CQC report explained · a residential care home
What the CQC found at Fenney Lodge
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staffing, risk management, medicines and infection control were generally safe, although inspectors noted some medicines temperature records, food labelling and kitchen temperature records were not consistently maintained.
- Effective?
- Good
- People's needs and choices were assessed, staff were trained and supported, and people received enough food, drink and healthcare. Inspectors found staff supported people to make choices and followed the Mental Capacity Act principles.
- Caring?
- Good
- Staff were kind, respectful and attentive. People were involved in decisions, supported to be independent, and helped to maintain contact with family and friends.
- Responsive?
- Good
- Care was personalised and people were supported with activities, community access and relationships. Some care plans needed more detail, including the sling configuration for people using a hoist.
- Well-led?
- Requires improvement
- The home had a warm and supportive culture, and the manager was visible and knew people well. However, audits and other quality systems were not robust enough to identify all the shortfalls found by inspectors.
What inspectors found, August 2019
Rated Good overall; inspectors found safe, kind and personalised care, but the home’s quality checks required improvement.
This was an unannounced planned inspection on 23 July 2019. One inspector spoke with people, a relative, the registered manager and staff. They also observed care and reviewed care records, audits, meeting notes and safeguarding records.
The home was rated Good for Safe, Effective, Caring and Responsive. Inspectors found people were protected from abuse, had enough staff, received their medicines, and had support with food, healthcare, activities and relationships.
Well-led was rated Requires Improvement. Quality checks did not always find problems with medicines records, care plans and risk assessments. The home had started an action plan, and inspectors said there was no immediate risk to people.
The overall rating remained Good, the same as at the previous inspection published on 20 February 2017. The home supports up to eight people with learning disabilities in one house.
Safe staffing
Inspectors found there were enough staff to meet people's needs safely. Recruitment checks and contingency plans were in place.
“Records showed that sufficient support staff were routinely on duty to provide people with the assistance they needed.” from the report
Kind and respectful care
People were treated with dignity and staff had positive relationships with them. People and relatives spoke positively about the care.
“Staff had developed positive and caring relationships with the people they supported.” from the report
Personalised support
People and relatives were involved in decisions about care. Staff supported people's preferences, independence, activities and contact with others.
“People and their relatives told us the personalised care and support provided reflected individual needs and preferences.” from the report
Good health support
Staff worked with health and social care professionals and kept detailed healthcare records. People had hospital passports with important information if they needed to transfer to hospital.
“Staff helped people to have access to healthcare services and receive ongoing healthcare support.” from the report
Quality checks missed problems
needs fixingAudits did not identify all the issues found during the inspection. This included medicines temperatures, PRN medicines information, care plans and risk assessments.
“However, these systems were not always robust and did not always identify opportunities for improvement.” from the report
Care plan detail
needs fixingSome care plans did not contain all the guidance staff needed. Inspectors specifically noted that sling configurations for people using a hoist were not recorded.
“However, we found instances where the detail of care plans could be improved.” from the report
Medicines and food records
needs fixingSome medicine room temperature records were above 25 degrees, and one PRN medicine did not have supporting confirmation from a GP or pharmacist. Some food and kitchen temperature records were also incomplete.
“Several temperature records of the medication room which were in excess of 25 degrees celsius.” from the report
Infection control details
needs fixingSome staff wore false or painted nails and jewellery contrary to NHS guidance. Not all refrigerated food had an opened-on date, and fridge and cooking temperatures were not consistently recorded.
“Some staff wore false or painted nails and jewellery which was contrary to NHS guidance.” from the report
- 01What changes have been completed to make medicines audits identify temperature problems and missing PRN supporting information?
- 02How are care plans now checked to ensure hoist sling configurations and other detailed guidance are recorded?
- 03How do you monitor fridge, cooking and medication room temperatures, and what happens when a reading is outside the expected range?
- 04What steps have been taken to ensure staff follow the infection control guidance on nails and jewellery?
This was an unannounced planned inspection covering all five CQC questions, with the premises and care provided both looked at. This explanation was written from the published report of 22 August 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.
What inspectors found, February 2017
Rated Good; inspectors found safe, kind and personalised care, with some staff checks held away from the home.
This was an unannounced comprehensive inspection on 25 January 2017. The inspector observed care, spoke with people, relatives, staff and health professionals, and checked care records, medicines, staff files and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training, respectful support and care plans that were reviewed as people's needs changed.
People were supported with activities, outings and healthcare. Staff understood people's communication methods and preferences. Relatives said the management team listened and acted promptly when concerns were raised.
The home was rated Good at the previous inspection and remained Good. One limitation was that essential pre-employment checks were not kept at the home, although head office confirmed they had been completed.
Safe staffing and risk support
Inspectors found enough staff on duty and saw that risks were assessed and reviewed. Staff knew how to support people safely while promoting independence.
“We found risk assessments were in place in people's care files.” from the report
Respectful communication
Staff understood people's gestures, facial expressions and other communication methods. Care plans explained how each person communicated their wishes.
“Staff communicated easily with people and always understood when someone required assistance or was asking for something even when the person had no verbal communication.” from the report
Personalised choices
People could choose how and when to eat, where to spend time, and which activities or holidays to join. Staff adapted support to individual preferences.
“There was a choice of meal and people were given the choice to eat together or on their own.” from the report
Kind and dignified care
Inspectors saw warm relationships between people and staff. Staff supported privacy, personal space and people's preferred appearance.
“We observed genuinely warm interactions between people and staff and it was clear that staff knew people very well.” from the report
Quality monitoring
The management team used regular audits and action plans to identify and address improvements. Staff said they could raise concerns openly.
“Effective systems to monitor and improve the quality of the service provided were in place.” from the report
Staff checks were not kept at the home
needs fixingThe essential pre-employment checks for the staff files sampled were held at head office rather than at the home. Head office confirmed that the checks had been completed.
“Although the essential pre-employment checks required were not kept at the location we received confirmation from the providers' head office that they had been received.” from the report
- 01How can the home access and check each staff member's pre-employment records when those records are held at head office?
- 02How are people's risk assessments reviewed when their needs or behaviour changes?
- 03How are people involved in updating their care plans and communication guidance?
- 04What activities, outings and holidays are currently available, and how are people's choices recorded?
- 05How are medicines audits carried out, and what happens if an error or concern is found?
This was an unannounced comprehensive inspection covering all five CQC questions, with observations, discussions and checks of selected records. This explanation was written from the published report of 21 February 2017 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 Fenney Lodge
3 rated inspections over 5 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
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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