CQC report explained · a residential care home
What the CQC found at Festing Grove
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- People were not always protected from abuse or avoidable harm. Risk assessments, incident reporting, medicines management, staffing for fire evacuation and infection control were not always reliable.
- Effective?
- Requires improvement
- Consent and deprivation of liberty records were incomplete or not properly checked. Staff support and training were inconsistent, and important health instructions were not always recorded or shared.
- Caring?
- Good
- This question was not inspected during this focused inspection, so no separate rating was given. Inspectors observed staff asking consent and offering choices, but also found some records used language that did not show dignity and respect.
- Responsive?
- Good
- This question was not inspected during this focused inspection, so no separate rating was given. Inspectors found that support plans did not always contain enough detail about people's needs, goals and wishes.
- Well-led?
- Requires improvement
- Quality checks did not identify the problems found by inspectors. Staff did not always feel supported or able to raise concerns, and there was no registered manager in post at the time of the inspection.
What inspectors found, December 2023
Festing Grove was rated Requires Improvement; inspectors found risks around safeguarding, medicines, care planning and management oversight.
This was an unannounced inspection on 5 and 6 November 2023. Three inspectors spoke with people, a relative, staff and health and social care professionals. They observed care and reviewed care plans, medicines records, staff files, incident records and management checks.
The home was not always safe. Risks were not always assessed or managed, safeguarding concerns were missed or not reported, and medicines procedures were not consistently followed. Staffing levels were briefly below the number needed for safe evacuation, and an unsafe assisted bath was still being used.
The inspection also found problems with consent paperwork, staff training and supervision, health information, nutrition monitoring and the condition of the property. The overall rating stayed at Requires Improvement, as did Safe, Effective and Well-led. Caring and Responsive were not separately inspected in this focused inspection.
Kind interactions
Inspectors saw staff asking for consent, offering choices and explaining care tasks. Some people also showed signs that they felt safe and comfortable with staff.
“We observed staff respectfully asking consent, offering choices, and explaining practical care tasks throughout the inspection.” from the report
People's community access
People told inspectors about going to the seafront. This shows that some opportunities to go out were taking place.
“We get to go to the sea front, and I like [staff member's name]. They help me.” from the report
Immediate action
The manager took action during and after the inspection, including increasing staffing to the required level for evacuation and arranging risk assessments and care plan reviews.
“The provider responded immediately during and after the inspection by reflecting on concerns, undertaking risk assessments, reviewing support plans and seeking advice on fire safety.” from the report
Safeguarding failures
seriousIncidents of abuse or possible abuse were not always identified, followed up or reported to the local authority. People were also left alone in communal areas despite a known need for supervision.
“People were not always safeguarded from abuse and avoidable harm.” from the report
Unsafe medicines practice
seriousStaff had not always been checked as competent to give medicines. Errors were not consistently reported or investigated, and records and guidance for medicines given when needed were incomplete.
“People had not always received their medicines in a safe way.” from the report
Risks not managed
seriousSome people had not been assessed for safe use of the stairs. An assisted bath judged unsafe was still being used, and incident records did not always show what had been learned.
“For example, the assisted bath was deemed unsafe by a competent professional. However, the bath was still being used for people” from the report
Consent and rights
needs fixingMental Capacity Act paperwork and checks on deprivation of liberty safeguards were not always in place. This created a risk that decisions were not made in people's best interests.
“People did not always have the necessary MCA paperwork in place.” from the report
Weak management checks
seriousThe home's monitoring systems failed to identify the shortfalls found during the inspection. Staff also said they did not always receive supervision or feel able to raise concerns.
“Quality assurance systems did not operate effectively. Monitoring had not identified the shortfalls found within the inspection.” from the report
Staffing and support
needs fixingInduction reviews, competency checks, team meetings and supervision had not always happened as planned. There was no registered manager in post at the time of the inspection.
