Fleet Hall Care Home

Signature at Fleet is a residential care home providing accommodation and personal care to up to 78 people. The service is provided to older people who may also be living with dementia. The ground and first floor were designated as ‘Assisted living’, whilst the second floor was the ‘Reminiscence’ unit for people living with dementia. At the time of our inspection there were 64 people using the service.

Two providers are dual registered to provide this service and both are responsible for service delivery at the location.

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

Potential risks to people were assessed with them and measures were in place to ensure they were enabled to stay safe, with minimal restrictions on their freedom. People were safeguarded from the risk of abuse. People’s medicines were managed safely. Staff had managed a recent outbreak of COVID-19 effectively, in line with their training, the provider's policies and national guidance. There were sufficient, appropriate staff of the required level of skill and experience rostered to meet people's needs. Staff were recruited safely. Incidents were reviewed and any required actions to minimise the risk of repetition were taken, any learning was shared.

People’s needs and choices were assessed and their care and support was planned and delivered in accordance with good practice guidance, to achieve effective outcomes for them. Staff had the required skills, knowledge and experience. People were provided with a range of nutritious food and drinks and any risks were identified and mitigated. Staff worked both across the team and with a variety of external agencies to ensure people’s health care needs were identified and met. The colour of the corridor wall on the reminiscence unit was not dementia friendly. The provider was aware and addressing this, with the planned refurbishment of the service, which was taking place this year.

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 treated people with kindness, respect and compassion. Staff recognised people’s emotional support needs and ensured they were met. People were involved in decisions about their care. People’s privacy, dignity and independence were promoted by staff. People were well supported by staff at the end of their lives.

People received personalised care which reflected their individual needs, preferences and wishes about their care. Staff had a good understanding of each person’s needs and how these were to be met. Staff understood people’s communication needs and ensured these were met. People were able to access a range of opportunities for social stimulation both in the home and in the wider community.

The registered manager created a person centred, inclusive and open culture, they were a good leader. Staff felt motivated by and proud of their work with people. There was a strong governance framework in place to monitor performance. Processes were in place to seek people’s feedback on the service and to drive improvements. Staff used the provider’s governance processes to monitor the quality of the service and to identify and address any areas for improvement. Staff worked openly with professionals and external agencies to ensure people’s care needs were met.

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

Rating at last inspection

This service was registered with us on 10 December 2021 and this is the first inspection. The last rating for the service under the previous provider was good, published on 26 September 2020.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

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

Sunrise of Fleet is a 'care home'. People in care homes receive accommodation and nursing or personal care, as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

This care home is run by two providers; namely, Sunrise UK Operations Limited and Sunrise Senior Living Limited. These two providers have a dual registration and are jointly responsible for the services at the home. This report is in relation to Sunrise UK Operations Limited. A separate report has been produced for Sunrise Senior Living Limited.

Sunrise of Fleet accommodates up to 78 people in one building over three floors. The first two floors were designated for ‘Assisted Living’, where people had a range of care needs but could carry out various aspects of daily living independently. The top floor was the ‘Reminiscence’ community, which had been designed as a living space suitable for people living with dementia. There were 70 people living in the home at the time of inspection. People living at the service were older people, some of whom were living with dementia.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was supported by a deputy manager and a coordinator for the ‘Assisted Living’ and ‘Reminiscence’ communities.

People experienced care that made them feel safe and were protected from avoidable harm and discrimination. When concerns had been raised, thorough investigations were carried out, in partnership with local safeguarding bodies.

Risks were assessed, monitored and managed effectively. Staff were aware of people’s individual risks and how to support them to remain safe. People were involved in developing support plans to manage their own risks, which promoted their freedom and independence.

There were sufficient staff to respond quickly and provide safe and effective care to people. The registered manager operated a robust recruitment process, based on relevant pre-employment checks, which assessed the suitability of candidates to support older people and those living with dementia.

People's dignity and human rights were protected, whilst keeping them and others safe. Staff supported people who experienced behaviour which may challenge sensitively and effectively.

The provider proactively reviewed all accidents and incidents and acted to reduce the risk of a future recurrence.

People received their prescribed medicines safely, from staff who had their competency to administer medicines assessed. People’s medicines management plans were reviewed regularly to ensure continued administration was still required to meet their needs.

High standards of cleanliness and hygiene were maintained throughout the home, which reduced the risk of infection. Staff followed the required standards of food safety and hygiene, when preparing, serving and handling food.

The provider and registered manager ensured staff had an effective induction, ongoing training and support to maintain necessary skills and knowledge to support people effectively.

People were supported to eat and drink enough protect them from the risk of poor nutrition and dehydration. Risks to people with more complex nutritional needs were promptly referred to relevant dietetic specialists.

Each person had an individual health action plan which detailed the completion of important monthly health checks. The registered manager consistently referred people to external services when required, which maintained their health.

The home had been designed to promote the independence and safety of people who live with dementia, which helped to reduce some of their symptoms like disorientation and confusion.

The registered manager had ensured people’s ability to make decisions was assessed in line with the Mental Capacity Act 2005 (MCA). People’s human rights were protected by staff who demonstrated a clear understanding of consent, mental capacity and Deprivation of Liberty Safeguards legislation and guidance.

People experienced meaningful relationships with staff who knew about their families and life histories. Staff consistently treated people with compassion, kindness and respect.

Staff spoke about people with pride, passion and fondness, recognising people’s talents and achievements, which demonstrated how they valued them as individuals. Relatives consistently reported that staff interaction with their loved ones had a positive impact on their well-being and happiness. People were supported to follow their interests and hobbies, and enjoyed the wide range of activities provided at the home. This protected them from the risk of social isolation and loneliness.

Staff were patient and unhurried when supporting people and encouraged them to take their time and not to rush. Staff consistently treated people with respect and dignity.

Staff supported people to maintain close links with their loved ones and understood the importance of celebrating important milestones.

People’s choices and independence were promoted by staff supporting and encouraging them to do things themselves. People were actively encouraged to carry on their familiar routines, such as visiting friends or local shops.

People actively contributed to their care planning and experienced care that was flexible and responsive to their individual needs and preferences. People received care and support that reflected their wishes, from staff who understood how to promote their independence and maximise the opportunity to do things of their choice.

Care plans were personalised and contained information such as the person’s life history, preferences and interests. People living with dementia had assessments relating to memory, cognition, mood, interactions and behavioural tendencies. It was noted that some plans lacked detail, or contained conflicting, out of date or repetitive information. The deputy manager had begun to review these care plans, since their return from a secondment.

There were regular opportunities for people and staff to feedback any concerns at review meetings, staff meetings and supervision meetings. People and their relatives knew how to complain. The registered manager used concerns and complaints to drive improvement within the home.

People were supported with care and compassion at the end of their life to have a comfortable, dignified and pain-free death. Staff were thoughtful and consistently treated relatives with kindness, which made them feel involved, listened to, and informed in the last days of their loved one’s life.

The home was consistently well-managed by the registered manager who provided clear and direct leadership. Staff consistently told us the management team had created a supportive environment where their opinions and views were discussed and taken seriously, which made them feel their contributions were valued.

Quality assurance systems were in place to monitor the quality of service being delivered, which were effectively operated by the management team, to drive continual improvement in the service.

The registered manager collaborated effectively with key organisations and agencies to support care provision, service development and joined-up care, for example; local GPs and community mental health and nursing teams.