CQC report explained · a nursing home
What the CQC found at Florence Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, March 2022
Rated Good; inspectors found safe care and stronger management, with previous regulatory breaches resolved.
This was an announced, focused inspection on 24 and 25 February 2022. One inspector spoke with people, staff and the manager, and checked care, medicine and staff records, training files and management audits.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, medicines were managed safely, there were enough staff, and infection control arrangements were in place.
The manager monitored the service, listened to people's views and worked with health and social care professionals. The home had improved since the previous inspection, which had been rated Requires Improvement and found several breaches of regulations.
Only Safe and Well-led were inspected in detail. The ratings for the other areas were carried over from the earlier comprehensive inspection when calculating the overall Good rating.
Risk management
Risks such as falls, moving and handling, eating and drinking, and medicines were assessed. Staff understood how to reduce these risks.
“Risk assessments included information for staff about the actions to be taken to minimise the chance of accidents occurring.” from the report
Safe medicines
Medicines were securely stored and administration records were complete. Nursing staff had been trained and assessed as competent.
“Medicines administration records had been completed in full.” from the report
Staffing and recruitment
Inspectors found enough staff to meet people's needs and saw evidence of appropriate checks before staff started work.
“There were enough staff to meet people's needs.” from the report
Listening to residents
The home used surveys and residents' meetings to gather views. Feedback had led to changes such as new furniture, improved lighting and menu ideas.
“The provider sought people views about the home through annual surveys and residents' meetings.” from the report
Learning and oversight
The manager used audits, spot checks and incident reviews to monitor the service and identify improvements.
“The registered manager recognised the importance of regularly monitoring the quality of the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How often are people's risk assessments reviewed, especially for falls, moving and handling, eating and drinking, and medicines?
- 02How do you check that medicines remain safely stored, administered and recorded?
- 03How do you make sure there are enough staff on every shift, including when staff are absent?
- 04What changes have been made in response to recent residents' surveys and meetings?
- 05How are incidents, accidents and infection risks reviewed, and how do you share any lessons with staff?
This was a focused inspection of Safe and Well-led; the other ratings were carried over from the previous comprehensive inspection. This explanation was written from the published report of 26 March 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.
What inspectors found, October 2020
Florence Nursing Home was rated Requires Improvement; inspectors found caring and effective support, but risks, records and quality checks were not always managed safely.
This was an unannounced inspection on 26 August 2020. It began as a targeted inspection about nursing care concerns, then widened to look at Safe, Effective and Well-led. Infection control during the coronavirus pandemic was also checked.
Inspectors found enough staff, safe medicines management, suitable support with eating and drinking, and access to health professionals. People were protected from abuse, and relatives generally said their family members were safe and well cared for.
There were important weaknesses. Some premises risks, such as unprotected radiators, an unrestricted window and an ungated staircase, had not been identified or managed. Some coronavirus guidance was out of date, and care and decision-making records were not always complete or up to date.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe and Well-led were rated Requires Improvement, while Effective remained Good. The manager took prompt action on some problems, but CQC required an action plan and will check progress.
Enough staff
Inspectors saw staff available to support people promptly and without rushing. Relatives also said staffing levels appeared adequate.
“We observed staff to be on hand and available to support people promptly, without rushing, throughout our inspection.” from the report
Medicines managed safely
Medicines were stored safely and given by trained staff whose competence was checked each year. Records included photographs, allergy details and guidance for medicines given when needed.
“People received their medicines as prescribed.” from the report
Support with food and health
People were offered food choices that reflected their needs, preferences and allergies. Staff also arranged appropriate support from health professionals.
“People were supported to ensure their nutritional needs were met.” from the report
Safeguarding
People and relatives said they felt safe. Staff understood different types of abuse and how to report concerns.
“People were protected from the risk of abuse.” from the report
Infection control practices
Staff wore suitable protective equipment, visitors had safety checks, and the home had arrangements for socially distanced visits. The home was clean.
“The service was clean and free from malodour, and the laundry room appeared organised with systems to separate clean and dirty clothes.” from the report
Unmanaged premises risks
seriousSome radiators had no covers, a large landing window was open without a restrictor, and a staircase was not gated as required by the home's own risk assessment. These issues placed people at risk of harm.
“Some risks to people were not always assessed, or, where they had been assessed there were not always effective risk management plans in place.” from the report
Weak quality checks
seriousThe systems for checking safety and quality had not found some building risks. Accident records also did not consistently show enough information to identify patterns or learning.
“Systems to manage risk and monitor the quality and safety of the service were not robust.” from the report
Out-of-date coronavirus guidance
needs fixingSome infection control and coronavirus guidance was out of date or did not cover current arrangements. The planned isolation period for new admissions was shorter than the government guidance referred to in the report.
“We were not assured that the provider's infection prevention and control policy was up to date, as it did not include guidance for staff in relation to Covid -19.” from the report
Incomplete records
needs fixingSome decisions about coronavirus testing and changing a GP had not been recorded. Inspectors also found gaps in records about accidents, incidents and nurses' clinical competence.
“However, the assessments and best interest decisions had not been recorded to ensure accurate, contemporaneous records of people's care were maintained.” from the report
Limited family updates
minorRelatives said they received little regular information during the pandemic when visits were restricted. This made it harder for families to stay up to date.
“During this time we haven't really had much information from the home.” from the report
- 01Have radiator covers, the window restrictor and the staircase gate now been fitted, and how are these risks checked regularly?
- 02What current coronavirus guidance do staff follow for new admissions, vulnerable staff and access to additional testing?
- 03How do you now check that care records, mental capacity decisions and best-interest decisions are complete and up to date?
- 04How do you record and review accidents and incidents so that patterns and learning are identified?
- 05How often will relatives receive updates when visits are restricted?
This was a targeted inspection about nursing care concerns that widened to a focused inspection of Safe, Effective and Well-led, including infection control; Caring and Responsive were not assessed and their previous ratings were not shown in this report. This explanation was written from the published report of 8 October 2020 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 Nursing Home
4 rated inspections over 5 years: the service has held its Good rating throughout.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- December 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2016
Registered with the Care Quality Commission on 9 August 2016.
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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