CQC report explained · a residential care home
What the CQC found at Fiveways
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, February 2020
Rated Good; inspectors found kind, person-centred care and improvements since the previous Requires improvement rating, with a few records needing attention.
The inspection was unannounced and took place on 21 January 2020. One inspector met everyone living in the home, spoke with three people, four staff, the manager and a quality assurance manager. The inspector reviewed care plans, staff records, medicines information and quality checks, and also spoke with relatives and health and social care professionals after the visit.
Inspectors found people were calm, happy and relaxed. Staff were kind, respectful and understood how people communicated and what support they needed. People were supported to make choices, take part in activities, develop skills, attend health appointments and stay in contact with relatives.
The home had enough staff, safe recruitment checks, suitable medicines arrangements and a clean, well-maintained environment. The home also had systems for learning from incidents and checking the quality of care. A few issues were found, including errors in two medicines records and unclear wording in one nutrition plan.
The overall rating and all five question ratings were Good. This is an improvement from the previous Requires improvement rating, published in February 2019. The provider had addressed the two previous breaches, so there were no breaches at this inspection.
Kind and respectful staff
Staff understood people's individual needs and communication methods. Inspectors saw people being comfortable with staff and able to approach them for support.
“We observed and heard staff speaking respectfully and kindly to people.” from the report
Choice and independence
People were supported to make choices, learn daily living skills and pursue activities they wanted to try. Support was adapted when plans changed.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Safe staffing and environment
Inspectors found enough staff to meet people's needs. The home was clean, well maintained and had up-to-date safety checks.
“People lived in a safe, clean and well-maintained environment.” from the report
Good communication and health support
People received information in ways they could understand, including pictorial prompts and easy-read materials. Staff supported people to attend health appointments and worked with health professionals.
“People were provided with information in formats that they could understand and best suited their needs.” from the report
Improved management
Quality checks, staff records and medicines audits had improved since the previous inspection. The home was no longer in breach of the regulations identified previously.
“Enough improvement had been made at this inspection and the provider was no longer in breach of regulation 17.” from the report
Service survey results combined
minorFeedback surveys were combined with results from other homes. Inspectors said this could make it harder for people and relatives to understand how this home was performing on its own.
“We discussed whether these could be separated out to enable people and their relatives to understand how their own service was performing.” from the report
DoLS notification mistake
needs fixingThe manager notified CQC about applications for authorisation rather than applications that had been approved. This was discussed during the inspection and the managers said it would not happen again.
“However, they had notified CQC about DoLS applications made instead of DoLS applications approved.” from the report
- 01How are medicines records checked now, especially the amounts carried forward on medicine administration records?
- 02What did the speech and language team advise about the required consistency of the softer, moist diet?
- 03How will you show families feedback and survey results for this home separately from other homes?
- 04How do you now make sure CQC is told when DoLS authorisations are approved?
- 05What activities and independence goals would be available for my relative, and how would their communication preferences be recorded?
This was an unannounced planned inspection covering all five key questions, with the previous Requires improvement rating used as the reason for inspection. This explanation was written from the published report of 21 February 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, February 2019
Rated Requires Improvement; inspectors found kind, personalised care but unsafe medicines, recruitment gaps and weak checks.
The inspection was unannounced and took place on 2 January 2019. The inspector observed care, spoke with people and staff, and reviewed care files, medicine records, recruitment files, audits and other records.
The home was caring, effective and responsive. People were treated with kindness and respect, had choices about daily life, received personalised support and were helped to take part in activities and the community.
The home was not consistently safe or well-led. Three people missed prescribed medicines for three days. Recruitment checks were incomplete, and audits had failed to identify important problems with medicines, staff files and incident follow-up.
The overall rating changed from Good at the previous inspection in June 2016 to Requires Improvement. The provider breached two regulations and was required to send CQC a report explaining what action it would take.
Kind and respectful care
People described staff as kind and caring. Inspectors saw staff offering reassurance and treating people with dignity.
“People told us staff were kind, compassionate and caring towards them.” from the report
Personalised support
Care plans recorded people's preferences, abilities and communication needs. Staff knew people well and supported them consistently.
“People received person centred care specific to their needs.” from the report
Staffing and safeguarding
Inspectors found enough staff to meet people's needs. Staff had safeguarding training and knew how to respond to possible abuse.
“There were sufficient numbers of staff to keep people safe and meet their needs.” from the report
Activities and community life
People took part in activities they chose, including holidays, day centres, local outings and events with family and friends.
“People were supported to take part in meaningful activities of their choice.” from the report
Incomplete recruitment checks
seriousStaff files did not include full employment histories, and gaps were not explored. Some references were not professional or did not match the work history.
“Not all recruitment checks had been completed to make sure staff were honest, reliable and trustworthy to work with people.” from the report
Missed medicines
seriousThree people did not receive a prescribed medicine for three days because medicines were not delivered as part of the new cycle. Staff did not act promptly or explore the possible impact.
“Staff failed to react when three people missed three days of medicines.” from the report
Weak management checks
seriousAudits did not identify the recruitment and medicines problems. Records also did not clearly show what action followed an incident or how recurrence would be reduced.
“Checks and audits had not been successful in identifying and minimising concerns identified during our inspection with risks to people, medicines management and the shortfalls in staff recruitment.” from the report
Medicines records
needs fixingMedicine stock counts were recorded incorrectly, and medicines that had been stopped still appeared on some records. Staff missed the error despite several checks.
“MAR and associated audits contained an incorrect number of stock medicines.” from the report
- 01How do you now make sure medicines are delivered and given on time when there is a problem with the pharmacy?
- 02How do you check medicine stock counts and make sure discontinued medicines are removed from records?
- 03How are full employment histories and professional references checked before new staff start work?
- 04How are accidents and incidents investigated, recorded and followed up to reduce the chance of them happening again?
- 05Have the quality assurance surveys now been analysed, and what changes were made as a result?
This was an unannounced inspection covering all five CQC questions and both the premises and care provided; the previous inspection in June 2016 had rated all five questions Good. This explanation was written from the published report of 12 February 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 Fiveways
4 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 26 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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39 live-in carers within about an hour of Kent
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 £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
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.