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What the CQC found at Fotherby House

Outstandingpublished 5 December 2019, 6 years ago

Rated Outstanding: inspectors found the home performing exceptionally well.

The five questions inspectors ask
Safe?
Good
Inspectors found enough staff, safe recruitment, appropriate safeguarding arrangements and care plans that identified risks. Medicines and infection control were managed safely.
Effective?
Good
People's needs and preferences were assessed, staff were trained and people were supported with food, drinks and healthcare. Inspectors found the Mental Capacity Act and related safeguards were being followed.
Caring?
Outstanding
People were treated with kindness, dignity and respect. Staff knew people well and supported their independence, personal identity, family relationships and individual choices.
Responsive?
Outstanding
Care and activities were tailored to people's histories, interests and communication needs. People were supported to maintain relationships, follow their beliefs and receive personalised end-of-life care.
Well-led?
Good
The provider and manager created an open, inclusive culture and used audits, feedback, complaints and incidents to improve care. Staff said they were supported and clear about their roles.
The latest report, explained

What inspectors found, December 2019

Rated Outstanding overall; inspectors found exceptionally caring and responsive support, with safe, effective and well-led care.

This was an unannounced planned inspection on 22 October 2019. One inspector spoke with people living at the home, relatives, staff, the cook and management. They observed care, meals, medicines and how people and staff interacted. They also reviewed care, medicine, recruitment and management records.

People told inspectors they were happy and felt safe. Staff were described as kind, compassionate and willing to do more than expected. Care was personalised, and people were supported to make choices, stay independent, keep relationships and take part in activities that mattered to them.

The home was rated Good for Safe, Effective and Well-led. Caring and Responsive were rated Outstanding. The overall rating was Outstanding, improved from Good at the previous inspection published in April 2017. Inspectors found medicines, staffing, safeguarding, care planning and quality checks were well managed.

What inspectors praised
  • Kind and compassionate staff

    People and relatives described staff as exceptionally caring. Inspectors saw warm relationships and staff spending meaningful time with people.

    “People were supported by very kind, caring and compassionate staff who often went the extra mile to provide people with good, high quality care.” from the report
  • Personalised choices

    Staff knew people's likes, dislikes, histories and communication needs. People were involved in decisions about their care and daily lives.

    “People were supported to make decisions for themselves about how they spent their time and were offered choices about the range of food and drinks provided.” from the report
  • Meaningful activities

    Activities were based on people's past lives and interests. This included community visits, music, reminiscence and maintaining important relationships.

    “Staff told us how they had worked with the person to understand their life history to plan activities that they would be interested in participating in.” from the report
  • Good safety arrangements

    Inspectors found enough staff, safe recruitment, suitable risk plans and well-organised medicines systems.

    “There were enough staff to provide consistent safe care and support to meet people's needs.” from the report
What inspectors were concerned about
  • Planned maintenance

    minor

    Some hallway decoration and new carpets were planned or ordered at the time of the inspection. Ask whether this work has been completed and maintained.

    “We saw updated decoration for the homes communal hallways was planned to be completed soon and that new carpets had been ordered to be fitted in December 2019.” from the report
Questions to ask them, based on this report
  1. 01Have the planned hallway decoration and new carpets been completed, and are there any further maintenance works planned?
  2. 02What did the fire service review find, and have all recommended fire safety actions been completed?
  3. 03How would you tailor activities to my relative's interests, history, culture and communication needs?
  4. 04How will my relative and our family be involved in care plan reviews and decisions about care?
  5. 05How do you check that medicines are given safely and that any errors or shortfalls are dealt with quickly?

This was an unannounced planned inspection covering all five key questions, the premises and the care provided. This explanation was written from the published report of 5 December 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.

An earlier report, explained

What inspectors found, April 2017

Fotherby House was rated Good overall; inspectors found kind, safe care, with several shortfalls fixed after the visit.

This was an unannounced inspection on 10 March 2017. Inspectors spoke with people living in the home, relatives and staff. They observed care, reviewed four care records and checked staffing, training, medicines and quality checks.

