CQC report explained · a residential care home
What the CQC found at Florence Court Care 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
- The home had enough staff and medicines were managed safely. However, infection risks from a fly infestation, unexplained injuries and other care risks were not always properly assessed, managed or reported.
- Effective?
- Good
- This key question was not assessed in this focused inspection. The report did recommend that the home improve how it applies the Mental Capacity Act.
- Caring?
- Good
- This key question was not assessed in this focused inspection. Inspectors observed staff being kind, attentive and caring, and people and relatives said the care was good.
- Responsive?
- Good
- This key question was not assessed in this focused inspection. The report said feedback and concerns about the infestation were not always acted on or communicated promptly.
- Well-led?
- Requires improvement
- The home's audits and management systems had not identified or controlled important risks. Some serious injuries and abuse allegations had also not been reported to CQC as required.
What inspectors found, April 2023
Rated Requires Improvement; inspectors found serious problems with infection risks, safeguarding and management systems.
This was an unannounced focused inspection on 24 February and 1 March 2023. It followed concerns about infection prevention and control, especially a fly infestation. Inspectors spoke with people, relatives, staff and health professionals, and checked care, medicine and management records.
Inspectors found people and relatives generally felt the care was good and staff were kind. There were enough staff and medicines were managed safely. However, the home had not properly assessed or controlled the health risks from flies, including flies on dressed wounds, food and drinks.
There were also gaps in investigating unexplained injuries, reporting safeguarding concerns, assessing other risks and recording best-interest decisions. The home's checks had not found these problems. The overall rating changed from Good at the previous inspection to Requires Improvement, with Safe and Well-led also rated Requires Improvement.
Staffing
Inspectors found there were enough staff to meet people's needs. Staffing numbers were based on people's needs, and additional roles and waking night staff had been added.
“There were enough staff to meet people's needs.” from the report
Medicines
Medicines were safely administered, stored and disposed of. The manager acted promptly on some recording issues found during the inspection.
“Arrangements were still in place for the safe administration, disposal, and storage of people's medicines.” from the report
Kind care
People and relatives described the care positively. Inspectors saw staff treating people in a kind, attentive and caring way.
“We observed staff were kind, attentive and caring in their approach with people.” from the report
External support
The home was working with the local authority, environmental health and health and social care professionals to improve risk management.
“The service worked with the GP surgery and community nursing team who regularly visited to provide healthcare to people in the service.” from the report
Fly infestation and infection risk
seriousThe infestation had continued since late October 2022. Risks were not properly assessed or controlled, and inspectors saw flies on dressed wounds, food and drinks.
“Flies were seen on people's dressed wounds, found in drinks, and seen on people's food.” from the report
Safeguarding and unexplained injuries
seriousSome safeguarding concerns were not reported promptly. An unexplained bruise had no incident record or evidence that it had been investigated.
“We found no evidence that people had been abused however, systems were not robust to demonstrate safeguarding risks were effectively managed.” from the report
Risk records
seriousCare records and risk assessments were missing or incomplete for issues including wounds, falls, pressure injuries and catheter monitoring. Some actions identified to reduce risks had not been completed.
“The lack of assessment and clear guidance for staff to support them to manage risks, meant people were placed at risk of harm.” from the report
Management and reporting
seriousQuality checks had not identified all the problems. Three serious injuries and three abuse allegations had not been reported to CQC as required.
“We found 3 incidents of a serious injury and 3 allegations of abuse had not been notified to CQC as required.” from the report
Best-interest decisions
needs fixingDecisions made for people who lacked capacity, including decisions about moving rooms during the infestation, were not always recorded to show that the proper process had been followed.
“Not all decisions made in the best interests of people who lacked capacity had been recorded to evidence the required process had been completed.” from the report
- 01Has the fly infestation been fully resolved, and what checks now show that food, drinks and dressed wounds are protected?
- 02How are unexplained bruises, wounds and other possible safeguarding concerns recorded, investigated and reported?
- 03What new checks make sure risk assessments and care plans for falls, pressure injuries, wounds and catheter monitoring are complete and up to date?
- 04How are serious injuries and abuse allegations identified and reported to CQC without delay?
- 05How are best-interest decisions recorded when a person lacks capacity, including decisions about moving rooms or staying in particular areas?
This was a focused inspection that examined Safe and Well-led, including infection prevention and control; the other three key-question ratings were not given in this report. This explanation was written from the published report of 14 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, December 2022
Florence Court Care Home was rated Good; inspectors found safe, kind, person-centred care and effective management.
This was the home’s first inspection. It was unannounced and took place on 24 November 2022. One inspector spoke with five people, three relatives, nine staff members and a community nurse. Records about care, medicines, staff recruitment and management were also checked.
Inspectors found that people felt safe and that there were enough staff to meet assessed needs. Medicines, infection control and risk management were handled safely. Staff had suitable training and supported people with food, drink and healthcare.
People described staff as kind and respectful. Care was tailored to people’s choices, interests, cultures and beliefs. The home offered activities, community trips and support with end of life wishes. Complaints were investigated and management systems were found to be effective.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. This was the first inspection since the service registered, so there was no earlier rating to compare with.
Enough staff
Inspectors found staffing levels met people’s assessed needs. Recruitment checks had also been completed safely.
“People were supported by enough staff to meet their assessed needs.” from the report
Safe medicines
Medicines were stored, given and disposed of safely. Staff had guidance for medicines prescribed for use when needed.
“People had their medicines stored, administered and disposed of safely.” from the report
Kind and respectful care
People described staff as caring and said they were not rushed. Staff knew people’s histories, beliefs and preferences.
“People, their families and visiting professionals described staff as caring.” from the report
Personalised activities
Activities reflected people’s interests, backgrounds and beliefs. People also took part in trips into the local community.
“People were able to take part in a range of activities that reflected their interests, history, religious and cultural backgrounds.” from the report
Strong management checks
The home used several levels of audits, action plans and follow-up reviews. Feedback was shared with staff to support learning.
“Quality assurance processes were robust and multi-layered.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you make sure staffing remains enough for my relative’s assessed needs if their care needs change?
- 02Are any non-urgent deprivation of liberty applications for my relative still awaiting assessment, and what is the current position?
- 03How often will my relative’s care plan and risks be reviewed, and how will we be involved?
- 04Which activities and community visits would suit my relative’s interests, culture and beliefs?
- 05How will you involve us in decisions about end of life care and our relative’s last wishes?
This was an unannounced first inspection covering all five key questions, including infection prevention and control; there were no previous ratings to carry over. This explanation was written from the published report of 23 December 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 Court Care Home
2 rated inspections over a year: the service has slipped, from Good to Requires improvement.
- April 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2022GoodSafe: GoodWell-led: Good
- August 2021
Registered with the Care Quality Commission on 3 August 2021.
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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