CQC report explained · a nursing home
What the CQC found at Fleming House Care Home with Nursing
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People felt safe and there were enough staff to meet their needs. Inspectors did see an agency nurse fail to clean their hands before and after giving medicines, although the manager acted promptly.
- Effective?
- Good
- Care plans gave staff detailed information about people's needs and choices. Most people enjoyed the food, but one person wanted more choice, and one dining room had inadequate supervision during a meal on the first day.
- Caring?
- Good
- Staff generally formed warm relationships with people and respected their privacy, dignity and independence. One agency worker was seen not communicating with people and telling one person to sit down.
- Responsive?
- Outstanding
- The home offered varied activities and social opportunities that were tailored to people's interests. Care plans included detailed routines and staff knew how to respond to individual needs.
- Well-led?
- Good
- Inspectors found open management, regular audits, staff meetings and feedback from people and relatives. Leaders were described as committed to improving the quality of care.
What inspectors found, September 2019
Rated Good; inspectors found kind, safe care and outstanding activities, but saw shortfalls in hand hygiene, mealtime supervision and one agency worker's approach.
Inspectors visited unannounced on 6 and 8 August 2019. They spoke with people living in the home, relatives, staff and health professionals. They also checked care plans, medicines records, staff files and management records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were all rated Good. Responsive was rated Outstanding. Inspectors found that people were treated with kindness, staff knew them well and care was usually personalised.
The home offered a wide range of activities, including a pub, tea room, nail bar, trips and social events. Inspectors said these gave people choice, stimulation and an active daily life.
Inspectors identified some problems during the visit. An agency nurse did not follow hand hygiene procedures when giving medicines. In one dining room, people were left at risk of choking because there was not enough staff supervision. An agency worker also spoke or interacted poorly with people. The manager acted promptly in response.
Personalised care
Care plans included people's life histories, preferences and daily routines. Staff knew people's needs and adjusted support accordingly.
“People experienced care that was personalised, and care plans contained detailed daily routines specific to each person.” from the report
Activities and choice
People could take part in many activities and suggest others. The pub, tea room, nail bar and trips helped people remain active and socially involved.
“The service went above and beyond to recognise and respond to people's needs for social interaction and mental stimulation and many innovative, person-centred activities took place daily.” from the report
Kind and respectful staff
Most staff built positive relationships with people. Inspectors saw staff protecting privacy and dignity and encouraging independence.
“Staff had built up positive relationships with people. Staff spoke about their work with passion and spoke about people warmly.” from the report
End of life care
Inspectors found strong attention to people's wishes and family support during the final stages of life. Families could stay at the home in dedicated rooms.
“People received outstanding end of life care by a team of staff that were passionate about providing high quality care during people's final stages.” from the report
Hand hygiene
needs fixingAn agency nurse gave medicines without washing their hands or using hand gel before or afterwards. This included giving eye drops for an eye infection. The manager took action during the inspection.
“The agency nurse did wear gloves but did not wash their hands or use hand gel before or after administering people's medicines.” from the report
Mealtime supervision
seriousIn one dining room, only one staff member was present and they kept leaving. People were left at risk of choking, and a relative helped two people eat. More staff were present the next day.
“The staff member kept leaving the room and leaving people at risk of choking and this resulted in one family member assisting two people to eat.” from the report
Agency worker's communication
needs fixingOne agency worker did not communicate properly with people in a lounge and told someone who was trying to stand up to sit down. The provider said they would not use that worker again.
“However, we observed an agency staff member not communicating with people in a lounge area and one person who kept trying to get up was told to sit down.” from the report
- 01How do you check that agency nurses follow hand hygiene procedures when giving medicines?
- 02How many staff will supervise meals for people who may be at risk of choking?
- 03How do you assess agency workers' communication and treatment of people before they work here?
- 04How are people's food preferences and requests for alternatives recorded and reviewed?
- 05What changes have been made since the inspection to prevent the problems inspectors saw?
This was an unannounced planned inspection covering all five CQC questions, including the care provided and the premises. This explanation was written from the published report of 18 September 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, February 2017
Rated Good overall; inspectors found outstanding personalised support, especially for people living with dementia.
This was an unannounced inspection on 8 December 2016. Inspectors spoke with people living at the home, family members, staff and a health professional. They also reviewed care plans, medicines records, recruitment files, staffing records, incidents and quality checks.
The home was rated Good for Safe, Effective, Caring and Well-led. Inspectors found enough staff, safe medicines practice, suitable training, kind care, respect for privacy and good links with health professionals. People had choices about food, care and activities.
Responsive was rated Outstanding. Inspectors found care was highly personalised and that the home had created an engaging environment for people living with dementia. This included a pub, a range of activities and personalised room doors. Overall, the Good rating means the home met the required standards at the time of this inspection, with some areas that could still improve.
Personalised care
Care plans contained detailed information about people's routines, preferences and needs. Staff understood how to support individuals and involved people and families in planning care.
“People received excellent care that was based around their individual needs that ensured care was personalised and responsive.” from the report
Dementia-friendly design
The home used personalised doors, murals, signs and different spaces to help people find their way around, feel at home and stay involved.
“This meant that the doors provided a sense of home and ownership as well as assisting people remember where their room was located promoting independence.” from the report
Activities and social life
People could choose from activities inside and outside the home. The pub created regular opportunities for conversation, hobbies and social contact.
“The pub was exceptional. The outside walls were painted authentically with brick work and included outside signage and brewery bunting.” from the report
Kind and respectful care
Inspectors saw friendly, unhurried interactions. Staff explained care, asked for consent and protected people's privacy and dignity.
“The relationships between staff and people receiving support demonstrated dignity and respect at all times.” from the report
Safe staffing
Inspectors found enough staff to respond to people's needs. Recruitment checks, safeguarding training and medicines training were in place.
“There were enough staff to keep people safe.” from the report
Communication could improve
minorA staff survey identified communication as an area for improvement. The home had responded by inviting senior managers to team meetings, but families may wish to ask how this is monitored now.
“Results showed communication could be improved and the home had improved communication by inviting senior managers to team meetings.” from the report
- 01What changes have been made to communication since the staff survey, and how do you check that communication is now effective?
- 02How does the home make sure the new call bell system continues to give prompt responses, particularly for people at risk of falls?
- 03What activities would be available for my relative if they could not attend group activities or leave their room?
- 04If my relative lacks capacity for a particular decision, how will you involve the family and record a best interests decision?
- 05What is the current position for people whose Deprivation of Liberty Safeguards applications were still being processed at the inspection?
This was an unannounced inspection covering all five questions and the overall quality of the home; inspectors spoke with 16 people, nine family members and staff, and reviewed care and service records. This explanation was written from the published report of 4 February 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 Fleming House Care Home with Nursing
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- September 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
Read what inspectors found at Fleming House Care Home with Nursing →
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
Read what inspectors found at Fleming House Care Home with Nursing →
- December 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- April 2014
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 10 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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