CQC report explained · a residential care home
What the CQC found at Florence House
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, February 2021
Inspected but not rated; inspectors found people felt safe and infection controls were generally effective, but some furniture was not securely fixed.
This was an unannounced, targeted inspection on 29 January 2021. It followed specific concerns and took place during a COVID-19 outbreak and lockdown. The inspector spoke with people and staff, observed care, checked care and medicine records, and reviewed policies and quality checks.
People said they felt safe and well supported. Inspectors found staff understood people's needs and risks, care records were updated when circumstances changed, and incidents were reviewed. Infection control arrangements included PPE, cleaning, testing and measures to manage the outbreak.
The home was inspected but not rated. The previous overall rating was Good, from an inspection completed on 11 April 2019. This visit only looked at specific parts of the Safe question, so it did not give a new full rating.
People felt safe
People said they felt safe and well cared for. Staff showed a good understanding of individual needs, risks and preferences.
“People told us they felt safe and well cared for living at the service.” from the report
Good risk records
People had personalised risk assessments and care plans. These were reviewed when needs changed or after incidents.
“People had individualised risk assessments and care plans in place, including in relation to the management of COVID-19.” from the report
Infection control
Inspectors found regular cleaning, suitable PPE and arrangements to manage the COVID-19 outbreak. People were kept informed about changes during lockdown.
“The service was visibly clean throughout, and staff told us they had access to sufficient levels of PPE.” from the report
Support during hospital stays
Staff kept in regular contact with people who were in hospital, helping them to remain connected with the home.
“Where people were in hospital, staff maintained regular contact with the ward to ensure people didn't feel lonely or forgotten about.” from the report
Furniture needed securing
needs fixingSome large items of furniture were not securely fixed. The registered manager said action would be taken immediately to address the risk.
“However, we did identify some large items of furniture were not always fixed securely.” from the report
Staff clothing and accessories
minorInspectors gave feedback that staff clothing and accessories should support bare-below-the-elbow practice during care tasks, to help hand hygiene.
“Feedback was provided in relation to ensuring staff clothing and accessories enabled them to be bare below elbow when completing care tasks, to aid hand hygiene and in line with recognised best practice.” from the report
- 01Have all large items of furniture now been fixed securely, and how is this checked?
- 02What changes have been made to staff clothing and accessories during care tasks?
- 03How will you maintain infection control arrangements if there is another outbreak?
- 04How do you make sure agency staff understand each person's needs and risks?
- 05What was the outcome of the next comprehensive inspection after this targeted visit?
This was a targeted inspection of specific concerns under Safe, including infection prevention and control; the other key questions were not assessed and the previous ratings were not fully reviewed. This explanation was written from the published report of 18 February 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.
What inspectors found, May 2019
Florence House was rated Good; inspectors found kind, safe care, but some care records and end-of-life planning needed improvement.
This was an unannounced inspection on 11 April 2019. One inspector and an expert by experience spoke with people, a relative, staff and external health professionals. They reviewed five people's care records, staff files and the home's management records.
The home supported 24 people with mental health conditions, although it could accommodate up to 27 people. Inspectors found enough suitably trained staff, safe medicines systems, a clean and comfortable environment, kind care and good links with health professionals.
There were some weaknesses. Some risk assessments conflicted or were difficult to use, and care plans did not always clearly show people's involvement or personal preferences. End-of-life care plans also needed more detail.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home was rated Good at its previous inspection in 2016, and the report says CQC will continue to monitor it through its normal inspection schedule.
Kind and respectful staff
People and health professionals described staff as kind, friendly and respectful. Inspectors also saw compassionate interactions and staff who knew people as individuals.
“We observed that staff treated people with kindness, understanding and compassion.” from the report
Enough trained staff
People and staff said there were enough staff to meet people's needs. Staff were suitably trained and their competence was checked.
“People told us they felt there were enough staff to meet their needs.” from the report
Safe medicines support
Medicines were stored, managed and given safely. Staff were trained and assessed as competent before administering them.
“There were robust systems in place to ensure medicines were administered in line with the instructions of the prescriber.” from the report
Good links with health services
External health professionals praised the home's communication and said concerns were raised promptly. The home worked with them to provide joined-up care.
“All the staff work very well with us. They raise concerns promptly so we can intervene and provide support to people at an early stage.” from the report
Activities and choice
People could take part in trips, games, gardening and other activities. The home employed activities staff to provide group and one-to-one support.
“The service provided people with a range of meaningful activities, including regular trips.” from the report
Conflicting risk information
needs fixingSome risk assessments were very similar and one person's assessments conflicted. Inspectors said the information needed a clearer format, even though staff understood the risks.
“However, some risk assessments were very similar and for one person they conflicted.” from the report
Care plans did not always show involvement
needs fixingThe records did not always clearly evidence people's or representatives' input into care planning. Some people were not aware of information recorded about them.
“Improvements were required to better evidence the input people and their representatives had in the planning of their care.” from the report
End-of-life plans needed more detail
needs fixingEnd-of-life planning was in place but did not fully reflect best-practice guidance. The report says improvements were needed in this area.
“However, this could be expanded upon to ensure it reflected best practice guidance such as the Gold Standards Framework for end of life care.” from the report
Some care plans were too general
minorSome care plans included generic statements rather than enough detail about individual preferences and needs.
“Some improvements could be made to further personalise these and avoid generic statements.” from the report
- 01How have you made risk assessments clearer and resolved the conflicting information identified by inspectors?
- 02How do you involve each person and their representatives in writing and reviewing care plans?
- 03What changes have you made to end-of-life care planning since this inspection?
- 04How do you make sure care plans describe each person's individual preferences rather than using generic statements?
- 05How do you check that improvements identified through audits have been completed and remain effective?
This was an unannounced inspection that looked at all five CQC questions and the overall quality and safety of the home. This explanation was written from the published report of 1 May 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 Florence House
2 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- May 2019Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2013
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- August 2012
Registered with the Care Quality Commission on 3 August 2012.
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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13 live-in carers within about an hour of Norfolk
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 £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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.