CQC report explained · a residential care home
What the CQC found at Florfield 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
- Medicines plans did not include enough information about purpose, dose, timing, route or side effects. Some risk assessments were unclear or out of date, although staff generally supported people safely and there were enough staff.
- Effective?
- Good
- People's health, nutrition and hydration needs were supported. Staff had the training and skills needed, worked with health professionals and supported people in line with the Mental Capacity Act.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. People were offered choices, and relatives said they were involved in decisions when needed.
- Responsive?
- Requires improvement
- People's communication needs were understood, but they were not always involved in care reviews. Activities were not consistently personalised or provided, and end of life wishes had not been recorded.
- Well-led?
- Requires improvement
- The home had a warm and caring culture, but its audits had not identified problems with medicines plans, risk assessments, care records, maintenance or activities. People were not always involved in giving feedback in a way suited to their communication needs.
What inspectors found, January 2024
Florfield Home was rated Requires Improvement; inspectors found kind care and enough staff, but safety records, activities and management checks needed improvement.
Inspectors visited on 15 December 2023. One inspector spoke with staff and a family member, observed care, reviewed two people's care files and checked management records. The visit was announced.
The overall rating fell from Good to Requires Improvement. Safe, responsive and well-led were rated Requires Improvement. Effective and caring remained Good.
Inspectors found risks in medicines information and some risk assessments. Activities were not always personalised or provided regularly. Management checks had not found these problems. The home was caring, clean and had enough trained staff.
Kind and respectful staff
Inspectors saw warm, respectful care. People appeared to trust staff, and relatives described the atmosphere positively.
“Staff treated people with genuine kindness and respect.” from the report
Enough trained staff
There were enough staff to support daily care and activities. Recruitment was carried out safely, and staff received the training needed for their roles.
“The provider ensured there were sufficient numbers of suitable staff.” from the report
Health support
Staff supported people to access healthcare and provided support with complex health, nutrition and hydration needs.
“People had complex health needs and staff supported them to access healthcare services as they needed them.” from the report
Choice and dignity
Staff offered choices, respected people's decisions and supported them in the least restrictive way. People's privacy and dignity were respected.
“We saw staff offered people choices and responded to people's subtle communication to ensure they were supporting them in a way they wanted.” from the report
Clean home
The home was clean and tidy. Minor maintenance problems affecting cleaning were fixed after inspectors raised them.
“Florfield home was clean and there were systems in place to ensure the home remained clean and a safe environment for people.” from the report
Medicines information
seriousMedicines plans did not give staff enough personalised information, including doses and timings. This created a risk that medicines might not be managed safely.
“The information available to staff about how to support people with their medicines was not sufficient.” from the report
Risk assessments
seriousSome risk assessments lacked detail or had not been updated after changes. Staff sometimes relied on verbal instructions from experienced colleagues.
“Risk assessments lacked detail of the nature of the risk and the specific actions staff should take to support people to be safe.” from the report
Activities were not consistent
needs fixingPeople did not always receive activities linked to their interests. One person's records showed only one music group visit in a month and no bowling trips.
“People were not always supported to follow their interests or take part in activities that were relevant to them.” from the report
Limited involvement in care reviews
needs fixingStaff involved relatives where appropriate but did not involve people themselves enough when reviewing care plans. Information was also not always provided in a form people could use.
“However, staff did not involve people in reviewing and updating their care plans so their views about their care were not always considered.” from the report
Weak management checks
seriousAudits and quality checks had not found several problems identified during the inspection. This led to a breach of the good governance regulation.
“The provider's system did not always effectively monitor the quality of care provided to drive improvements.” from the report
End of life planning
needs fixingPeople did not have plans recording their wishes if they became seriously unwell. The manager said meetings would be arranged to develop these plans.
“People did not have plans in place to reflect their wishes in the event that they became seriously unwell.” from the report
- 01Have all medicines plans been rewritten to include each person's purpose, dose, route, timing and possible side effects?
- 02Have the choking, moving and handling, and fire safety risk assessments been updated and checked?
- 03How will you make sure each person is involved in reviewing their care in a way that matches their communication needs?
- 04What individual activities are now planned for each person, and how do you record whether these happen?
- 05What checks now make sure problems with medicines, care plans, risk assessments and activities are found quickly?
This was an announced inspection covering the overall service, including the premises and care, and all five CQC questions; the previous inspection rated the service Good in 2017. This explanation was written from the published report of 9 January 2024 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 2017
Florfield Home was rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
The inspection was unannounced and took place on 25 and 26 July 2017. One inspector reviewed records, spoke with one resident, staff and a family member, and observed care. The inspector also checked information from local safeguarding and contract monitoring teams.
The home supported four people with physical and learning disabilities. Inspectors found detailed risk assessments, safe medicines management, enough suitable staff and a clean environment. People were supported with food, healthcare, activities, communication, privacy and personal choices.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. At the previous inspection, the home had been asked to improve the clarity of risk assessments. Inspectors found that the necessary improvements had been made.
Safe medicines
Medicines were ordered, stored, administered and returned safely. Records checked by inspectors were accurate, and medicines were audited weekly.
“Medicines were well managed. They were ordered, stored and returned safely.” from the report
Respectful care
Staff communicated warmly and respectfully. People were encouraged to make choices, express themselves and do tasks independently where possible.
“We observed that staff members were polite and respectful to people throughout the inspection.” from the report
Personalised support
Care records included people's preferences and circumstances. People were supported with community activities, hobbies and family relationships.
“Details in care records about how people wished to be supported were personalised and provided clear information to enable staff to provide appropriate and effective support.” from the report
Open management
Staff and relatives said the manager was approachable. The home used meetings, handovers, audits and feedback to identify and act on improvements.
“There was an open and positive culture at the service.” from the report
Inspectors raised no specific concerns in this report.
- 01How are risk assessments kept up to date when a person's health or behaviour changes?
- 02Who is responsible for giving medicines on each shift, and how are medicine errors checked and followed up?
- 03How will my relative be involved in planning and reviewing their care if they do not communicate verbally?
- 04What activities and community opportunities would be available for my relative?
- 05What has changed at the home since this 2017 inspection?
This was an unannounced inspection covering all five areas, but inspectors spoke directly with only one person using the service and reviewed two people's care records. This explanation was written from the published report of 4 October 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 Florfield Home
3 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- January 2024Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 November 2010.
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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