Background to this inspection
Updated
28 December 2023
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.
Inspection team
The inspection team consisted of 1 inspector.
Service and service type
Fisher Close 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. Fisher Close is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. The manager was in the process of completing their CQC registration.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
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 sought feedback from partner agencies and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We reviewed information we held on the service. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who used the service. Not everyone using the service was able to share feedback verbally. With support from staff we communicated with some people in their preferred way, and carried out observations of communal areas to help us understand the experience of people who could not talk with us. We spoke with 3 relatives of people using the service. We spoke with 7 staff, including the manager, nursing staff, team leaders and support staff. We reviewed a range of records, including 7 people’s care plans and relevant risk assessments, medicine administration records and some records relating to the management of the service.
Updated
28 December 2023
About the service
Fisher Close is a nursing care home providing personal and nursing care to up to 15 people. The service provides support to people with a learning disability and autistic people, people with a physical disability and sensory impairment, younger people, older people, people with mental health support needs including dementia. Accommodation is provided within 3 separate bungalows. At the time of our inspection there were 15 people using the service.
People’s experience of the service and what we found:
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
Right Support
Some records relating to medicines were not always in place in line with best practice guidance. One person’s care plan and risk assessment were not reflective of their current needs and risks. Staff were working to review and update all care plans. Accidents and incidents were reported, however they were not always robustly analysed to identify themes and trends to mitigate risk. Systems were in place to oversee the service, however prompt and effective action was not always taken to address areas for improvement.
Person centred guidance was in place and staff worked with people to plan for when they experienced periods of distress.
The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.
Right Care
People were protected from the risk of abuse because staff understood their responsibilities in relation to safeguarding.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
Right Culture
Feedback was encouraged, and work was underway to ensure equal opportunities to feedback were in place for everyone. People and their relatives felt listened to.
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff.
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.
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 10 February 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified breaches in relation to safe care and treatment, and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.