Fleetwood Nursing Home

Updated 9 August 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.

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

Two inspectors took part in the inspection process.

Service and service type

Fleetwood Nursing Home 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. Fleetwood Nursing Home 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 a registered manager in post but they have since left the service. The provider had recently appointed a new manager who had submitted an application to register with us. We are currently assessing this application.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from professionals at the local authority. We used 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

During the inspection we spoke with 4 people living at the home and 4 relatives about their experience of the care provided by Fleetwood Nursing Home. We spoke with 7 members of staff including the registered manager, the housekeeper, a kitchen assistant, a clinical lead and carers. We walked around the home to check it was safe and fit for purpose. We observed people’s interactions and the care they received. This helped us understand experiences of people who could not talk with us.

We reviewed a range of records, policies and procedures. This included 3 people’s care records, recruitment information for 2 carers, and records relating to the management of the service. These included audits, meeting minutes, accidents and incidents and health and safety checks.

We looked around the building, at the environment, equipment, and cleanliness. We observed how medicines were being managed.

Following the inspection

Following the inspection we sought additional clarification from the management team around risk management, fire safety, policies and procedures and training, and reviewed the evidence received.

Updated 9 August 2023

About the service

Fleetwood Nursing Home provides accommodation for persons who require nursing or personal care or treatment of disease, disorder, or injury. The service can support up to 30 older people, including those with mental health conditions. At the time of our inspection there were 20 people using the service. The property is set over 2 floors with lift access to the upper floor. There were several communal areas and a large rear garden for people to enjoy. Aids and adaptations were in place to meet people’s individual needs.

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

Relatives felt people were safe and the registered manager was responsive to concerns. However, fire safety measures were not always in line with guidance and some information conflicted. Potential environmental hazards also needed consideration. Records identified low levels of training in subjects required to keep people safe or meet individual needs. Whilst care records were detailed and risk assessments in place, appropriate mitigation was not always considered. The home had systems for the safe handling, storage and disposal of medicines and we saw good infection prevention and control practices.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. We have made a recommendation around this.

Though audits and checks were in place, these were not always effective. A number of concerns around quality assurance, risks and regulatory requirements were identified during inspection and management monitoring had not picked this up. From observations, people seemed happy and relaxed. When asked what they thought of the staff, 1 person said, “I love them all, they are caring and look after me.” A relative told us they hoped to move into the home because their loved one was so happy and well looked after. People, relatives and staff were engaged through regular conversations, meetings and surveys. The team worked together or in partnership with others to achieve good outcomes.

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 requires improvement (published 16 January 2020). The service remains rated requires improvement. This service has been rated requires improvement for 3 consecutive inspections.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fleetwood Nursing Home on our website at www.cqc.org.uk.

Previous recommendations

At our last inspection we recommended that the provider improved deployment of staff and worked within guidance and best practice to improve quality monitoring systems. At this inspection staffing levels were better, but we still had concerns that best practice guidance was not always followed, and quality monitoring systems needed improving.

Why we inspected

This inspection was prompted by a review of the information we held about this service; to check if sufficient improvements had been made. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained requires improvement based on the findings of this inspection.

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 have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to risk management, staff training and monitoring and improving quality at this inspection. A recommendation has been made around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

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 to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.