20 December 2022
During an inspection looking at part of the service
Fremington Manor Nursing and Residential Home is a residential care home providing personal and nursing care to 48 people aged 65 and over at the time of the inspection. The service can support up to 60 people.
The service is a large country manor house which has been extended and adapted to meet the needs of people who are frail and elderly. There are passenger lifts to all floors with bedrooms on two floors and mainly communal spaces on the ground floor. There are level access garden areas.
People’s experience of using this service and what we found
The current deployment of staff within the service had not ensured people’s needs were consistently met. All of the people and relatives we spoke with told us they currently felt staffing levels at the service did not ensure people’s needs were met in a timely way. People gave examples of how the current staffing levels had impacted them. Staff feedback in relation to staffing levels was also consistent in that the current numbers did not ensure care was consistently and safely provided.
The current governance systems in operation had not identified the areas of concern we found during the inspection. There were both service and provider level monitoring systems in place but neither had resulted in the identification of failings or change to staffing deployment. Following the inspection, we raised immediate concerns with the provider about staffing. Immediate steps were taken by the provider to review staffing dependency levels and an action plan was produced and sent to the Care Quality Commission (CQC).
People were cared for by staff who understood their responsibilities to safeguard them. There were systems in place to ensure medicines were ordered, stored, administered and disposed of safely. People’s individual care and treatment needs were planned and were reviewed regularly to ensure the support provided reflected their current needs.
The service environment was effectively maintained to ensure people were supported safely. Infection control measures within the service promoted people’s health, safety and welfare. There were no restrictions on visiting at the time of the inspection in line with government guidance.
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. There were systems in place that ensured people who were deprived of their liberty were done so with the appropriate legal authority.
There was effective governance in place around incidents and accidents, the service environment and care planning. The service manager had recently commenced employment with the provider and was new in post. They were currently looking at ways to engage with people, their relatives or representatives and staff to enhance the service. There were links with the local community established for the benefit of people living at Fremington Manor Nursing and Residential Home.
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 Good (published 4 September 2021).
Why we inspected
The inspection was prompted in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks.
We also 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.
Enforcement and Recommendations
We have identified breaches in relation to staffing and good governance.
You can see what action we have asked the provider to take at the end of this full report.
The overall rating for the service has changed from Good to Requires Improvement based on the findings of this inspection.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.