CQC report explained · a nursing home
What the CQC found at Farnworth Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe medicines management, sufficient staffing, suitable risk assessments and effective infection control.
- Effective?
- Good
- This question was not inspected during this focused visit. The report says the rating was carried over from an earlier comprehensive inspection.
- Caring?
- Good
- This question was not inspected during this focused visit. The report says the rating was carried over from an earlier comprehensive inspection.
- Responsive?
- Good
- This question was not inspected during this focused visit. The report says the rating was carried over from an earlier comprehensive inspection.
- Well-led?
- Good
- Managers had improved audits, reporting and oversight. Staff were supported, training was up to date, and people and relatives were involved and kept informed.
What inspectors found, December 2020
Farnworth Care Home was rated Good; inspectors found safe, well-managed care and improvements since the previous inspection.
This was an unannounced focused inspection. Inspectors visited on 4 and 24 November 2020, and completed inspection activity on 25 November. They reviewed safe care and how the home was managed, after concerns had been raised about staffing, medicines, dietary needs, pressure care, incidents and infection control.
Inspectors spoke with five people, four relatives and 11 staff. They observed care and reviewed care plans, medicines records, staff files, training information, rotas, incidents and quality checks.
They found people were protected from abuse, medicines were managed safely, staffing levels were enough, and infection control measures were effective. Staff were supported and managers had improved monitoring and oversight.
The overall rating improved from Requires Improvement to Good. The previous breach of Regulation 12 was no longer in place. However, this inspection only directly assessed Safe and Well-led. Ratings for the other areas came from earlier comprehensive inspections.
Safe medicines
Inspectors found medicines were given safely, records had no gaps, staff were trained, and storage and stock checks were carried out.
“Medication was administered safely. Staff had a good understanding around the timely administration of medication and there were no gaps in medication records.” from the report
Enough staff
Staffing levels were judged sufficient for people's needs. The home regularly checked staffing ratios.
“Staff levels were sufficient to meet people's needs. Regular analysis was completed to ensure staffing levels remained at an appropriate level.” from the report
Infection control
Staff used protective equipment properly and the home had increased infection control measures in response to COVID-19.
“Staff used personal protective equipment (PPE) appropriately and supplies were good; staff had received training and guidance regarding the use of PPE.” from the report
Improved management
The home had strengthened its audits and quality checks. Managers acted on identified improvements and reported incidents and concerns appropriately.
“Auditing and analysis systems were in place and used to identify areas where improvements could be made and risks managed.” from the report
Good communication
Relatives said they were kept informed when people became unwell or went to hospital. Families were also supported to keep in contact during the pandemic.
“Relatives praised the homes staff in maintaining contact with them throughout the coronavirus pandemic.” from the report
Records were being reorganised
minorCare plans and daily records were being moved to an electronic system. At the time of inspection, some records were not organised into one complete plan, so families should ask how this has been resolved.
“Care plans and daily records were in the process of being transferred on to an electronic systems, meaning some records weren't organised into one plan.” from the report
- 01Are each person's care plans and daily records now held together in one complete electronic record?
- 02How do you check that staffing levels remain sufficient for people's changing needs?
- 03How are medicines that are given when required, covertly, or with thickened fluids recorded and reviewed?
- 04How are relatives kept informed if someone becomes unwell, has a bad night or goes to hospital?
- 05What were the latest ratings and findings for Effective, Caring and Responsive care, which were not inspected during this visit?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 19 December 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, November 2019
Rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines management and weak quality checks.
The CQC made an unannounced, planned inspection visit on 15 and 16 October 2019. Inspectors spoke with people, relatives, staff and a visiting professional. They observed care and reviewed care plans, medicine records, staff files and management records.
The home was rated Good for Effective, Caring and Responsive. People were treated kindly, involved in their care and supported with personalised care plans, activities and healthcare. Staff understood safeguarding and people said they felt safe.
Safe and Well-led were both rated Requires Improvement. Medicines were not managed safely on the Firwood unit. There were two administration errors, medicine stocks did not always match records and fridge temperatures were not managed correctly.
The home had improved since the previous inspection, including its care quality checks and medicines arrangements on two units. However, improvements had not been sustained in all areas. The provider remained in breach of Regulation 12 and was asked to send an action plan.
Kind and respectful staff
People said staff were kind and sensitive. Inspectors saw staff protecting privacy and dignity and spending time with people.
“People told us staff were kind, courteous and sensitive.” from the report
Personalised care
Care plans described people's individual needs, abilities and preferences. Staff knew people's routines and supported their choices.
“People's care plans were personalised and included detailed information about their individual needs, abilities and preferences.” from the report
Pressure care
Pressure care was generally managed well, and no one had developed a pressure ulcer while living at the home.
“People's pressure care was managed well and no-one had developed a pressure ulcer.” from the report
Activities and relationships
People could choose from individual and group activities, trips out and social opportunities. Relatives and friends were welcome to visit.
“People had access to a range of activities.” from the report
Medicines on Firwood unit
seriousInspectors found two administration errors and medicine stocks that did not match the records. Some people may have waited too long for pain relief, and there was a risk of medicines being given too close together.
“We found two administration errors during the inspection and other medicine stocks did not always match records, so we could not be sure people always received their medicines as prescribed.” from the report
Medicine fridge checks
seriousStaff did not know the correct process for checking fridge temperatures. One fridge had been outside the recommended range for several months without being reported to managers.
“One fridge had been above the recommended range and staff had recorded this for several months and not reported it to managers as the medicines policy stated.” from the report
Pressure mattress checks
needs fixingAirflow mattress settings were recorded, but daily checks were not completed to confirm the settings remained accurate.
“Monthly checks were carried out on pressure relieving equipment, however airflow mattress checks were not done daily to ensure the mattress settings were accurate on a day to day basis.” from the report
Modified diet records and training
needs fixingSome people on modified diets did not have records showing what they had eaten. The chef and kitchen assistants who modified food had not received the training directly.
“This training was not directly provided to the chef or the kitchen assistants who had the direct responsibility of modifying people's foods.” from the report
Quality assurance
needs fixingThe home's systems had improved but did not identify the medicines, pressure care and modified diet issues before the inspection.
“Our findings during the inspection showed the medicine audits required improvement.” from the report
- 01What changes have been made to medicines management on the Firwood unit since the inspection?
- 02How are medicine administration errors, stock checks and fridge temperatures now monitored and reviewed?
- 03How are airflow mattress settings checked each day and recorded?
- 04What direct training do the chef and kitchen assistants now receive for preparing modified diets?
- 05How are quality audits tested to make sure they identify problems before the CQC or another person finds them?
This was an unannounced inspection of the care home, including both the premises and the care provided, and it assessed all five CQC questions. This explanation was written from the published report of 27 November 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Farnworth Care Home
4 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2019Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 25 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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