CQC report explained · a nursing home
What the CQC found at Fryers House - Care Home with Nursing Physical Disabilities
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, April 2019
Fryers House was rated Good; inspectors found very caring support, but staffing shortages and previous medicine errors needed close attention.
This was an unannounced inspection on 1 and 2 April 2019. Inspectors brought it forward by three months after concerns about medicine errors and two injuries that were not recorded promptly. They spoke with people, relatives, staff and health professionals, and checked care records, medicine records, recruitment files, audits and safety information.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were treated with kindness and dignity, received suitable nursing and personal care, and had access to healthcare, activities and personalised support.
There were still issues to watch. The home had many support worker vacancies and relied heavily on agency staff. A new electronic medicines system had reduced errors, but some system problems remained. Activities could be cancelled at weekends because of staffing shortages, and some water safety work was still awaiting approval.
Kind and respectful care
Staff were observed spending time with people, understanding non-verbal communication and treating people with warmth, dignity and respect.
“Staff were very busy but made time to ensure that people felt valued.” from the report
Personalised support
Care plans covered people's health, social needs, preferences and communication. Staff had time to read care plans before supporting people.
“All new staff, including agency staff, were given sufficient time to read and become familiar with peoples care plans before supporting them.” from the report
Good healthcare support
People had access to GPs, physiotherapy, nutrition advisers, hospital specialists and tissue viability nurses. Healthcare planning was proactive for people at risk of infections and other problems.
“There was proactive healthcare evident in people's care plans.” from the report
Clean and accessible home
The buildings were purpose-built and accessible. Inspectors found them clean, homely and in very good decorative order.
“The service was very clean and there were no unpleasant odours at any time during our inspection.” from the report
Staff vacancies and agency use
needs fixingThe home had many support worker vacancies and relied heavily on agency and bank staff. Two agency workers did not arrive on one inspection day, so an activity was rearranged and some support levels were changed.
“Due to having insufficient staff employed there was heavy use of agency staff.” from the report
Medicine recording system
needs fixingMedicine management was judged safe at the inspection after a new electronic system was introduced. However, the system still recorded some false errors and the provider was working with the supplier and pharmacy to fix problems.
“The EMAR system flagged an error for each medicine not administered by the home even though this was not an error.” from the report
Weekend activities
needs fixingActivities were planned every day, but staffing shortages meant that planned activities might not happen at weekends.
“Activities were planned for seven days per week however at weekends, due to staff shortages, activities may not take place as planned if there were insufficient staff to release to run them.” from the report
Outstanding water safety work
needs fixingWater safety was being monitored, but a contractor had identified work that was still outstanding. Quotes had been obtained, but approval to proceed had not yet been given.
“A contractor had risk assessed the water hygiene management in December 2018 and there were outstanding works following the assessment.” from the report
- 01How many support worker vacancies do you have now, and how often are agency staff used?
- 02What medicine errors or electronic medicines recording problems have occurred since the inspection, and how were they resolved?
- 03Have the outstanding water safety works identified in December 2018 been completed?
- 04How do you make sure people still receive activities at weekends when staffing levels are lower?
- 05How quickly are call bells answered during busy periods such as mornings?
This was an unannounced inspection of the whole care home, including the premises and care provided, and all five CQC questions were rated. This explanation was written from the published report of 30 April 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, February 2017
Rated Good overall; inspectors found safe, kind and responsive care, but the home needed to improve its leadership and consent records.
Inspectors visited without notice on 10 and 11 January 2017. They spoke with people living in the home, relatives, staff and a manager. They reviewed care records, medicines, training, complaints, incidents and quality checks.
The home was rated Good for safe, effective, caring and responsive care. People said they felt safe and were treated with dignity. Staff were suitably checked and trained, medicines were managed safely, and people received support with food, drink, healthcare and activities.
The well-led rating was Requires Improvement. Checks were in place but had not found that some risk reviews were overdue or that consent forms were unclear and completed incorrectly. The home had started introducing a new quality assurance process.
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs and saw staff respond promptly. Recruitment records showed the required checks had been completed before staff started work.
“There were sufficient staff deployed to support and meet the needs of the people living in the home.” from the report
Medicines were managed safely
People received medicines as prescribed. Staff had training and competency checks, and medicine records and audits were in place.
“People received their medicines as prescribed.” from the report
Kind and respectful care
People and relatives spoke positively about staff. Inspectors saw staff protect privacy and dignity and support people to do things for themselves.
“People were treated with dignity and respect and staff respected their right to privacy.” from the report
Personal care and activities
Care plans reflected people's needs and preferences. People were supported to take part in activities they enjoyed and to stay connected with their families and community.
“People were supported to follow their interests and take part in social activities.” from the report
Consent records were unclear
seriousThe home did not always record consent correctly. Some forms made it unclear whether a person had capacity to consent or whether a best-interests decision was needed.
“Consent to care forms had not been completed accurately and were confusing.” from the report
Quality checks did not find problems
needs fixingThe home's audits had not identified overdue risk reviews or the problems with consent records. A new quality assurance process was being introduced.
“These had not identified the concerns we found during this inspection.” from the report
- 01How do you check and record whether a person can consent to each part of their care?
- 02What happens if a person cannot consent, and how do you record a best-interests decision?
- 03Have all risk assessments and personal emergency evacuation plans been reviewed on time since this inspection?
- 04What changes were made through the new quality assurance process, and how do you know they are working?
- 05How will you ensure care plans and consent records are signed by the person or their representative when needed?
This was an unannounced inspection covering all five CQC questions; the report also records that the service was rated Requires Improvement at its previous inspection. This explanation was written from the published report of 24 February 2017 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 Fryers House - Care Home with Nursing Physical Disabilities
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- April 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Fryers House - Care Home with Nursing Physical Disabilities →
- February 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fryers House - Care Home with Nursing Physical Disabilities →
- March 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- August 2013
Report published without a new overall rating.
- February 2013
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 12 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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