Fewcott House Nursing Home

Updated 30 December 2021

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 Care Act 2014.

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 team consisted of three 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

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

The service had a manager registered with the Care Quality Commission. 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.

Notice of inspection

This inspection was unannounced. We visited the service location on 27 October 2021.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We looked at notifications received from the provider. A notification is information about important events which the provider is required to tell us about by law. This ensured we were addressing any areas of concern.

During the inspection

We spoke with eight people and one relative. We looked around the home and observed the way staff interacted with people. We looked at three medicine administration records (MAR). We spoke with eight members of care staff, the registered manager, operations director, head of care, the chef, kitchen assistant, and a member of the house keeping team. We looked at three recruitment and training records as well as health and safety processes.

Following the inspection

We contacted number of external health and social care professionals and commissioners to obtain their views about the service and continued to seek clarification from the provider to validate evidence found.

Updated 30 December 2021

About the service

Fewcott House Nursing Home is a residential care home providing personal and nursing care to 30 older people at the time of the inspection. The service can support up to 40 people.

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

People were truly respected and valued as individuals and were the heart of the service. Staff were clearly committed and compassionate, striving to provide excellent care at all times. The registered manager had developed an open, transparent and person centred culture that was driven by a motivated and committed staff team. This motivation resulted in a whole team who were totally supportive and dedicated to providing high quality, individualised care. The staff team told us they were truly valued and respected. Staff were skilled, motivated and knowledgeable. People received exceptionally personalised care and support which met their needs, reflected their preferences and promoted their self-worth. The provider upheld people's human rights.

The service worked very closely with healthcare professionals and provided excellent end of life care. People experienced a comfortable, dignified and pain-free death. Management had undertaken training on the Gold Standards Framework (GSF) programme on End of Life Care. This framework enables earlier recognition of patients with life-limiting conditions, helping them to plan ahead to live as well as possible right to the end. The service had been awarded the Gold standard. Staff had the specific skills to understand and meet the needs of people and their families in relation to emotional support and the practical assistance they needed at the end of the person’s life. Records showed staff had attended end of life care training. Staff told us they were supported by the management team with empathy and understanding.

The service was exceptionally well-led. The provider and the registered manager were clear about their expectations relating to how the service should be provided and led by example. The registered manager demonstrated how their open and listening management style and robust quality assurance systems had sustained continual development and improvement at the service. They were supported by the provider who was passionate about providing people with high quality care and supported staff fully to enable them to deliver this. The provider and registered manager had developed and maintained, through the pandemic, positive links with the community which benefited those living in the service. There was a strong commitment from the provider and management team to ensure there was equality and inclusion across the staff team. Staff were highly satisfied working in the service.

People and relatives told us staff were extremely caring. Staff did all they could to promote people’s independence and we saw examples of this. People received highly effective personalised care, tailored to their individual needs and preferences, and staff supported people and their relatives to be involved with decisions relating to their care. People's privacy and dignity was upheld through the approaches taken by staff as well as in relation to the care environment.

Staff knew how to identify and report any concerns. The provider had safe recruitment and selection processes in place which incorporated their values.

Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.

People were supported to meet their nutritional needs and complimented the food at the home. People had a pleasant well-presented dining experience which offered a variety of appetising food choices available at times that suite people’s preferences. Staff supported people to maintain food and fluid intakes, including, through the use of snacks, and making people hot drinks to help them relax and maintain their comfort.

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 had a particularly good understanding of when the principles of the Mental Capacity Act should be applied. People were supported to meet their nutritional needs and complimented the food at the home.

Rating at last inspection

The last rating for this service was Outstanding. Published 5 October 2019.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk