CQC report explained · a nursing home
What the CQC found at Fleetwood Nursing Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found concerns about fire safety, environmental hazards, bedrail risks and staff training. Medicines and infection control were managed safely, and staffing levels had improved.
- Effective?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used for the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used for the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused inspection. The previous rating was used for the overall rating.
- Well-led?
- Requires improvement
- The home's quality checks had not identified important problems with fire safety, environmental risks and staff training. Inspectors also found that some policies and procedures were inconsistent.
What inspectors found, August 2023
Rated Requires Improvement; inspectors found caring staff and better staffing, but serious concerns about fire safety, training and checks.
This was an unannounced focused inspection on 12 and 17 May 2023. Inspectors spoke with people, relatives and staff, observed care, checked the building and medicines, and reviewed care records, training and management records.
The home was rated Requires Improvement for Safe and Well-led. Fire safety arrangements were not always suitable. Evacuation instructions conflicted, some fire checks and drills had not been completed as required, and there were other possible hazards. Risk assessments did not always explain how risks would be reduced.
Staffing levels had improved since the previous inspection, and people said staff responded quickly. Medicines and infection control were managed well. However, training was incomplete in important areas, and the home's checks had not found several of the problems identified by inspectors.
The overall rating remains Requires Improvement. This was the third consecutive inspection with that rating. The ratings for Effective, Caring and Responsive were not reassessed during this inspection and carried over from the previous inspection.
Staffing had improved
More staff had been put in place since the previous inspection. Inspectors saw enough staff on site and people were not rushed.
“During our visits there was enough staff onsite. People were well cared for; we saw no signs people were rushed and staff responded promptly to people's needs.” from the report
Medicines were managed safely
Qualified nurses managed medicines, and people received them as prescribed. There were also clear arrangements for medicines given only when needed.
“Medicines were managed safely. People received their medicines as prescribed.” from the report
Cleanliness and infection control
Inspectors saw staff using protective equipment properly and found suitable cleaning arrangements. Relatives said they found the home clean.
“Appropriates measures were taken to ensure good cleanliness and hygiene in the home.” from the report
People felt safe and cared for
People and relatives described staff as caring. Inspectors observed people who appeared happy and relaxed, and staff responded to concerns.
“From observations, people seemed happy and relaxed.” from the report
Fire safety and evacuation
seriousSome bedroom doors were propped open, fire drills and checks were not always completed as required, and evacuation instructions conflicted. Inspectors said this could cause confusion in an emergency.
“PEEPs advised leaving people in their bedrooms until the fire service arrived, procedures mentioned phased horizontal evacuation and other information told staff to move people downstairs.” from the report
Staff training
seriousTraining was incomplete or overdue in several subjects needed to keep people safe and meet their individual needs. This included safeguarding, moving and handling, diabetes, choking and learning disabilities.
“Training levels were poor in some key subjects. For example: safeguarding, emergency first aid, health and safety awareness, moving and handling and information governance.” from the report
Quality checks did not find problems
seriousThe home's audits and checks had not identified the fire safety, environmental and training problems found during the inspection. The provider had been told at the previous inspection to improve quality monitoring, but inspectors found insufficient improvement.
“Quality assurance processes were in place but had not identified shortfalls found during this inspection.” from the report
Mental capacity and restrictions
needs fixingThe home was not fully following the principles of the Mental Capacity Act. DoLS arrangements had not considered CCTV, some consent forms were signed incorrectly, and some staff training was out of date.
“We found the service was not fully working within the principles of the MCA.” from the report
- 01What changes have been made to the fire evacuation plans, bedroom doors, fire drills and emergency equipment since the inspection?
- 02How many staff still have overdue training, and when will training be completed for safeguarding, moving and handling, diabetes, choking and learning disabilities?
- 03What checks now identify environmental hazards such as unsecured wardrobes and missing window restrictors?
- 04How are bedrail risks assessed and reviewed for each person who uses them?
- 05How are CCTV and other restrictions included in Mental Capacity Act and DoLS decisions?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried over from the previous inspection. This explanation was written from the published report of 9 August 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, January 2021
Fleetwood Nursing Home was inspected but not rated; inspectors were assured about infection control during the pandemic.
This was an unannounced, targeted inspection on 3 December 2020. It followed concerns about infection prevention and control. Inspectors looked only at how the home prevented and managed infection.
Inspectors were assured that the home was using protective equipment safely, following shielding and social distancing rules, testing people and staff, and keeping its infection control policy up to date. They also found good cleanliness and safe arrangements for new admissions and visitors.
The home was not given an overall quality rating or a rating for Safe. The other areas, such as Caring and Well-led, were not assessed in this inspection.
Infection control
The home had enhanced infection control procedures during the pandemic. Staff had extra training and understood the relevant procedures and guidance.
“The registered manager implemented enhanced infection control procedures to maintain people's safety during the pandemic.” from the report
PPE and cleanliness
Staff had good supplies of PPE and were trained to use and dispose of it. Housekeepers and care staff worked together to maintain cleanliness.
“Staff had access to good stocks of personal protective equipment (PPE) and were effectively trained in its use and disposal.” from the report
Safe visiting
The home restarted visiting because staying in contact with relatives had affected people's wellbeing. Inspectors said the visiting system was secure.
“The system was secure to retain everyone's safety.” from the report
Staffing and oversight
Staffing levels had been increased to support people's safety and wellbeing. Managers also carried out several audits to oversee safety and welfare.
“Staffing levels were increased to ensure people were safe and their wellbeing was optimised.” from the report
Inspectors raised no specific concerns in this report.
- 01What infection prevention and control arrangements are in place now, including PPE, cleaning and staff training?
- 02How do you currently manage visits from relatives while keeping people safe from infection?
- 03How are new residents admitted and assessed for infection risks and support needs?
- 04What testing arrangements are currently available for residents and staff?
- 05When was the home last assessed on Caring, Responsive and Well-led, as these areas were not covered by this inspection?
This was a targeted inspection of infection prevention and control under Safe; the service was inspected but not rated and the other areas were not assessed. This explanation was written from the published report of 6 January 2021 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 Fleetwood Nursing Home
5 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- August 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2021Inspected but not ratedSafe: Inspected but not rated
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2018Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2018Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 27 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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