CQC report explained · a nursing home
What the CQC found at Fort Horsted Care Home Ltd
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, July 2022
Fort Horsted Care Home Ltd was rated Requires Improvement; inspectors found medicines and safety checks were not always reliable.
This was an unannounced, focused inspection on 11 May 2022. The inspector spoke with five people, eight staff members and reviewed care, medicines, recruitment and management records.
The home was not always safe. Some medicines records were incomplete, one emergency medicine was out of date, and risks linked to a call bell lead, damaged flooring and a broken call bell were not managed promptly. Immediate action was taken on the day or soon after these risks were reported.
The home was not always well-led because its checks had missed important problems. People generally said they felt safe and were happy, staff were supported, and the culture was open. The overall rating and the ratings for Safe and Well-led changed from Good to Requires Improvement.
Protection from abuse
People said they felt safe. Staff understood how to recognise and report abuse, including concerns outside the organisation if needed.
“People were protected from abuse and avoidable harm.” from the report
Staffing and support
There were suitable numbers of staff for assessed needs. People had regular staff they knew, and staff said they were well supported.
“There were suitable numbers of staff to provide the care and support people were assessed as needing.” from the report
Open culture
People knew how to complain and felt able to speak with nurses and managers. Relatives also received updates about changes or concerns.
“People knew the staff and the registered manager and felt that there was an open culture.” from the report
Infection control
Inspectors were assured about most infection prevention arrangements, including admissions, testing, hygiene and managing outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Medicines records and expiry dates
seriousSome medicines administration records had gaps, so the home could not confirm that medicines had been given as prescribed. One emergency epilepsy medicine had expired and was not listed on the medicines record.
“The provider had failed to ensure medicines were managed safely.” from the report
Risks and repairs
seriousA person at risk from a call bell lead had access to one. A hole in the dining room floor created a trip risk, and a broken call bell left one person needing to shout for help.
“One person had been assessed as a ligature risk.” from the report
Quality checks
needs fixingAudits did not identify the expired medicine, the damaged floor or the call bell lead risk. The provider changed the audits after the inspection.
“The systems to audit the quality of the service were not always robust or sufficient to alert the provider of concerns and issues found during the inspection.” from the report
Recruitment records
minorOne staff employment record did not contain a full employment history. The registered manager addressed this after the inspection.
“Staff recruitment records showed gaps in one member of staffs' employment history.” from the report
- 01How are you now checking that every medicine administration record is complete?
- 02How do you check emergency and as-needed medicines are in date and have clear instructions?
- 03What permanent repair was made to the dining room flooring, and how are similar hazards now reported and followed up?
- 04How do you check that call bells and other safety equipment work in every room?
- 05What evidence can you show that the revised audits have identified and corrected problems since this inspection?
This was a focused inspection of Safe and Well-led; the other three key questions were not rated in this report. This explanation was written from the published report of 27 July 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, April 2020
Rated Good; inspectors found safe, kind and personalised care, with improvements made since the previous inspection.
Inspectors visited on 10 and 11 March 2020. The first day was unannounced and the second was announced. They spoke with people, relatives and staff, observed care, and checked care records, medicines, staffing, training and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from abuse, received their medicines safely, and had enough suitably trained staff. People and relatives described staff as kind, friendly and caring.
The home had improved from Requires improvement at the previous inspection, published on 16 March 2019. The two earlier breaches of regulation were no longer breaches at this inspection. Inspectors found that quality checks and records had improved, although some handwritten records were still difficult to read and some staff had not completed a fire drill within two years.
Kind and respectful staff
People and relatives spoke positively about the staff. Inspectors saw friendly interactions and found that staff knew people's preferences and personal histories.
“People and relatives told us staff were kind and caring.” from the report
Safer risk management
Moving and handling risks, health risks and environmental risks were assessed and managed. Staff understood how to use people's equipment safely.
“Risks to people's safety and individual health and wellbeing had been assessed and well managed.” from the report
Well-managed medicines
Medicines were stored safely, records were complete and accurate, and staff received training and competency checks.
“Medicine administration records were complete and accurate, and people received their medicines as prescribed.” from the report
Personalised activities
The home offered varied activities and also provided one-to-one activities for people who stayed in bed or in their bedrooms.
“People who were cared for in bed received one to one activities such as hand massage, nail care, reading and chatting.” from the report
Improved management
The home had strengthened its quality checks and records since the previous inspection. The manager was visible and staff said they felt supported.
“The systems to review and check the quality of the service were robust.” from the report
Fire drill experience
needs fixingSome staff had not completed a fire drill within two years. The manager arranged for this to be completed after inspectors raised it.
“Some staff had not completed a fire drill within two years.” from the report
Records sometimes hard to read
minorSome handwritten daily monitoring and care records were not always legible. Staff could read most of them and fill in blanks, but this could make information harder to follow.
“Some hand-written records such as daily monitoring sheets and daily records were not always legible.” from the report
Behaviour guidance was being added
needs fixingCare plans did not initially give specific instructions for supporting some people whose behaviour others might find challenging. The manager changed the care plans during the inspection.
“Care plans did not list specific ways in which staff should work with people who were presenting behaviours that others might find challenging.” from the report
Carer gender preferences
minorPeople had not been asked whether they preferred a male or female carer. There were no male carers employed at the time, and the provider was asked to consider this for the future.
“People had not been asked if they preferred a male or female carer, however there were no male carers employed at the current time.” from the report
- 01Have all staff now completed a fire drill, and how often is this checked?
- 02How do you make sure handwritten daily records are clear and easy for staff to read?
- 03How are care plans kept up to date when a person shows behaviour that others may find challenging?
- 04How do you record and meet a person's preference for a male or female carer?
- 05How will you maintain the improvements made since the previous inspection?
This was a planned inspection of the care home covering all five CQC questions, including the premises and the care provided; the previous Requires improvement rating and two breaches had been followed up. This explanation was written from the published report of 18 April 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 Fort Horsted Care Home Ltd
4 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- July 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2016
Registered with the Care Quality Commission on 23 December 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
91 live-in carers within about an hour of Medway
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 £980 to £1,250 a week. 78 can care for a couple. 10 years' experience on average.
“Usha rapidly became 'one of the family' and is sorely missed.”
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
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.