CQC report explained · a nursing home
What the CQC found at Fountain Lodge Care Home Limited
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Risk assessments, infection-control arrangements, staffing, recruitment and medicines systems were found to be suitable.
- Effective?
- Good
- People's needs, choices, nutrition and hydration were assessed and reviewed. Staff had training and support, and healthcare professionals were involved when needed.
- Caring?
- Good
- Staff were kind and respectful. People and relatives were involved in care planning, and inspectors saw people's dignity, privacy, independence and personal choices being supported.
- Responsive?
- Good
- Care plans reflected people's preferences, communication needs and health needs. People could take part in activities, maintain relationships and raise complaints.
- Well-led?
- Requires improvement
- Management and quality systems had improved, but inspectors said more time was needed for the changes to become established. The provider was no longer in breach of the regulations identified at the previous inspection.
What inspectors found, April 2022
Rated Good overall and no longer in special measures, but well-led Requires Improvement while recent improvements become established.
This was an unannounced follow-up inspection on 12 January 2022. Inspectors spoke with people living at the home, relatives, staff and health and social care professionals. They observed care and checked care plans, medicines, staff recruitment records and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found people were protected from abuse, risks were assessed, staffing was suitable and medicines were managed safely. Staff were trained and kind, and people were involved in their care and supported with food, activities, healthcare and communication.
Well-led was rated Requires Improvement. The provider had introduced stronger checks and an action plan, but inspectors said more time was needed for these changes to become established. The home had previously been rated Requires Improvement overall, with breaches, and had been in special measures since July 2021. It was no longer in breach and was no longer in special measures after this inspection.
Risk and safeguarding
The home had up-to-date risk assessments and staff knew how to recognise and report abuse. Accidents and incidents were reviewed so action could be taken.
“Care plans included up to date and comprehensive individual risk assessments which gave staff the information they needed to maintain people's safety.” from the report
Kind and respectful staff
People and relatives described staff as kind, friendly and attentive. Inspectors saw considerate care and support for people's dignity and independence.
“We observed staff supported people with consideration and compassion.” from the report
Personalised care
People and relatives helped create and review care plans. These included personal preferences, communication methods, activities and end-of-life wishes.
“People and relatives were involved in the development of their care plans which included their likes, dislikes, hobbies and interests.” from the report
Improved management systems
The provider introduced an action plan and new audits involving staff and managers. These changes helped address the problems found at the previous inspection.
“The provider and registered manager had established new, robust systems for auditing safety and quality within the service to continue to drive improvement.” from the report
Infection control
Inspectors were assured that the home had suitable arrangements for visitors, protective equipment, testing, hygiene and managing infection outbreaks.
“We were assured that the provider was making sure infection outbreaks can be effectively prevented or managed.” from the report
Leadership improvements still need to settle
needs fixingAlthough management and governance had improved, the rating for well-led remained Requires Improvement. Inspectors wanted the new systems to be consistently established over a longer period.
“a longer period of time was needed for the changes made to become embedded in the service.” from the report
- 01How have the new safety and quality audits been kept up to date since the inspection?
- 02What evidence can you show that the improvements in management and governance are now fully established?
- 03How are accidents, incidents and safeguarding concerns reviewed, and how are lessons shared with staff?
- 04How will you involve our family member and us in reviewing their care plan and end-of-life wishes?
- 05What are the current visiting arrangements and infection-control requirements?
This was an unannounced follow-up inspection that reviewed action from the previous inspection and included infection prevention and control; the report gives ratings for all five key questions. This explanation was written from the published report of 6 April 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, July 2021
Fountain Lodge Care Home Limited is rated Requires Improvement, with Safe Requires Improvement and Well-led Inadequate after repeated failures to improve.
This was an unannounced, focused inspection on 6 May 2021. Two inspectors and a specialist nursing adviser visited the home. They spoke with people, relatives and staff, and checked care, medicine, recruitment and management records.
Inspectors found enough staff, safe medicine arrangements and good infection control. People said they felt safe and relatives were happy with the care. The home had also improved some areas of its environment and helped people keep in touch with relatives during COVID-19 restrictions.
There were serious weaknesses in management oversight. Potential abuse incidents had not always been referred to safeguarding teams, some care records conflicted, and checks did not reliably lead to improvements. Safe remained Requires Improvement, while Well-led fell from Requires Improvement to Inadequate. The overall rating remained Requires Improvement.
Enough staff
Inspectors found enough staff to support people safely. Recruitment checks were also described as robust.
“There were enough staff to support people safely.” from the report
Medicines
Medicines were ordered, stored, given and disposed of safely. Staff who administered them had training and competency checks.
“Medicines were ordered, stored, administered and disposed of safely.” from the report
Infection control
Inspectors were assured that the home followed infection control measures, including PPE, testing, cleaning and visiting arrangements.
“We were assured that the provider was using PPE effectively and safely.” from the report
Possible abuse was not referred
seriousFour unexplained injuries involving one person and an injury during hoist use had not been referred to the local safeguarding team. Inspectors said staff training had not been effective enough.
“These incidents had not been identified as potential abuse and had not been referred to the local safeguarding team for investigation as legally required.” from the report
Conflicting care information
needs fixingSome records gave conflicting information about people's care, support and health needs. This meant staff might not have had accurate information to use.
“Some people's records contained conflicting information about their care, support and health needs.” from the report
Weak management checks
seriousQuality checks did not reliably identify problems or show whether actions had been completed. This contributed to the breach of good governance requirements.
“The provider's systems to monitor the quality and safety of the service remained ineffective.” from the report
Failure to notify CQC
seriousThe registered manager had not told CQC about six incidents that should have been reported, including allegations of abuse.
“We identified six incidents which we had not been informed of.” from the report
- 01How are all possible abuse incidents and unexplained injuries now identified, recorded and referred to the local safeguarding team?
- 02How do you make sure care records do not contain conflicting information about a person's needs?
- 03What quality checks are now in place, and how can you show that actions are completed and reviewed?
- 04What additional training or competency checks have staff received for moving people safely with a hoist?
- 05How are significant incidents now reported to CQC within the required timescale?
This was a focused inspection of Safe and Well-led only; the other ratings were carried over from previous comprehensive inspections. This explanation was written from the published report of 30 July 2021 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 Fountain Lodge Care Home Limited
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- April 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fountain Lodge Care Home Limited →
- July 2021Requires improvementSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at Fountain Lodge Care Home Limited →
- September 2020Inspected but not ratedSafe: Inspected but not rated
- May 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- March 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 1 February 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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