CQC report explained · a nursing home
What the CQC found at Florence Care Reading Ltd
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found clear risk assessments, safe medicines management, suitable recruitment checks and regular safety monitoring. People and relatives said they felt safe, and people said there were enough staff.
- Effective?
- Good
- This key question was not assessed during this focused inspection.
- Caring?
- Good
- This key question was not assessed during this focused inspection, although inspectors observed friendly and person-centred conversations.
- Responsive?
- Good
- This key question was not assessed during this focused inspection.
- Well-led?
- Good
- Inspectors found an open and positive culture, regular quality checks and clear monitoring of incidents, records and staff competency.
What inspectors found, April 2023
Florence Care Reading Ltd was rated Good; inspectors found people were safe and the home was well managed, with one late notification and some décor improvements still planned.
This was an unannounced focused inspection on 12 April 2023. Two inspectors and an Expert by Experience spoke with people, relatives and staff. They observed care and reviewed care records, medicines records, accident records and quality checks.
The inspection was prompted by concerns about staffing levels and how people's nursing needs were managed. Inspectors found no evidence that people were at risk of harm from these concerns. People said they felt safe and there were enough staff. Medicines, risk assessments, recruitment checks and safety checks were found to be managed safely.
The home had an open culture and staff knew people well. Its quality checks were being used to monitor areas such as medicines, care plans, weight loss and staff competency. The overall rating was Good, as were Safe and Well-led. The other three areas were not assessed during this focused inspection.
Clear risk management
People had individual risk assessments covering issues such as falls, pressure sores and nutrition and hydration. Emergency plans and regular fire drills were also in place.
“People had individualised risk assessments in place to mitigate the risk of harm to people.” from the report
Safe medicines
Staff administering medicines were trained and checked for competence. Inspectors found no gaps in the medicine records they reviewed.
“We reviewed people's MAR charts and no recording gaps were seen.” from the report
Enough staff reported
People and staff said staffing levels were sufficient for people's needs. Inspectors saw staff respond promptly to requests for help during the visit.
“We saw staff responded to people's request in a timely manner for support during the day of the inspection.” from the report
Positive staff culture
Inspectors saw staff having friendly, person-centred conversations and found that staff knew the people they supported well.
“We observed a positive and caring culture amongst staff at the service.” from the report
Quality monitoring
The home used audits and monthly trackers to monitor records, medicines, weight loss, staff competency and incidents.
“An analysis of audits was completed monthly to identify themes and trends.” from the report
One late notification
needs fixingOne incident from the week before the inspection had not yet been reported to CQC. The notification was submitted immediately after inspectors identified this.
“We identified one incident which had occurred the week before our inspection which had not yet been submitted to CQC.” from the report
Décor improvements planned
minorThe management team had identified that the décor still needed improvement. This was included in its plan for further work.
“The management team had a clear plan on additional areas requiring improvement. This included the continued improvement to décor within the home” from the report
- 01How do you currently check that staffing levels are enough for people's nursing and care needs?
- 02What caused the late notification to CQC, and what has changed to prevent this happening again?
- 03How are incidents and accidents reviewed, and how is any learning shared with staff?
- 04What décor improvements are still planned, and when do you expect them to be completed?
- 05How often are medicines records, care plans and staff medicines competency checked?
This was an unannounced focused inspection of Safe and Well-led only; the other three key question ratings were not assessed during this inspection. This explanation was written from the published report of 25 April 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, February 2022
Rated Good overall; inspectors found improvements in pain care, the premises and leadership, while Safe was inspected but not rated.
This was a focused inspection. One inspector visited on 3 February 2022, spoke with people and staff, observed care and checked records and quality checks.
The home had improved since the previous inspection, which was rated Requires Improvement. Pain monitoring, care planning, decoration and signs to help people find their way around had improved.
The home was rated Good overall. Effective and Well-led were rated Good. Safe was inspected for infection prevention and COVID-19 arrangements but was not given a new rating. Other areas were not inspected during this visit and their previous ratings were used to calculate the overall rating.
Infection prevention
The inspector was assured that the home had arrangements to prevent and manage infections, including COVID-19.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Person-centred care
Care plans included people's preferences, routines and choices. Staff were described as knowing people well.
“Plans were person centred and contained information covering their likes and dislikes and a summary of daily routines, including how the person would like the care to be carried out.” from the report
Improved environment
The home had redecorated part of the building, improved flooring and added signs and objects to support people living with dementia.
“The provider had recently redecorated one wing of the home, removing patterned carpet, replacing it with hard flooring to support with people's mobility” from the report
Staff training and support
Staff had completed mandatory training and new staff received induction and shadowing before working independently.
“All new staff completed an induction that was overseen by senior members of staff before being reviewed by the registered manager.” from the report
Quality oversight
The manager used audits and trackers to monitor areas such as medicines, weight loss, falls, accidents and pressure sores.
“The registered manager had quality assurance systems in place.” from the report
Inspectors raised no specific concerns in this report.
- 01What further changes have been made to the signage and coloured toilet seats mentioned in the report?
- 02How are you continuing to monitor and respond to people's pain, including for people who cannot easily describe it?
- 03What progress has been made with the planned refurbishment of the garden?
- 04How do your current audits check that medicines records and care plans remain accurate and complete?
- 05Is the weekly physiotherapy service still available, and what improvements in mobility or independence has it supported?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and previous ratings for areas not inspected were used in the overall rating. This explanation was written from the published report of 23 February 2022 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 Florence Care Reading Ltd
7 rated inspections over 8 years: the service has held its Good rating throughout.
- April 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2022Goodup from Requires improvementSafe: Inspected but not ratedWell-led: Good
- March 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- September 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Inadequate
- December 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- November 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- August 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- March 2011
Registered with the Care Quality Commission on 4 March 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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