CQC report explained · a residential care home
What the CQC found at Francis House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were assessed and managed, and staff knew how to respond to safeguarding concerns and emergencies. Medicines were generally managed safely, but the report records previous medicine errors and incomplete employment dates in 3 of 4 staff files reviewed.
- Effective?
- Good
- This question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Caring?
- Good
- This question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Responsive?
- Good
- This question was not inspected during this visit. Its previous rating was used to calculate the overall rating.
- Well-led?
- Good
- Inspectors found effective management, governance and communication arrangements. The culture was described as open, positive and inclusive, with people, relatives and staff involved in the service.
What inspectors found, December 2023
Rated Good; inspectors found safe, well-managed care, but noted recent medicine errors and gaps in staff recruitment records.
This was an unannounced focused inspection on 16 November 2023. One inspector spoke with people living at the home, relatives, staff and the registered manager. They reviewed care plans, medicine records, staffing files, meeting records and checks on quality and safety.
Safe and Well-led were both rated Good. Inspectors found that risks were assessed, medicines were generally managed safely, the home was clean, and emergency and safeguarding arrangements were in place. People and relatives said they felt safe and were positive about staffing.
Inspectors also found some issues. Medicine errors had happened before the inspection, although no one was harmed, and 3 of 4 staff files did not contain full dates for previous employment. The home took action after these findings.
The overall rating stayed Good because the other three questions were not inspected at this visit. Their previous ratings from the comprehensive inspection published on 30 August 2018 were used.
Safety planning
Risks linked to people's health, mobility, the environment and equipment were assessed and reviewed. Staff understood how to follow people's care plans and emergency procedures.
“Risks to people's safety associated with their health condition, environment and any equipment used, were assessed and managed in a timely manner.” from the report
Clean and hygienic home
Inspectors found the home, furnishings and care equipment visibly clean. Staff had suitable cleaning routines and supplies of protective equipment.
“All areas of the home, furnishing and any equipment used for people's care were visibly clean and hygienic.” from the report
Person-centred culture
People and relatives said staff knew them well and understood what mattered to them. Inspectors found that independence, dignity and individual preferences were taken seriously.
“People and relatives told us staff knew people well and what was important to them for their care.” from the report
Incomplete employment histories
needs fixingThree of the four staff files reviewed did not contain full dates for previous employment. This could make it harder to identify or investigate gaps before staff are appointed, although the home agreed to correct this.
“However, in 3 out of 4 staff files we looked at, full dates of their previous employment listed, were not always obtained for the purposes of their job application.” from the report
Recent medicine errors
needs fixingThe home told inspectors about a series of medicine errors before the inspection. No one was harmed, and extra training, competency checks and management checks had been introduced.
“Before this inspection, the registered manager told us about a series of medicines errors, which had occurred at the service, with no resulting harm to any person.” from the report
- 01What medicine errors happened, and how will you show that the extra training and competency checks are preventing a repeat?
- 02Have all staff employment applications now been updated with full previous employment dates?
- 03How often are medicine records and medicine practices checked by management?
- 04Which ratings were carried forward from the 2018 comprehensive inspection rather than assessed during this visit?
- 05How are people and relatives involved when changes or improvements to care are planned?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection published in 2018. This explanation was written from the published report of 16 December 2023 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
Francis House was rated Good; inspectors found safe, kind and individualised care, with a review needed of night staffing arrangements.
This was a comprehensive, unannounced inspection on 24 May 2018. The inspector spoke with people living there, a relative, staff, managers and a visiting social care professional. They observed care and checked care plans, medicines records and records about safety and management.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People said they felt safe and were happy with the care. Inspectors found staff were kind, respectful and supported people's choices, independence, health needs and preferred routines.
There were no serious risks or concerns identified. The home agreed to review lone working and staff deployment at night. Inspectors also noted a previous medicines safety incident where no one was harmed, and said improvements had been made afterwards.
The Good rating means the evidence supported care that met the required standards at the time of this inspection. It was the same overall rating as at the previous inspection in October 2015. End of life care was not assessed because nobody was receiving it during the visit.
Kind and respectful care
Inspectors found that staff formed good relationships with people and treated them with patience, respect and compassion.
“We saw this was so throughout our inspection and found that staff treated people with patience, respect and regularly showed compassion and good humour.” from the report
Personalised support
Staff followed people's preferred routines, interests and communication needs. They supported people to make choices and remain as independent as possible.
“People continued to receive individualised care, which met with their wishes, preferred daily living routines and lifestyle choices.” from the report
Health and rehabilitation support
Staff helped people access health professionals and supported a person's goal to regain independent living skills through planned, stepped tasks.
“This was done in consultation with them and a relevant external health professional; to support the person's rehabilitation and goal for independent living.” from the report
Good quality oversight
Managers checked care, medicines, incidents, complaints and safety, and staff were updated about changes to procedures.
“The registered manager and an external manager for the provider, regularly checked the quality and safety of people's care at the service.” from the report
Night staffing arrangements
needs fixingThe home agreed to review lone working and how staff were deployed at night. This was intended to provide further assurance about people's safety.
“Management action was agreed, to review staff lone working and deployment arrangements at night, to further ensure people's safety.” from the report
Previous medicines incident
needs fixingA medicines safety incident had occurred before the inspection. No one was harmed, and the home introduced revised procedures, training, supervision and checks.
“Whilst no harm resulted to any person receiving care, their subsequent management review of the incident, found improvements were needed to help prevent any future re-occurrence.” from the report
Delay in notification
minorThe provider usually sent CQC notifications about important events, but there had been a delay on one occasion.
“With the exception of a delay; the provider usually sent us notifications about important events when they happened at the service.” from the report
- 01What changes were made after the review of lone working and staff deployment at night?
- 02What happens if the member of staff working alone at night becomes seriously unwell?
- 03What changes were made after the previous medicines safety incident, and how are medicines checks monitored now?
- 04How do you make sure care plans still reflect each person's routines, communication needs and independence goals?
- 05How would you support someone needing end of life care, which was not assessed during this inspection?
This was a comprehensive inspection covering all five rating areas, but end of life care was not assessed because nobody was receiving it during the visit. This explanation was written from the published report of 30 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 Francis House
3 rated inspections over 8 years: the service has held its Good rating throughout.
- December 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2018Goodstayed GoodSafe: GoodWell-led: Good
- October 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 24 April 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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