CQC report explained · a residential care home
What the CQC found at Fosse House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about several infection-control arrangements, including safe admissions, hygiene and social distancing. They were only somewhat assured about PPE use, COVID-19 testing and outbreak management because they found specific risks.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Outstanding
- Is care built around the person? Care plans, activities, complaints.
- Well-led?
- Good
- Is the home run well? The manager, the culture, how problems get found and fixed.
What inspectors found, February 2022
Fosse House was inspected but not rated; inspectors found good infection-control arrangements but several COVID-19 safety problems needing action.
This was a targeted inspection during a COVID-19 outbreak. Inspectors visited on 30 December 2021 and reviewed more documents and the provider’s action plan on 11 January 2022. They looked mainly at infection prevention and control, and asked about staffing pressures.
Inspectors were assured about safe admissions, visiting arrangements in place at the time, hygiene, social distancing, shielding and the infection-control policy. Staff vaccination requirements were also being met.
There were some problems. Three staff members were not wearing masks correctly. PPE was not readily available, outbreak testing was late, and one person was not being supported to stay with others on the same unit after COVID-19 cases were found. Staff handovers and testing in a shared area also created a transmission risk.
The service was inspected but not rated. This means the report does not give a Good, Requires improvement or Inadequate rating for the home overall, and this inspection was not a full review of all areas of care.
Safe admissions
Admissions were planned carefully, including isolation when needed and in line with guidance.
“Any admission was carefully planned, with periods of isolation being completed where required and in accordance with guidance.” from the report
Visitor infection controls
Where visits were taking place, visitors received guidance and PPE and completed COVID-19 testing. Vaccination status was checked where applicable.
“Where visits were being provided at the service, there were robust infection control procedures in place.” from the report
Staff vaccination
All staff were vaccinated against COVID-19 or had declared a medical exemption, and the provider had checked the evidence.
“All staff working at the service had been fully vaccinated against COVID-19 or had declared themselves medically exempt.” from the report
Masks and PPE
needs fixingThree staff members were not wearing masks correctly. PPE supplies were not readily available because stocks had not been replenished and access was limited.
“We observed three members of staff who were not wearing face masks correctly.” from the report
Outbreak testing
needs fixingRoutine testing was taking place, but whole-home testing during an outbreak was not completed within the required timescales.
“However testing, known as 'whole home testing' conducted during an outbreak, was not being completed within the required timescales.” from the report
Transmission risks
seriousOne person was not being supported to cohort with others on their unit after COVID-19 cases were found. Staff also gathered for handover and testing in an area before going to their units, which created another transmission risk.
“One person was not being supported to cohort with other people living on the same unit as them, where cases of COVID-19 had been identified.” from the report
Visitor restrictions
minorBefore the outbreak, limits had been placed on the number, timing and length of visits. The provider said these arrangements would be reviewed after the outbreak.
“The registered manager confirmed that restrictions were in place prior to the outbreak with regards to the number of visits per day being offered, the times of day that visits could be facilitated and the duration.” from the report
- 01What changes have been made to make PPE readily available on every unit?
- 02How do you now make sure all staff wear masks correctly and follow the current PPE procedure?
- 03How quickly is whole-home COVID-19 testing completed when there is an outbreak?
- 04How are people who may need to cohort supported when COVID-19 cases are found on their unit?
- 05What are the current visiting arrangements, and what changed after the review promised in this report?
This was a targeted inspection of infection prevention and control and staffing pressures during a COVID-19 outbreak; it was not a full inspection of all five key questions and the service was not rated. This explanation was written from the published report of 22 February 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, August 2018
Rated Good overall; inspectors found kind, safe care and Outstanding support for activities and personal interests, with some records and staffing issues to watch.
The inspection was unannounced and took place on 24 July 2018. Inspectors observed care, spoke with people, relatives, staff and health and community services, and reviewed care records, medicines records, training records and quality checks.
People told inspectors they felt safe and were treated kindly. Staff understood people's needs, medicines were managed safely, health needs were met and there were enough staff on duty at the time of the visit. The report also noted 350 vacant staff hours each week, mainly covered by bank staff and overtime.
The home was rated Good for Safe, Effective, Caring and Well-led. It was rated Outstanding for Responsive because people had many varied opportunities, including activities, outings and support to achieve personal wishes. The overall rating was Good, the same as at the previous inspection in June 2016.
Personalised activities
People were offered a wide range of activities, outings and experiences. Staff made serious efforts to support individual dreams and interests, including wishes that required creative planning.
“The service had continued to improve on ensuring people had many and varied opportunities to engage in activities that made their lives more interesting and meaningful.” from the report
Kind and respectful staff
People and relatives described staff as caring. Inspectors saw staff offering choices, protecting privacy and building positive relationships.
“Staff had developed positive and caring relationships with people they clearly knew well.” from the report
Safe medicines support
Medicines were stored, administered and checked safely. Staff received training and their competence was checked.
“There were suitable arrangements for the safe storage, management and disposal of medicines and people were supported to take their medicines by trained staff.” from the report
Good health and nutrition support
People were supported to eat and drink enough, and received access to health professionals when needed.
“People's day to day health needs were met in a timely way and they had access to health care and social care professionals when necessary.” from the report
Vacant staff hours
needs fixingThe manager reported 350 vacant staff hours each week. These were mainly covered by bank staff and overtime, so ask whether this affects familiar staffing or the support available at busy times.
“The registered manager said these vacant hours were mainly covered by bank staff and by overtime” from the report
Emergency evacuation information
needs fixingPersonal emergency evacuation plans did not always explain fully how each person should be supported during a fire. Staff could describe the required support, but the written information needed improvement.
“Whilst these documents would benefit from more information about how people should be supported to evacuate the home or to move to a safe zone in the event of a fire” from the report
Care records
needs fixingThe quality of care plan information varied. Daily records did not always show clearly that people had received their personal care and support as they wished.
“Daily records were not always informative and did not always provide assurances that people had received their personal care and support as they wished.” from the report
- 01How are the 350 vacant staff hours each week covered, and will my relative usually be supported by familiar staff?
- 02What changes have been made to personal emergency evacuation plans since this inspection?
- 03How do you now check that daily records accurately show the personal care and support each person received?
- 04How will you make sure activities are tailored to my relative's interests, abilities and wishes?
- 05How are relatives involved in care plan reviews and decisions about future care?
This was an unannounced comprehensive inspection covering all five CQC questions and both the premises and care provided. This explanation was written from the published report of 14 August 2018 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 Fosse House
3 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- February 2022Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- August 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- August 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 6 January 2011.
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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