CQC report explained · a residential care home
What the CQC found at Fordrough Cottage
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm and staff understood their needs and risks. Inspectors found a medicines stock-count error and a waste bin problem, but both were addressed during the inspection.
- Effective?
- Good
- Care plans were personalised and staff had relevant training. People were supported with food, healthcare, communication, independence and decisions about their care.
- Caring?
- Good
- People received kind and compassionate care. Staff respected privacy and dignity, understood individual communication styles and supported people to make choices.
- Responsive?
- Good
- Support was adapted to people's needs, interests, communication methods and goals. People were supported to try new experiences, develop skills and raise concerns.
- Well-led?
- Requires improvement
- Management and leadership were not consistent in all areas. Relatives wanted better updates, some staff had not understood updated COVID-19 testing guidance, and there was no registered manager in post.
What inspectors found, November 2022
Fordrough Cottage was rated Good overall; inspectors found kind, safe care, but leadership and communication needed improvement.
Inspectors visited on 8 and 12 September 2022. The inspection was unannounced and included conversations with a person using the service, relatives, staff and a professional. They also reviewed care plans, medicines records, staff files and management records.
The home supported three people with learning disabilities or autism. Inspectors found that people were safe, treated kindly and supported to make choices, develop skills and take part in activities. Care plans were personalised, staff understood people's communication needs and healthcare was well supported.
The overall rating improved from Requires Improvement to Good. Safe, Effective, Caring and Responsive were all rated Good. Well-led remained Requires Improvement because communication with relatives was not always timely or detailed, staff did not all understand updated guidance, and there was no registered manager in post.
Kind and respectful care
Relatives spoke positively about the staff. Inspectors found that staff used respectful language and protected people's dignity and privacy.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Personalised support
Care plans reflected people's health needs, strengths, wishes and goals. Staff reviewed plans with people and those important to them.
“People had care and support plans which were personalised, holistic, strengths-based and reflected their needs and aspirations.” from the report
Choice and independence
People were supported to make choices, pursue interests, try new experiences and develop skills. Staff aimed to use the least restrictive approach.
“Staff supported people to have the maximum possible choice, control and independence over their own lives.” from the report
Good communication support
Staff understood how each person communicated, including through non-verbal methods. Individual communication plans explained what worked best for each person.
“Staff had good awareness, skills and understanding of individual communication needs, they knew how to facilitate communication and when people were trying to tell them something.” from the report
Updates to relatives
needs fixingSome relatives said they were not always told about incidents quickly enough. They also wanted more detailed and timely regular updates and greater involvement in reviews.
“Some felt they were not always informed of incidents which had occurred in a very timely way.” from the report
No registered manager
needs fixingThere was no registered manager in post at the inspection. A new manager had started the application process.
“At the time of our inspection there was no registered manager in post.” from the report
Medicines stock record
needs fixingAn extra tray of medicines had not been included in the stock count. The medicines were locked away and were returned to the pharmacy during the inspection.
“We found a tray of medicines in excess of the total recorded for a person in the medicine's cupboard.” from the report
- 01How will you make sure relatives are told promptly and given enough detail when an incident affects their family member?
- 02How are relatives involved in care reviews, especially after changes to the staff team?
- 03Who is managing the home now, and what is the current position of the registered manager application?
- 04What checks are now in place to make sure medicines stock counts are accurate?
- 05How do you make sure all staff receive and understand important updates to policies and guidance?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control; the previous overall rating was Requires Improvement and the new overall rating was Good. This explanation was written from the published report of 5 November 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, September 2019
Fordrough Cottage was rated Requires Improvement; inspectors found kind, personalised care but weaknesses in medicines, staff checks and management.
This was the first unannounced, comprehensive inspection of the newly registered home. One inspector reviewed care and medicine records, staff recruitment and supervision files, management records, and spoke with relatives, staff and a health professional.
The home was rated Good for Caring and Responsive. Staff were described as kind, respectful and knowledgeable about the people they supported. People had individual care plans, were involved in decisions, and were supported with activities, communication, independence and community access.
The home was rated Requires Improvement for Safe, Effective and Well-led. Medicine records were not always completed correctly. Some staff had worked before all checks were complete, and induction, supervision and competency checks were not always done as needed. Management systems had improved since a new registered manager started, but inspectors said these systems still needed to become established.
Requires Improvement means the service was not consistently meeting the standard expected by the CQC. The report says there was an increased risk that people could be harmed, although action had started in several areas.
Kind and respectful staff
Relatives said staff were kind and caring. Inspectors found that privacy, dignity, equality and diversity were respected.
“The staff are kind and respectful.” from the report
Personalised support
People had individual care plans and activity plans. Staff understood complex needs and supported people to make choices and become more independent.
“People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.” from the report
Activities and community access
People were supported to enjoy their hobbies and interests and to go out into the community.
“People were encouraged to integrate into the community as much as possible and went out regularly to the local shops and readily accessed other local amenities.” from the report
Family involvement
Relatives were involved in assessments, care planning and reviews. The home also communicated with relatives and health professionals about people's support.
“People and their families were involved in care planning and their views and wishes were respected.” from the report
Medicine records
seriousMedicine administration records had gaps, even though staff said medicines had been given. Controlled drugs were not always signed by two staff as required by the home's policy.
“Medication administration records (MARS) were not always completed accurately and we identified gaps where staff should sign to confirm they had administered medication as prescribed.” from the report
Recruitment checks
seriousSome staff files did not contain full employment histories or the required references. Some staff had worked before all appropriate checks were in place.
“Some care staff had been working without appropriate checks in place.” from the report
Training and supervision
needs fixingSome staff had not completed induction learning before starting work. Staff had also not always received regular supervision or competency checks, including checks on medicine administration.
“Care staff received induction training however they had not always completed this before they started work.” from the report
Management oversight
needs fixingThere had been ineffective auditing before the new registered manager arrived. New systems had identified problems and actions had started, but inspectors said the systems were not yet fully established.
“These systems now need to become embedded into the service.” from the report
- 01What has changed to make sure every medicine administration record is signed accurately each time?
- 02How do you now make sure controlled drugs receive the required counter-signature?
- 03How do you check that all staff complete induction training before they start working with people?
- 04How often do staff receive supervision and competency checks, particularly for medicines and managing behaviours that may challenge?
- 05How will you show that the new audits and action plans are now fully embedded?
This was an unannounced comprehensive inspection covering all five CQC questions and was the home's first inspection. This explanation was written from the published report of 11 September 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 Fordrough Cottage
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- November 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2019Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2018
Registered with the Care Quality Commission on 12 September 2018.
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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