitho, about their experience of the care provided. We received feedback from two new staff and two healthcare professionals on email.

Updated 2 September 2022

About the service

Frances Bolitho Care Home is a residential care home providing personal and nursing care to up to 12 people. The service provides support to older people and people with physical disabilities. At the time of our inspection there were ten people using the service.

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

Frances Bolitho Care Home was registered with the CQC on 29 June 2021 using a temporary building, whilst a permanent larger building was being constructed on the same site. The completion of this permanent building was in progress but had been delayed.

Originally the service was fully commissioned as Discharge to Assess (D2A) beds by the NHS. This meant people came to stay for short periods for rehabilitation following a stay in hospital, with the intention of returning home or elsewhere. The D2A contract ended in March 2022. The service now supported some permanent residents, some people staying for respite and a few people remaining from the D2A process who continued to receive therapy support.

Storage was a challenge at the service. One communal bathroom was unusable as it was stacked full of equipment, much of which was not being used. For example, many walking frames and perching stools, along with raised toilet seats and other rehabilitation aids. Boxes of dressings and oxygen masks were found in corridors. The residents dining room held boxes of COVID-19 tests and Personal Protective Equipment (PPE). The clinical lead explained, “There is no other place for them to be stored.” We have made a recommendation about this in the effective section of this report.

Unsecured confidential information and an unlocked key cabinet were found in the manager’s office. This room was open and unattended throughout the inspection. This meant there was a risk confidential information and keys to various places in the service were accessible to people without the appropriate authority.

The communal shower room held many unnamed toiletries and multiple unopened packs of bars of soap, one opened bar was found in use on the sink. The service was in a COVID-19 outbreak and the use of communal toiletries and soap bars increased the risk of cross infection. The clinical lead arranged for these to be disposed of immediately.

A recent COVID-19 outbreak had meant several care and ancillary staff were off sick at the time of this inspection. There were no domestic staff on duty on the day of our inspection. We were told the day and night care staff were carrying out cleaning and laundry tasks in their absence. However, there was no cleaning schedule available for care staff to complete, to record when high touch point areas and key areas such as bathrooms and toilets, had been cleaned to help reduce the risk of spread of COVID-19. This was immediately addressed during the inspection.

Records relating to the induction of new staff were not available. We have made a recommendation about this in the effective section of this report.

People were supported by staff who had been appropriately trained and were skilled in their role. Staff had received regular supervision and were provided with appraisals, although the clinical lead did not hold an effective overview of this.

Mental capacity assessments had been carried out where it was indicated as necessary. Deprivation of Liberty Safeguards (DoLS) authorisations had been applied for appropriately. No authorisations for restrictive care plans, were in place at the time of this inspection.

Recruitment procedures were robust. There were sufficient staff on shift to support people at the time of this inspection. Several staff had been off sick with COVID-19 in recent weeks. The service was using agency staff and were being supported by the local authority. However, the rotas showed not all shifts had been covered by the planned number of staff. This had not impacted on people's care.

Care plans were completed for each person and contained details of the person's needs and preferences. Care plans had been regularly reviewed and updated. Risks were identified, assessed, recorded and reviewed regularly.

People's care and support needs were assessed before they started using the service. People received support to maintain good health and were supported to maintain a balanced diet. Some people were having their food and drink intake recorded and were regularly weighed.

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 told us they felt safe with staff. There were systems to help protect people from abuse. Staff had received training on how to recognise abuse.

Staff understood the importance of respecting people's diverse needs and promoting independence.

People told us they liked living at Frances Bolitho and that the staff were caring and responded when they called. People commented, "I like it here, nice food, and I don’t think of the carers as staff they are more like friends" and “Carers are great, food is great, no concerns. I see my GP and my social worker. I just want to get home to live by myself again soon."

Staff were positive about working at Frances Bolitho. Comments included, “(Clinical lead) is so very caring and kind, they are very supportive” and “I am really enjoying this role and the staff have all been welcoming, as have the residents. Lovely clean environment that has a very homely feel.”

People and staff were asked for their views by the provider through a survey, responses had been audited and acted upon. Staff meetings had been held to seek the views of staff and share information.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

This service was registered with the Care Quality Commission on 29 June 2021 and this was the first inspection.

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.