“At the time of our inspection there was not a registered manager in post.” from the report
- 01What has changed to make sure all safeguarding incidents are identified, recorded, investigated and reported to the local authority?
- 02How are medicines now checked, including staff competency, stock checks, errors and medicines given when needed?
- 03Have every person's risks, including use of the stairs and assisted bathing, been assessed and added to their care plan?
- 04How are Mental Capacity Act and deprivation of liberty records checked to make sure decisions are lawful and in people's best interests?
- 05Who is currently responsible for the home, and how often do staff receive supervision and quality checks?
This was a focused inspection of Safe and Well-led, widened to include Effective after a consent concern; Caring and Responsive were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 30 December 2023 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, March 2022
Rated Requires Improvement; inspectors found risks in safeguarding, medicines, fire safety, infection control and management.
The inspection took place over four visits in January and February 2022. Inspectors spoke with people, relatives, staff and a visiting professional. They reviewed care, medicine, recruitment and management records, and involved a fire safety officer.
The home was not always safe. Inspectors found delays in reporting an allegation of abuse, incomplete risk assessments, unsafe medicines records, gaps in fire safety checks and weaknesses in infection control. They also found that some incidents were not properly recorded or shared with relatives.
Leadership was inconsistent. The registered manager was not always on site, staff were unclear about responsibilities and audits had not led to prompt improvements. The overall rating fell from Good at the previous inspection to Requires Improvement. This means improvements are needed and there was limited assurance about safety, with an increased risk that people could be harmed.
Enough staff
Inspectors found that staffing levels were enough to meet people's assessed needs, and recruitment checks promoted safety.
“People were supported by enough staff to meet their assessed needs.” from the report
Kind staff
Some people, relatives and staff described the care as kind and compassionate.
“Staff were safely recruited, and relatives told us those staff they had spoken with were kind and compassionate.” from the report
Community links
Most people used community services such as an external day centre. The home also worked with health and social care professionals.
“The service worked in partnership with other health and social care organisations, which helped people using the service improve their wellbeing.” from the report
Action after inspection
The provider took prompt action on safeguarding concerns and increased management presence after the inspection.
“Following the inspection, the provider took prompt action to address the safeguarding concerns found so that people were safe.” from the report
Medicines were not consistently safe
seriousMedicine administration and storage records were incomplete. Staff had not all been trained and checked as competent for a person's prescribed injection.
“Records to support the safe administration of people's medicines were not always completed.” from the report
Fire and premises checks
seriousFire safety actions and routine health and safety checks were overdue. Some newly recruited staff had not received on-site fire training or taken part in a drill.
“Actions identified from fire risk assessment carried out in November 2021, had not been completed within the recommended timescale for the identified risk level.” from the report
Safeguarding response
seriousAn allegation of abusive behaviour was not reported promptly. Inspectors also found that financial safeguards were not always followed.
“There had been a delay in the reporting of this allegation, which meant the person could have been at risk of continued harm.” from the report
Infection control
seriousVisitor checks, COVID-19 requirements, cleaning records and laundry arrangements were not always handled safely.
“The service did not always use effective infection, prevention and control measures to keep people safe.” from the report
Care records and activities
needs fixingSome care plans and risk assessments were out of date. Inspectors found limited evidence of meaningful activities for one person who spent most days at home.
“One person was mostly in the home every day without evidence of meaningful support.” from the report
- 01What evidence can you show that medicines records are now complete and that all staff giving the prescribed injection have passed a competency check?
- 02Have all fire risk assessment actions, fire checks, emergency lighting checks and fire drills been completed and recorded?
- 03How do you now report safeguarding concerns and make sure they are acted on without delay?
- 04How are infection control checks, visitor screening, laundry and cleaning records monitored?
- 05What activities and support are now available for people who spend most of their time at home?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection published on 14 November 2019. This explanation was written from the published report of 24 March 2022 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 Festing Grove
4 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- December 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- November 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- March 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2014
Report published without a new overall rating.
- November 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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