CQC report explained · a residential care home
What the CQC found at Fethneys Living Options - Care Home Physical Disabilities
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, November 2023
Fethneys Living Options - Care Home Physical Disabilities is rated Requires Improvement; inspectors found unsafe risk monitoring, limited personalised support and weak oversight.
This was an unannounced focused inspection. Inspectors visited on 19 October 2023, spoke with people, relatives, managers and staff, and checked care plans, risk assessments, recruitment records and audits.
The home was not always safe. Staff did not consistently follow physiotherapy plans, fluid records were inaccurate, and known constipation risks were not always acted on. Agency staff did not always know people's health risks. Medicines and infection controls were otherwise mostly managed safely.
People were supported by kind staff, but care was not always personalised. Some people could not go out or take part in activities when they wished because of staffing, transport and training problems. Inspectors also found weak management checks and personal information left where others could see it.
The overall rating changed from Good in 2019 to Requires Improvement. This focused inspection only assessed Safe and Well-led. The other ratings were carried over from the previous inspection.
Kind staff
Inspectors found that staff were kind and caring towards people.
“People received support from staff who were kind and caring.” from the report
Medicines
Medicines were stored securely, given as prescribed and checked through effective audits.
“Audits monitored all aspects of medicines management and were effective.” from the report
Infection control
The home used protective equipment safely and had arrangements for preventing and managing infections.
“The service was using PPE effectively and safely.” from the report
Safe recruitment
Staff recruitment checks included employment histories, qualifications and DBS checks.
“New staff were recruited safely and their employment histories were checked, their qualifications, and their suitability to work in a care setting.” from the report
Health risks not consistently managed
seriousInspectors found that known risks were not always acted on. This included inaccurate fluid records and insufficient action to reduce constipation risks.
“Risks to people were not always managed safely.” from the report
Physiotherapy not followed
seriousA person's physiotherapy plan was not included in their care plan and was not followed consistently. Inspectors said the person's mobility had deteriorated over time.
“The physio plan advised the person needed to do stretches daily and support from staff 3 times a week to do some walking.” from the report
Limited choice and activities
seriousPeople could not always go out or take part in activities they wanted. Staffing, transport and a lack of trained staff affected opportunities such as swimming.
“People did not receive person-centred care that reflected their preferences and wishes.” from the report
Weak management checks
seriousThe provider's audits had not identified important problems with care, records and support. Inspectors were not assured that managers and staff fully understood people's needs.
“Governance systems were not sufficiently robust to identify areas for improvement to enable actions to be taken.” from the report
Confidential information exposed
seriousInformation about hospital appointments, finances, staff records and personal activities was left in open areas where it could be seen.
“Some personal information about people was not kept confidentially.” from the report
Hand hygiene concern
needs fixingSome staff had long, painted nails. Inspectors said this could prevent effective hand washing.
“Some staff were not following the provider's Employee Handbook (March 2021) to ensure hand hygiene techniques were followed effectively to prevent the risk of infection to people.” from the report
- 01What has been done to make sure every person's physiotherapy plan is included in their care plan and followed?
- 02How do you check that fluid records are accurate and that low fluid intake or constipation risks are acted on promptly?
- 03How many permanent staff and agency staff are usually on duty at weekends, and how do you make sure agency staff know each person's risks and preferences?
- 04How can residents use the accessible minibus and go swimming or take part in other activities when they choose?
- 05What has changed to keep people's medical, financial and personal information private?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from the previous inspection. This explanation was written from the published report of 23 November 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 2019
Rated Good overall; inspectors found safe, kind and personalised care, but well-led was Requires Improvement after safeguarding concerns were not notified promptly.
This was an unannounced, comprehensive inspection on 21 January 2019. The inspector spoke with people living at the home, staff and managers, reviewed care, medicines and management records, and observed care and staff interactions.
The home supported seven people with severe physical disabilities and/or acquired brain injuries. Inspectors found people were safe, treated with dignity, supported by trained staff and given personalised care. Medicines, food, healthcare and activities were managed well.
The main weakness was leadership. There had been a period without a registered manager, and some safeguarding incidents had not been reported to CQC or the local safeguarding authority at the time. Senior managers had since taken action, and a new manager had started.
The overall rating was Good, the same as at the previous inspection. Safe, Effective, Caring and Responsive were rated Good. Well-led was rated Requires Improvement.
Safe care
Inspectors found that risks were assessed, staff understood safeguarding and medicines were managed safely.
“People were safe and were supported by staff who were trained to recognise the signs of any potential abuse or harm.” from the report
Kind and respectful staff
Staff were observed treating people warmly and patiently. People had privacy and were treated with dignity.
“We observed positive interactions between people and staff, underpinned with banter and laughter.” from the report
Personalised support
Care plans included detailed information about people's needs, preferences and daily routines. People were involved in care decisions and chose their keyworkers.
“People received personalised care that was responsive to their needs.” from the report
Activities and choice
People were supported to take part in activities they chose, including community activities, cooking, swimming, shopping and volunteering.
“Activities were planned with people according to their interests.” from the report
Safeguarding notifications
needs fixingSome incidents, including safeguarding concerns, had not been reported to CQC or the local safeguarding authority when they happened. This was the reason the well-led rating required improvement.
“Some incidents, including safeguarding concerns, had not been notified to CQC or to the local safeguarding authority at the time they happened.” from the report
Management stability
needs fixingThe home had been without a registered manager for several months. A new manager started on the inspection day and was still registering with CQC.
“There was no registered manager in post.” from the report
Lapsed supervisions
minorStaff supervisions had lapsed after the previous manager left, although recent supervisions had taken place with senior managers.
“Staff supervisions had lapsed since the last manager had left.” from the report
- 01Who is the registered manager now, and what has happened with the new manager's CQC registration?
- 02What safeguards are now in place to make sure every safeguarding concern is reported promptly to CQC and the local authority?
- 03What changes were made after the period of management instability?
- 04How are staff supervisions now scheduled and checked?
- 05Why was new admission temporarily suspended, and what evidence showed that the home was ready to accept new residents again?
This was a planned, unannounced comprehensive inspection covering all five CQC questions and both the premises and care provided; all ratings were assessed at this inspection. This explanation was written from the published report of 8 March 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 Fethneys Living Options - Care Home Physical Disabilities
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- November 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fethneys Living Options - Care Home Physical Disabilities →
- March 2019Goodstayed GoodSafe: GoodWell-led: Requires improvement
Read what inspectors found at Fethneys Living Options - Care Home Physical Disabilities →
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
28 live-in carers within about an hour of West Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,170 a week. 23 can care for a couple. 11 years' experience on average.
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.