CQC report explained · a nursing home
What the CQC found at Frome Care Village
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, September 2023
Rated Requires Improvement; inspectors found staffing, training, cleanliness and management oversight problems, although people were usually treated kindly.
This was an unannounced, focused inspection after concerns about management and staff skills. Inspectors visited on 23 May, 2 June and 8 June 2023. They spoke with people living there, relatives, staff and health professionals, and checked care, medicines, staffing and management records.
The inspection found that there were not always enough staff on the Woodlands unit. This led to waits for care, limited activities, less sociable mealtimes and some people spending more time in bed than they wanted. Some staff training was overdue, parts of the home were not clean, and some medicines records were incomplete.
The home was rated Requires Improvement for Safe and Well-led. This means some parts of the service were not always safe and there was limited assurance about safety. It was the third consecutive inspection where the overall rating was below Good. The provider said staffing had since increased, some training had been completed and further improvements were planned.
People felt safe
People told inspectors they felt safe. Staff were confident about reporting abuse concerns, and visiting professionals had not seen poor practice.
“People were protected from the risk of harm and abuse as staff were confident in reporting any concerns to the management team.” from the report
Kind and respectful staff
Most people were satisfied with their care. Inspectors saw staff treating people in a supportive and respectful way.
“People spoke positively of the culture of the service, which was described as calm, and friendly or jolly.” from the report
Risks were monitored
Care records covered risks such as falls, skin damage, dehydration, malnutrition and choking. Staff shared changes in people's needs at daily meetings.
“Risks to people's safety were identified and managed.” from the report
Open approach to concerns
The manager was described as approachable. Relatives said they were told about changes or incidents and that complaints had been handled well.
“The manager was open, and willing to listen and act on any concerns.” from the report
Not enough staff
seriousStaffing and deployment on Woodlands did not always meet people's needs. This affected waiting times, personal care, meals, activities and people's ability to get out of bed.
“There were not enough staff on duty and staff were not always appropriately deployed to support people in a timely and person-centred way on the Woodlands unit.” from the report
Overdue training
seriousTraining in several areas was overdue, including basic life support, diabetes, end of life care and wound care. Some staff in clinical roles had not completed all training recommended for their role.
“Training in relation to learning disability, basic first aid and life support, diabetes, end of life care, catheterisation and wound care management was overdue.” from the report
Cleanliness and maintenance
needs fixingSome bedrooms, carpets, equipment, furniture and communal areas were not clean, and some areas had a strong smell. Cleanliness improved significantly by the second day, but cleaning records had gaps.
“Some areas of the premises were not clean.” from the report
Weak quality checks
seriousThe home's audits did not identify problems with staffing, cleanliness and person-centred care. Inspectors found that improvements from the previous inspection had not been sustained.
“The systems in place were not entirely effective to monitor, review and improve the quality of the service.” from the report
Routines were not always personal
needs fixingMany people were supported in bed and it was not always clear why. Some people did not have access to a call bell, and inspectors recommended reviewing daily routines.
“We recommend daily routines are reviewed to ensure person-centred care and support is consistently delivered to people living at the service.” from the report
Medicines records
needs fixingRecords did not always show the time that 'when required' medicines were given, or the action taken when storage temperatures were outside the recommended range.
“Times of administration were not always recorded for these medicines, so that it was not always possible to show that a suitable time gap was left between doses.” from the report
- 01How many staff are now deployed on the Woodlands unit at different times of day, and how do you adjust this when people need two staff for moving or meals?
- 02Which staff are currently working in nursing or clinical roles, and have they completed all the training and competency checks required for those roles?
- 03What has changed in the cleaning checks, and how do you make sure the home stays clean every day?
- 04How do you now check that people are helped out of bed, offered activities and given access to a call bell where needed?
- 05What action has been taken to improve recording of 'when required' medicines and medicine storage temperatures?
