CQC report explained · a nursing home
What the CQC found at Fountain Nursing and Care Home Limited
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, February 2020
Fountain Nursing and Care Home Limited was rated Good; inspectors found safe, effective and responsive care, but caring was not always consistent.
This was an unannounced comprehensive inspection on 27 January 2020. Inspectors reviewed care records, medicines, staff files, training, complaints and management checks. They spoke with people living in the home, relatives, staff and the manager, and observed care.
The home was rated Good overall. Safe, Effective, Responsive and Well-led were all rated Good. Inspectors found that people generally received personalised care, had access to health professionals and were supported by trained staff.
Caring was rated Requires Improvement. Inspectors saw delays when one person needed help to use the toilet. They also saw an out-of-date newspaper being given to a resident and four people with dementia sitting near a television that was not working properly.
Personalised care
Care plans recorded people's individual needs and preferences. Staff knew people's life histories and how they liked to be supported.
“Care plans were personalised to the individual and recorded details about each person's specific needs and how they liked to be supported.” from the report
Safety improvements
The home had addressed several problems found at the previous inspection. Inspectors found secure doors and gates, working call bells and safer wheelchairs.
“At this inspection we saw doors and gates were secure and cleaning material were safely secured and call bells were working.” from the report
Skilled staff
Staff had relevant training and qualifications, with induction, supervision and refresher training in place.
“People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs.” from the report
Management checks
The manager used audits in areas such as medicines, infection control and care plans. Inspectors found that identified improvements were acted on.
“Improvements had been made and a variety of audits were completed within the home.” from the report
Delays in getting help
needs fixingOne person in a lounge had no call bell and waited for assistance to use the toilet. Staff did eventually help safely, but there was a further delay while a second carer was found.
“The resident began shouting for assistance however no staff members entered the lounge.” from the report
Care was not always dignified
needs fixingInspectors saw an out-of-date newspaper given to a resident and four people with dementia facing a television that was flashing and not working properly.
“We also observed four residents all diagnosed with dementia sitting in a lounge facing a television which was not working.” from the report
Missing decision-making records
needs fixingSome care plans did not contain legal power of attorney documents. The manager said this information was being obtained from relatives.
“We found that some care plans lacked legal power of attorney documentation, this information confirms who has the legal right to make decisions on behalf of someone who lacks capacity.” from the report
- 01How will you make sure every lounge is monitored and that people can get prompt help when there is no call bell?
- 02What checks are made to ensure people with dementia have a comfortable, suitable environment and working equipment?
- 03How do you monitor whether staff consistently treat people with dignity and respect?
- 04Have all missing power of attorney documents now been obtained and added to the relevant care plans?
- 05How will you maintain the improvements made since the previous inspection?
This was an unannounced comprehensive inspection covering all five CQC questions; Safe and Well-led improved from Requires Improvement, Effective and Responsive remained Good, and Caring fell from Good to Requires Improvement. This explanation was written from the published report of 19 February 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.
What inspectors found, February 2019
Rated Requires Improvement; inspectors found kind and responsive care, but safety and leadership systems were not consistently reliable.
This was an unannounced inspection on 16 January 2019. Inspectors spoke with people, relatives, staff and a visiting professional. They reviewed care plans, medicines, staff recruitment records, audits and other records.
People generally said they felt safe and well cared for. Inspectors found good care in the areas of effectiveness, kindness and responsiveness. Medicines were managed safely, people had access to food, drink and health professionals, and their choices, dignity and preferences were respected.
The overall rating was Requires Improvement. Staff were not always following infection control procedures. Some call bells, wheelchairs, doors and storage arrangements needed attention. Staff did not always receive refresher training or supervision, and management checks had failed to identify or act on some problems.
The home had the same overall rating as at the previous inspection. The report says some earlier concerns had been addressed, including medicines management and privacy and dignity. No enforcement action was required.
Kind and respectful care
People and relatives spoke positively about the staff. Inspectors saw staff supporting people patiently, protecting their dignity and encouraging independence.
“People told us they were treated with kindness and were positive about the staff's caring attitude.” from the report
Safe medicines practice
Medicines were stored and disposed of safely. Records showed people received medicines at the right times, including medicines given when needed.
“Medication was stored and disposed of safely and records showed that people received their medication at the right times.” from the report
Personalised support
Care plans reflected people's preferences and were updated when needs changed. People could make everyday choices and take part in a wide range of activities.
“Peoples' needs had been assessed and care and support was provided in line with these assessments and peoples' preferences.” from the report
Good end of life support
Care plans included individual wishes, including religious preferences and funeral arrangements. Staff had received end of life care training.
“Care plans contained information in relation to people's individual wishes regarding end of life care, including religious preferences and who they wanted to arrange their funeral.” from the report
Infection control
seriousStaff were not consistently following cleaning and infection control procedures. Some toilets and bathrooms also had no soap.
“People were not consistently protected from the risk of infection because staff were not following the correct procedures for cleaning and infection control.” from the report
Environmental safety
seriousSome doors and gates were unlocked, including doors to the kitchen and cleaning storage cupboards. Some call bells were not working, and most communal wheelchairs lacked footplates.
“Some people were living with dementia and were therefore at risk from harm.” from the report
Training and supervision
needs fixingMost staff had not completed planned refresher training in areas including health and safety and dementia awareness. Supervision sessions were also not happening in line with policy.
“Staff did not complete training in line with the provider's schedule.” from the report
Weak management checks
needs fixingAudits did not identify some problems found during the inspection, and known low completion rates for training and supervision had not improved. DoLS renewals were not always submitted on time.
“Some audits had been completed but had not been followed by appropriate action.” from the report
Limited involvement in improvement
minorThere was little evidence that people or staff were regularly involved in giving feedback to develop the home. Feedback that had been collected had not been analysed or linked to improvement plans.
“There was little evidence that people or staff had been involved or engaged on a regular basis in giving feedback to develop the service.” from the report
- 01What action has been taken to ensure staff follow the correct infection control procedures, including using the right bins, mops and buckets?
- 02Are all call bells now working, and how are they tested and repaired?
- 03Do all communal wheelchairs now have safe footplates, so people can access the dining room and other areas?
- 04How are doors, gates and cupboards containing cleaning materials kept secure, particularly for people living with dementia?
- 05How are staff refresher training, supervision and action from audits now monitored?
This was an unannounced inspection covering all five CQC questions, with both the premises and care provided examined. This explanation was written from the published report of 16 February 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 Fountain Nursing and Care Home Limited
6 rated inspections over 5 years: the service has held its Good rating throughout.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: Requires improvementResponsive: GoodWell-led: Good
Read what inspectors found at Fountain Nursing and Care Home Limited →
- February 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fountain Nursing and Care Home Limited →
- August 2017Requires improvementdown from GoodSafe: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- April 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- December 2014GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 5 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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