CQC report explained · a residential care home
What the CQC found at The Fountains Care Centre
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found problems with medicines records and advice, cleaning, staffing consistency and staff debriefs after incidents. They also found safe recruitment, safeguarding training and regular reviews of risks to people's health.
- Effective?
- Good
- This key question was not inspected during this focused visit. The report says the previous ratings were used to calculate the overall rating.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says the previous ratings were used to calculate the overall rating.
- Responsive?
- Good
- This key question was not inspected during this focused visit. The report says the previous ratings were used to calculate the overall rating.
- Well-led?
- Requires improvement
- Audits did not identify cleaning and medicines problems, supervision was not regular and some relatives felt poorly informed. The home had complaints systems and evidence that concerns were addressed.
What inspectors found, May 2022
Requires Improvement; inspectors found unsafe medicines practices, poor cleaning and inconsistent staffing and oversight.
This was an unannounced, focused inspection on 17 March 2022. Inspectors looked only at Safe and Well-led because of concerns about safety, infection prevention and leadership. They spoke with people, relatives and staff, and reviewed care, medicines, recruitment and management records.
The home was not always safe. Medicines were sometimes given in a different way from the prescription without advice from a GP or pharmacist, and some records were not checked properly. Inspectors also found dust and cobwebs, and people and staff reported that staffing was sometimes not enough or consistent.
The home was not always well-led. Audits had not found the cleaning and medicines problems, staff did not always receive regular supervision, and some relatives did not feel kept informed. The home did have safe recruitment, safeguarding training, health monitoring, activities and respectful care.
The overall rating changed from Good at the previous inspection, published on 20 November 2018, to Requires Improvement. The other three key questions were not inspected during this visit, and their previous ratings were used in calculating the overall rating.
Safeguarding
Staff had safeguarding training and knew how to report concerns. People said they felt safe and could approach staff and managers.
“Staff knew how to escalate safeguarding concerns. Staff were confident in reporting safeguarding concerns to management.” from the report
Respectful care
Inspectors observed kind interactions. People were supported with privacy, dignity, independence and social activities.
“People were treated with dignity and respect. Our observations on how people interacted with each other and staff were positive.” from the report
Safe visiting arrangements
The home used booking, screening, testing and protective equipment arrangements to support visits safely.
“The provider facilitated people receiving visits from their family and friends safely.” from the report
Medicines were not always managed safely
seriousAdvice was not always sought before medicines were given differently from the prescription. A handwritten medicine entry was not checked by a second member of staff.
“Advice wasn't always sought from a GP or pharmacist when people needed their medicines differently from how it was prescribed.” from the report
Cleaning standards
needs fixingInspectors found built-up dust in several bedrooms and cobwebs in communal areas. The home's audits had not identified these problems.
“During our inspection we found flooring in several bedrooms had built-up dust and communal areas had cobwebs on fixtures.” from the report
Staffing and rotas
needs fixingPeople and staff reported that staffing could be lower during sickness and that rotas were issued at short notice. Inspectors said this risked inconsistent support.
“This meant people were at risk of not receiving consistent support.” from the report
Incident learning
needs fixingRecords did not show that staff were always debriefed after incidents when they could not keep themselves safe. The provider later said it had reviewed its process.
“Where staff could not maintain their safety during untoward incidents, records did not evidence the provider debriefed staff.” from the report
Weak quality checks
needs fixingManagement checks did not reliably identify problems with cleaning or medicines. Supervision records were also not regular and consistent.
“Systems to ensure people were being given medicines safely were not always effective.” from the report
Some relatives felt uninformed
minorSome relatives said they were not asked to complete surveys and were not kept informed about changes to people's care and support needs.
“Some relatives felt strongly that the provider didn't keep them informed about changes to peoples care and support needs.” from the report
- 01What checks now make sure medicines are not given differently from the prescription without advice from a GP or pharmacist?
- 02How do you check that medicine administration records are completed correctly and countersigned when needed?
- 03What has changed to make sure bedrooms and communal areas are cleaned effectively and that audits identify problems?
- 04How do you cover sickness, weekends and short-notice rota changes so people receive consistent support?
- 05How are relatives now kept informed about changes to a person's care and support needs?
This was a focused inspection of Safe and Well-led only; the other ratings carried over from the previous inspection and were used to calculate the overall rating. This explanation was written from the published report of 25 May 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, December 2018
Rated Good; inspectors found safe, kind and personalised care, with some records and feedback arrangements still being improved.
Inspectors made an unannounced, comprehensive visit on 20 November 2018. They spoke with people living in the home, relatives and staff. They observed care and medicines, and reviewed five people's care plans and other records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People were protected from avoidable harm, received their medicines safely and had enough trained staff to support them.
Inspectors found kind care that respected people's privacy, choices and independence. Care was personalised and health, food and drink needs were supported. Activities and family contact were encouraged.
A new manager had been in post for five weeks and was making improvements. People and relatives did not always have access to written care plans, and some records about family involvement and feedback needed strengthening.
People felt safe
Everyone spoken to, including relatives, said the home felt safe. Staff knew how to report concerns and manage identified risks.
“All of the people we spoke with, and their family members, told us they felt the home was a safe place to live.” from the report
Kind and respectful care
Staff treated people with kindness and supported their dignity, privacy, choices and independence.
“We found that staff treated people in a kind and caring way.” from the report
Safe medicines support
Medicines were stored and given safely by trained staff. Regular checks were carried out.
“People received their prescribed medicines safely.” from the report
Personalised activities
Activities were available, and staff also visited people who preferred to spend time in their rooms.
“We also saw the activity co-ordinator took time to visit people who spent time in their bedroom to minimise any feeling of isolation.” from the report
Improving leadership
The new manager had an improvement plan, worked alongside staff and encouraged them to raise concerns.
“Staff told us, and we saw that there was an open and inclusive culture within the home.” from the report
Access to care plans
needs fixingPeople and relatives had discussed care with staff but said they had not seen the written care plans. The manager was taking action to improve access.
“although people and their family members were involved in discussions about their care they told us they had not seen their care plans.” from the report
Records of family involvement
needs fixingSome records did not clearly show how and when relatives had been consulted about best-interest decisions. The manager acknowledged this and was addressing it.
“some records were not clear about how and when family members had been consulted.” from the report
Gathering people's views
minorMost people and relatives had not been offered a survey or meetings at the time of the inspection. The manager had arranged meetings and prepared a survey.
“most people and their family members said they had not been offered the opportunity to complete a survey or attend meetings.” from the report
- 01How can residents and relatives see and contribute to the written care plan?
- 02How do you record relatives' involvement in best-interest decisions?
- 03How often do you ask residents and relatives for feedback through meetings or surveys?
- 04What improvements has the new manager made since this inspection?
- 05How are people's food preferences and dietary needs recorded and reviewed?
This was an unannounced comprehensive inspection covering all five ratings, and the previous Good overall rating from March 2016 remained unchanged. This explanation was written from the published report of 14 December 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 The Fountains Care Centre
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- May 2022Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2018Goodstayed GoodSafe: GoodWell-led: Good
- May 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 7 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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9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
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Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.