This was an unannounced focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 2 September 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, July 2022
Rated Requires Improvement; inspectors found improvements, but cleanliness, fire safety work, medicines storage and oversight still needed attention.
This was an unannounced focused inspection on 26 and 28 April 2022. Inspectors spoke with 10 people living at the home, five relatives and 11 staff. They reviewed care and medicines records, two recruitment files and records about how the home was managed.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. Inspectors found improvements since the previous inspection, including better staffing, safer premises in many areas and improved communication. However, some areas in The Parsonage needed cleaning, food safety checks were not reliable and some medicines had been stored above the recommended temperature.
The home had not completed all work required by the fire service and had asked for more time. Recruitment checks had gaps, and the home's monitoring systems had not identified some of the problems inspectors found. The provider was no longer in breach of Regulations 15 and 17 at this inspection, but further improvement was still needed.
Safeguarding
Staff knew how to recognise and report abuse. The home reported safeguarding concerns as required and staff said learning was shared.
“There were effective safeguarding systems in place. Staff knew how to identify abuse and were aware of how to report it.” from the report
Risk management
People had individual risk assessments covering areas such as moving and handling, health conditions and pressure ulcers. Plans were also in place for people who could become anxious or pose a risk.
“Risks to people had been assessed and recorded. People had individual risk assessments.” from the report
Improved staffing
People and relatives said there were enough staff. Agency use had reduced, and staffing had improved since the previous inspection.
“Staffing has very much improved.” from the report
Positive staff culture
Staff spoke positively about working at the home and felt able to raise concerns. Relatives also gave positive comments about the staff team.
“If there are any problems you can raise them, and they are listened to.” from the report
Improved environment
The home had carried out refurbishments, repairs and changes to rooms and décor. Inspectors found Woodlands cleaner than at the previous inspection.
“Improvements had been made overall to the premises and environment.” from the report
Cleanliness and food safety
needs fixingSome areas of The Parsonage needed cleaning, including carpets, bins and kitchen areas. Fridges and freezers were not clean, and food was not always labelled or kept under regularly checked temperatures.
“This meant the provider could not be assured food and drink was safe for people to consume.” from the report
Incomplete fire safety work
seriousThe fire service had set requirements after an earlier inspection. Not all the work had been completed, and the provider had requested another extension.
“The fire service contacted us to inform us not all of the work had been completed and the provider had requested an additional extension.” from the report
Medicines storage temperatures
seriousMedicines rooms in The Parsonage were recorded as being above the recommended temperature several times. Staff had not acted until inspectors raised the issue.
“The temperature of the medicines rooms in Parsonage were recorded as being above the recommended temperature on several occasions in April 2022.” from the report
Recruitment records
needs fixingTwo staff files did not show that the previous employer had been contacted for verification, despite this being part of the home's recruitment procedure.
“However, we found two people whose previous employer had not been approached for verification in line with the providers recruitment procedure.” from the report
Quality monitoring
needs fixingAudits and action plans were in place, but they had not identified some of the cleanliness, food safety and records problems found by inspectors.
“These had not been identified by the quality monitoring systems in place.” from the report
- 01What work required by the fire service is still outstanding, and what is the new completion date?
- 02How are cleanliness checks in The Parsonage now recorded and independently checked?
- 03How are fridge, freezer and food temperatures monitored, and what happens if a temperature is too high?
- 04How do you make sure medicines are stored at the correct temperature every day?
- 05Who is currently managing the home, and what is the progress with the manager's application to become registered?
This was a focused inspection of Safe and Well-led only; the other three key question ratings were not assessed in this report. This explanation was written from the published report of 1 July 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.
Every inspection of Frome Care Village
5 rated inspections over 6 years: the service has held its Requires improvement rating throughout.
- September 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2022Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- October 2021Requires improvementSafe: Requires improvementWell-led: Requires improvement
- December 2020Inspected but not ratedSafe: Inspected but not rated
- August 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- February 2016
Registered with the Care Quality Commission on 1 February 2016.
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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