All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safely managed medicines, suitable care and support, kind treatment, activities, healthcare support and fairly handled complaints.

Inspectors did find some problems. These included missing receipts for some personal spending, unsafe window latches, one incomplete recruitment check, a broken bathroom lock and less individual dementia support than planned. The home sent evidence that several physical and record-keeping problems had been fixed shortly after the inspection.

What inspectors praised
  • Kind and respectful care

    Inspectors saw staff treating people with compassion, kindness and respect. Staff took time to talk with people and support their wellbeing.

    “We saw that people were treated with compassion, kindness and respect.” from the report
  • Safe medicines and staffing

    Medicines were ordered, stored and given safely. There were enough staff on duty, and people received help without delay.

    “We found that there were reliable arrangements for ordering, storing, administering and disposing of medicines.” from the report
  • Good training and healthcare support

    Staff had introductory and refresher training and understood people's care needs. People were helped to see doctors and other healthcare professionals when needed.

    “We found that care staff had the knowledge and skills they needed to consistently provide people with the assistance they needed.” from the report
  • Activities and dementia support

    People were offered activities, trips and support with hobbies and interests. Staff used different approaches to help people living with dementia feel settled and involved.

    “Care staff promoted positive outcomes for people who lived with dementia.” from the report
  • Complaints handled properly

    The one formal complaint received in the previous year was investigated and answered appropriately.

    “Records showed that the concern had been properly investigated and that the complainant had received an informative and polite reply.” from the report
What inspectors were concerned about
  • Personal money records

    needs fixing

    Some spending from people's personal money was not backed by receipts. This reduced the assurance that money had always been used correctly, although the home said it had changed the process after the visit.

    “Although there was a record of each occasion on which money had been spent on a person's behalf some of these entries were not supported by receipts.” from the report
  • Window safety

    serious

    Some windows did not have safety latches to stop them opening too far. This increased the risk of injury or falls, and the home later sent photographs showing that latches had been fitted.

    “some of the windows were not fitted with safety latches to prevent them from opening too far.” from the report
  • Recruitment checks

    needs fixing

    Some background checks had not been completed for one new care worker. Other checks had been done, and the recruitment procedure was revised during the inspection.

    “they had not completed some of the background checks that need to be made before new care staff are appointed.” from the report
  • Bathroom privacy

    needs fixing

    One bathroom and toilet had no working lock, and the alternative sign was not used reliably. The home later provided evidence that a new lock had been fitted.

    “one bathroom/toilet did not have a working lock.” from the report
  • Individual dementia support

    needs fixing

    Individual support from the dementia support worker was not always provided as often as the manager believed was needed. The manager said this would be addressed straight away.

    “this individual support had not always been provided as frequently as the registered manager had assumed and considered to be necessary.” from the report
  • Quality checks

    needs fixing

    Some quality checks did not identify problems quickly enough. The home said it would strengthen its audits so future problems could be found and resolved sooner.

    “some quality checks had not always been effective in quickly putting problems right.” from the report
Questions to ask them, based on this report
  1. 01How do you now check that every item paid for from a resident's personal money has a receipt?
  2. 02When were the window safety latches and bathroom lock last checked, and how are these checks recorded?
  3. 03Are all recruitment checks completed before staff start work, including checks with previous care employers?
  4. 04How often will a person living with dementia receive individual support, and how will you show that it has happened?
  5. 05What extra quality audits were introduced after this inspection, and what action is taken when they find a problem?

This was an unannounced inspection covering all five CQC questions, with observations, discussions and checks of care and management records. This explanation was written from the published report of 26 April 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.

The story over the years

Every inspection of Fotherby House

3 rated inspections over 5 years: the service has improved, from Good to Outstanding.

  1. December 2019Outstandingcurrent ratingup from Good
    Safe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Good

    Read what inspectors found at Fotherby House →

  2. April 2017Goodstayed Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read what inspectors found at Fotherby House →

  3. January 2015Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read this report on cqc.org.uk

  4. August 2013

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  5. December 2012

    Report published without a new overall rating.

    Read this report on cqc.org.uk

  6. January 2011

    Registered with the Care Quality Commission on 25 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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