CQC report explained · a residential care home
What the CQC found at Fiorano
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safe recruitment, suitable risk assessments and effective safeguarding arrangements. Medicines, infection control, emergency planning and incident reviews were also found to be managed safely.
- Effective?
- Good
- People had detailed assessments and care plans, and staff received specialist training, supervision and competency checks. People had access to healthcare, suitable food and support with communication, consent and independence.
- Caring?
- Good
- Staff were observed treating people with kindness, dignity and respect. People were involved in daily decisions where possible, and relatives and professionals were involved when people could not make particular decisions themselves.
- Responsive?
- Good
- Care was personalised and regularly reviewed. People were supported with their communication, hobbies, work, holidays, community activities and contact with family and friends.
- Well-led?
- Good
- Inspectors found the home well run, with supportive leadership, clear staff roles and effective quality checks. Feedback, incidents and care plan reviews were used to make improvements.
What inspectors found, November 2019
Fiorano was rated Good overall; inspectors found safe, kind and personalised care with strong support for independence.
This was an unannounced inspection on 29 October 2019. One inspector spoke with a person living at the home, observed care, spoke with the manager and a staff member, reviewed records, and later received feedback from a relative.
The home supported six younger men with learning disabilities or autism and was registered for up to eight people. Inspectors found enough staff, safe medicines systems, detailed care plans, suitable training, kind staff and good links with families and health professionals.
People were supported to make choices, build skills, use local facilities and take part in activities, work and holidays. The home had a complaints process and used checks, incident reviews and feedback to improve care.
All five CQC areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous inspection rating was also Good, published on 3 May 2017.
Independence and choice
People were supported to make choices, gain skills and take part in everyday activities. Staff used an Active Support programme to encourage involvement in tasks such as cooking and laundry.
“The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.” from the report
Skilled staff
Staff received specialist training for people's high support needs, as well as regular supervision and competency checks.
“People living at Fiorano had very high support needs. Staff received comprehensive and specialist training to meet these needs.” from the report
Kind and respectful care
Inspectors observed caring interactions. Staff respected people's privacy, dignity, preferred names and individual identities.
“We saw caring interactions between care staff and people. Staff greeted people when they saw them, offering support and reassurance where necessary.” from the report
Community involvement
People were supported to use local facilities, maintain relationships and pursue interests, including volunteer work and holidays.
“In line with 'registering the right support' people were part of their communities.” from the report
Strong management
The home had clear leadership and used audits, incident reviews and care plan checks to monitor and improve care.
“Information from the quality assurance system, care plan reviews and incidents were used to inform changes and improvements to the quality of care people received.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you support my relative to build independence through everyday activities?
- 02What specialist training would staff caring for my relative receive, and how is their competency checked?
- 03How would you support my relative's communication needs and make sure their choices are understood?
- 04What activities, work opportunities and community access could be offered to my relative?
- 05How would you involve our family in care planning, reviews and decisions about health or best interests?
This was an unannounced inspection covering all five CQC areas, and the report says the previous rating in each area was Good. This explanation was written from the published report of 26 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.
What inspectors found, May 2017
Fiorano was rated Good overall; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced, comprehensive inspection on 23 February 2017. Inspectors checked care records, medicines, staffing, training, recruitment, the building and quality checks. They observed care and spoke with people, staff, a relative and a healthcare professional.
The home supported eight people with learning disabilities. Five people were living there on the inspection day. Inspectors found that people were kept safe, received their medicines correctly and had enough suitably trained staff. Staff understood people's communication, health and support needs.
People were treated with kindness and respect. They were involved in choices about their care, food and daily activities. Care plans were personalised, relatives were involved and people could raise concerns. The manager was visible and quality checks were being used to improve the service.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This was an improvement from the Requires Improvement rating in February 2016, when the provider had breached Regulations 12 and 18. Inspectors found the required improvements had been made by this inspection.
Safe medicines
Inspectors checked all medicines records and found them signed and up to date. Staff were trained and assessed as competent to give medicines safely.
“These records were signed and up to date, which showed people's medicines were administered in accordance with their prescriptions.” from the report
Kind and respectful care
Staff asked permission, protected privacy and dignity, and responded patiently to people's communication and distress.
“We observed staff providing care and support which was thoughtful, patient and sensitive.” from the report
Personalised support
Care plans included people's preferences, past history and individual support needs. People were helped to choose their routines, activities and time with others.
“People received personalised care and support which was responsive to their changing needs.” from the report
Trained staff
Staff had training and supervision relevant to their roles. They could explain how they supported people with communication, autism, epilepsy, nutrition and distressed behaviour.
“Staff had received appropriate training and supervision relevant to their roles and felt supported by the manager.” from the report
Visible leadership
The manager worked alongside staff, listened to people and staff, and used audits and action plans to monitor the service.
“The manager was a clear visible presence in the service and it was apparent that everyone knew them well.” from the report
Keys left unattended
seriousInspectors saw an isolated incident in which staff left keys unattended in a communal area. The manager said this would be addressed.
“We observed an isolated incident whereby staff left their keys unattended in the communal area which posed a risk to people's safety.” from the report
Feedback systems not fully formalised
needs fixingThe provider had quality checks, but its plan to bring telephone monitoring and survey feedback together into one report was not yet complete.
“This had not been formalised in full and we discussed this with the manager on the day of inspection.” from the report
- 01How do you make sure keys and other items that could affect people's safety are never left unattended?
- 02Has the planned formal system for telephone monitoring and survey feedback now been completed?
- 03How are staff given time to discuss care and raise concerns if staff meetings are not held regularly?
- 04How will the new manager continue the improvements made since the February 2016 inspection?
- 05How are people's communication books, routines and preferred activities kept up to date in their care plans?
This was an unannounced comprehensive follow-up inspection covering all five key questions and checking improvements required after the February 2016 inspection. This explanation was written from the published report of 3 May 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 Fiorano
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- November 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- August 2014
Registered with the Care Quality Commission on 21 August 2014.
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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