CQC report explained · a nursing home
What the CQC found at La Fontana
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2022
La Fontana is rated Good; inspectors found safe, kind care and stronger management, but noted minor medicines and staffing issues.
This was an unannounced inspection. Two inspectors and an Expert by Experience visited the home on 11 and 17 October 2022. They spoke with nine people, two relatives and 18 staff, and checked care, medicines, recruitment and management records.
The home was rated Good overall, with Good ratings for Safe and Well-led. Inspectors found people felt safe and well cared for. Staff were kind, safeguarding systems were in place, risks were assessed, and accidents and incidents were reviewed.
There were some areas to improve. Topical creams were not always recorded clearly enough, and one medicine practice was not changed promptly after an error. Cleaning was being improved, agency staff were used because of vacancies, and there was no registered manager in post during the inspection.
Kind and safe care
People said they felt safe, listened to and well cared for. Inspectors saw positive and caring interactions between staff and people.
“We observed many positive, kind and caring staff interactions with people.” from the report
Enough staff during visits
People, relatives and staff generally said there were enough staff. Inspectors saw a good staff presence and people received care without waiting.
“People received care when they needed it and did not have to wait.” from the report
Learning from incidents
Accidents, incidents and near misses were investigated. The home took action and shared lessons with staff to reduce the chance of problems happening again.
“Accidents, incidents and 'near misses' were recorded and investigated and where appropriate, measures were put in place to mitigate the risk of reoccurrence.” from the report
Improved quality monitoring
The home had a wide range of audits. Inspectors found that earlier improvements in monitoring risks and quality had been embedded and sustained.
“There were effective systems in place to monitor and review the quality of the service and to make sure improvements were carried out.” from the report
Topical cream records
needs fixingSome topical creams were not recorded on both computer systems. This meant care staff might not have had a clear record of which creams they needed to apply.
“Improvement was needed in the management of topical creams to ensure people had them applied as prescribed.” from the report
Prompt medicine changes
needs fixingAfter a medicine error, one change to medicine administration practice was not made promptly. The required change was made between the two inspection visits.
“We found one example where changes had not been made promptly to medicine administration practice following an error being made for one person.” from the report
Agency staff and vacancies
minorThe home had vacancies for nurses, carers and housekeepers, so agency staff were used regularly. People said agency staff were good but did not know them as well as permanent staff.
“There are lots of agency staff here. They are good but don't know you as well as the permanent staff.” from the report
No registered manager
minorThere was no registered manager in post during the inspection. The deputy manager and head of care were running the home with support while recruitment was under way.
“At the time of our inspection there was not a registered manager in post.” from the report
Cleaning was being improved
minorInspectors were assured about infection prevention arrangements, but daily cleaning of the home was still being improved during the visits.
“Daily cleaning of the home was being improved when we visited.” from the report
- 01How do you now record and check that every person's topical creams are applied as prescribed?
- 02What procedure do you follow after a medicine error, and how quickly are changes made and checked?
- 03How many nurse, carer and housekeeping vacancies are there now, and how often are agency staff being used?
- 04Who is currently responsible for managing the home while recruitment of a registered manager is completed?
- 05What changes have been made to daily cleaning and mask use since the inspection?
This was a focused inspection of Safe and Well-led, including infection prevention and control; ratings for the other key questions carried over from the last inspection. This explanation was written from the published report of 29 October 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.
What inspectors found, February 2021
Inspected but not rated; inspectors found major improvements in infection control, but the previous Requires Improvement rating remained.
This was an unannounced, targeted inspection on 7 January 2021. Two inspectors followed up concerns about infection control after a significant COVID-19 outbreak in December 2020.
Inspectors found that infection control had improved. Staff had training and supervision, used protective equipment correctly, and were allocated to specific areas to reduce the risk of infection spreading. The home was no longer in breach of the infection control regulation.
This visit did not reassess the whole service. The previous overall rating of Requires Improvement remained, and the Safe question was recorded as Inspected but not rated.
Better infection control
The inspectors found enough improvement for the home no longer to be in breach of the infection control regulation.
“Enough improvement had been made at this inspection and the provider was no longer in breach of the Regulations.” from the report
Correct use of PPE
Staff had access to protective equipment, understood how to use it, and were observed following good practice.
“Staff knew how to use PPE and we observed best practice being followed.” from the report
Reduced spread between areas
Staff were allocated to particular units and one area was set aside for people who had COVID-19.
“Staff were allocated to specific units to minimise the risks of cross infection.” from the report
Ongoing checks
The management carried out competency checks and infection control audits, with shortfalls identified and corrected.
“Audits of infection control were regularly occurring at the home to identify shortfalls which were then rectified.” from the report
The full service was not reassessed
minorThe inspection only checked infection control. The previous Requires Improvement rating therefore remained in place.
“The ratings have not changed because the last two inspections have been targeted.” from the report
- 01What infection control improvements have been maintained since the inspection on 7 January 2021?
- 02Have the conditions added to the provider's registration now been removed?
- 03What was found at the next comprehensive inspection, including for care, staffing, medicines and management?
- 04How are staff competency checks and infection control audits carried out now?
- 05How would the home manage a new infection outbreak or a person who tests positive?
This was a targeted inspection of infection prevention and control under the Safe question only; the other areas and the previous ratings were not reassessed. This explanation was written from the published report of 11 February 2021 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 La Fontana
6 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- October 2022Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2021Inspected but not ratedSafe: Inspected but not rated
- February 2021Inspected but not ratedSafe: Inspected but not rated
- April 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- January 2020Requires improvementstayed Requires improvementSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- May 2011
Registered with the Care Quality Commission on 30 May 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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