CQC report explained · a nursing home
What the CQC found at Fountains Lodge Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found safe care, suitable staffing, safe medicines systems, good infection control and arrangements to learn from accidents and incidents.
- Effective?
- Good
- Staff had suitable induction, training and supervision, and knew how to meet people's needs. People were supported with food, drinks, healthcare and decisions about their care.
- Caring?
- Good
- People and relatives were positive about the care. Staff were described as kind, polite and respectful, and people were supported to make choices and maintain their privacy and independence.
- Responsive?
- Good
- Care was personalised and responded to people's needs, interests and communication needs. Improvements included more accessible care information, menus and complaints information.
- Well-led?
- Good
- The home had quality checks, staff meetings and systems to respond to concerns and incidents. Leaders had improved the way staffing levels were assessed and involved people and relatives in developing the service.
What inspectors found, July 2019
Rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
This was an unannounced inspection on 19 and 20 June 2019. The inspection team spoke with people living in the home, relatives and staff. They reviewed care records, medicines, recruitment, training, complaints and checks on quality.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines systems, suitable training and good infection control. People were treated with dignity, involved in decisions and supported with activities, food, healthcare and end-of-life care.
The home had improved since earlier inspections. Effective, Responsive and Well-led had previously been Requires Improvement and were now Good. The report says improvements had been made to staff supervision, care plans, accessible information and staffing decisions.
Safety
Inspectors found that people were protected from abuse and avoidable harm. Risks were assessed and managed, including risks linked to mobility, skin care and falls.
“People were safe and protected from avoidable harm. Legal requirements were met.” from the report
Kind and respectful care
People were treated with dignity and respect. Staff supported people's choices, privacy, independence, communication and personal routines.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Strong leadership
Leaders used audits and feedback to monitor care and make changes. Staffing decisions took account of people's needs, call-bell response times and the layout of the building.
“The service was consistently managed and well-led. Leaders and the culture they created had promoted high-quality, person centred care.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now decide how many nurses and care staff are needed at different times of day and night?
- 02How often do staff receive supervision, and how is their practical care observed and reviewed?
- 03How will information, menus and complaints details be provided in the format my relative can understand?
- 04How do you involve relatives and healthcare professionals when someone cannot make an important care decision?
- 05How do you check that end-of-life medicines are available and that people's wishes are followed?
This was an unannounced planned inspection covering all five CQC questions; the report also records improvements from earlier inspections. This explanation was written from the published report of 16 July 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.
What inspectors found, July 2018
Rated Requires Improvement; the home had improved from Inadequate and special measures, but inspectors wanted more evidence that improvements would last.
Inspectors visited unannounced on 22 and 23 March 2018. They spoke with people, relatives, managers and staff. They observed care and checked care plans, medicines, staff records, rotas and quality checks.
The home was rated Good for Safe and Caring. Inspectors found safe staffing, medicines management and risk assessments. They saw kind care that respected people's privacy, dignity and choices.
The home was rated Requires Improvement for Effective, Responsive and Well-led. Staff supervision was not always of a high enough quality. Some care information was difficult for people to understand. Inspectors also wanted proof that the improved systems would continue to work over time.
At the previous inspection in June 2017, the home was Inadequate and in special measures. This inspection found that all the earlier breaches had been met, so the home was no longer in special measures.
Safe staffing
Inspectors found enough staff to meet people's needs. The home had also reduced its use of agency staff and improved consistency.
“There were sufficient staff deployed to keep people safe and meet their needs.” from the report
Kind and respectful care
Staff were seen to support people warmly and compassionately. They respected privacy and dignity and encouraged people to remain independent where safe.
“People were treated with kindness and compassion in their day to day care.” from the report
Personalised activities
Activities were varied and included group and one-to-one sessions. Staff used people's interests to plan activities, including outings and gardening.
“The service employed three activities coordinators, including an activities coordinator working at weekends to ensure people had meaningful occupation.” from the report
Learning from mistakes
The home investigated accidents and medicine errors and shared learning with staff. Changes included protected medicine rounds to reduce interruptions.
“Lessons had been learned when things went wrong in the service.” from the report
Staff supervision
needs fixingSome supervision records from 2017 were vague, reactive and not well structured. The home was recommended to supervise staff to a consistently high standard.
“We recommend that the registered manager supervises staff to a consistently high level.” from the report
Information was hard to understand
needs fixingSome care plans, menus, activity information and complaints information used small print and standard formats. Inspectors said much of this was inaccessible to people.
“The service was not meeting the accessible information standard and some people's care plan documentation was not written in a way they could understand.” from the report
Improvements needed to last
needs fixingQuality monitoring had improved, but inspectors wanted evidence that this improvement would continue over time and when more people were admitted.
“However, there were several vacancies in the service and we will need to be able to evidence that improvements can be sustained over time, and if and when the service admits new people.” from the report
- 01How are you checking that staff supervision remains consistently high quality?
- 02What have you changed to make care plans, menus, activity information and complaints information easier for residents with dementia to understand?
- 03How will you show that the improved quality monitoring continues to work if more people move into the home?
- 04How many staff vacancies remain, and how are you maintaining consistent staffing while filling them?
- 05How are residents and their families involved in reviewing care plans in a format they can understand?
This was an unannounced inspection of the whole care home, including accommodation, care and the five key questions. This explanation was written from the published report of 3 July 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Fountains Lodge Care Home
4 rated inspections over 4 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Requires improvementup from InadequateSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- December 2017Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: OutstandingWell-led: Good
- October 2014
Registered with the Care Quality Commission on 13 October 2014.
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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