CQC report explained · a nursing home
What the CQC found at The Fountains Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments covered health conditions, falls, mobility, oral health and choking. Medicines records were accurate, and inspectors found suitable infection control arrangements.
- Effective?
- Good
- Staff had completed training in relevant areas, including skin care, epilepsy and diabetes. People's food and fluid intake was recorded, and their health needs were followed up with healthcare professionals.
- Caring?
- Good
- People and relatives said staff were kind and respectful. Staff supported people's privacy, dignity, independence, choices, equality and diversity.
- Responsive?
- Good
- Care plans were person-centred and reviewed monthly. Activities and safe visiting arrangements were provided, although COVID-19 restrictions limited outside activities and visits at the time.
- Well-led?
- Good
- The new management arrangements and quality checks had addressed earlier problems. People, relatives and staff were able to give feedback, and the home acted on issues raised.
What inspectors found, February 2022
Rated Good and no longer in Special Measures after improving from Inadequate; inspectors found safe, kind care and no current breaches.
Inspectors visited without warning on 6 and 7 January 2022. They spoke with people living in the home, relatives and staff. They observed care and checked care records, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found better risk assessments, safer medicines management, improved staff training, more person-centred care and stronger checks on quality.
The home had previously been rated Inadequate and had been in Special Measures since August 2021. Inspectors found the earlier problems had been addressed, so the home was no longer in Special Measures and was no longer breaching regulations.
Improved risk management
The home had introduced detailed assessments for people's health conditions and other risks. Staff understood how to support people safely, and records showed relevant checks were completed.
“Detailed risk assessments were in place for people with health conditions, including diabetes and epilepsy.” from the report
Safer medicines
Medicines administration records were up to date, stock balances matched, and guidance was available for medicines given when needed or covertly.
“MARs were maintained accurately and were up to date. We did not see any unexplained gaps on MARs.” from the report
Kind and respectful care
People and relatives described staff as caring. Inspectors saw staff give sensitive reassurance and protect people's dignity during personal care.
“We saw that staff interacted with people in a caring and sensitive manner during our inspection.” from the report
Person-centred support
Care plans described people's individual needs, communication methods and preferences. Staff knew how to support people and involved them in choices about food and activities.
“Care plans were in place for people. These were person-centred and set out how to meet the needs of individuals.” from the report
Stronger leadership and oversight
A new manager and deputy manager were in place. The provider had introduced regular audits, action plans and meetings to hear people's and relatives' views.
“During this inspection we found previous breaches of regulations had been addressed and effective quality assurance systems were now in place.” from the report
Accident records used two systems
minorSome accidents and incidents were recorded electronically and others on paper. The manager said they would consider moving to one system, so this is worth checking.
“We discussed this with the registered manager who said they would look into using a single system for recording accidents and incidents.” from the report
- 01How are you making sure the improvements to risk assessments and care plans are being maintained?
- 02How many permanent staff currently work here, and when are agency staff used?
- 03Have you moved to one system for recording accidents and incidents?
- 04How often are medicines audits and other quality checks completed, and what happens when they find a problem?
- 05What activities and visiting arrangements are available now that COVID-19 restrictions have changed?
This was an unannounced follow-up inspection covering all five CQC questions and infection prevention and control, after the previous Inadequate inspection. This explanation was written from the published report of 4 February 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, September 2021
The Fountains Care Centre was rated Inadequate and placed in special measures; inspectors found serious shortfalls in safety, training, food and management.
This was an unannounced inspection on 6, 11 and 13 May 2021. Inspectors reviewed 16 people's care records, medication records, staff files and management records. They spoke with people, relatives and staff, and checked the building and infection control arrangements.
The home was not always safe. Risk assessments were missing or inaccurate, medicines records and instructions were not always reliable, and staff lacked important training. Food and drink records were incomplete, people's choices were not always recorded, and maintenance problems were not dealt with quickly.
Inspectors found kind and respectful care, and rated Caring Good. Responsive was Requires Improvement. Safe, Effective and Well-led were Inadequate. The overall rating fell from Good at the previous inspection, published in December 2018. The home was placed in special measures, with a planned reinspection within six months.
Kind and respectful care
People and relatives said staff were caring. Inspectors found that people's privacy, dignity and equality needs were respected.
“People and relatives told us staff were caring and they were treated with respect.” from the report
Staffing and recruitment
Inspectors found enough staff working during the inspection. Recruitment checks included criminal record checks, references and identity checks.
“The provider carried out checks on prospective staff to test their suitability to work in a care setting.” from the report
Infection control
The home had arrangements for infection prevention, testing, protective equipment and visits during the Covid-19 pandemic.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Mental capacity arrangements
Decision-specific capacity assessments and best-interest meetings were carried out. DoLS applications and authorisations were monitored.
“The provider held 'best interests' meetings for people, which involved the person, their relatives and appropriate healthcare professionals.” from the report
Risk assessments and medicines
seriousImportant risk assessments were missing or inaccurate, especially for skin care, diabetes and epilepsy. Medicines guidance and records were not always safe or complete.
“In total, we looked 16 risk assessments for people and found areas of concern with 15 of them.” from the report
Staff training
seriousMany care staff had not been trained in conditions and risks relevant to the people they supported. This included diabetes, epilepsy, skin care and pressure ulcer prevention.
“Many staff had not undertaken training in key subjects relevant to their roles and the people they supported.” from the report
Food and fluids
seriousRecords of food and fluid intake had gaps, and the home did not always record people's food choices properly. Fluid plans did not always state how much people should drink.
“This meant it was not possible to monitor whether they were taking enough fluids to keep them safely hydrated.” from the report
Premises maintenance
seriousSome windows did not open or close properly, and loose, uneven paving created a trip hazard. Staff also reported repeated sewage overflow problems.
“There were loose and uneven paving stones in the garden patio which constituted a trip hazard to people.” from the report
Weak quality checks
seriousThe home's audits did not identify significant problems with care, training and maintenance. Required staff competency checks and surveys had not been completed as expected.
“However, systems for monitoring and improving care were either not being used or were ineffective.” from the report
Care was not always personalised
needs fixingCare plans did not always include all the instructions staff needed to provide person-centred care. Some staff did not know which people had diabetes or epilepsy.
“Care records did not always capture all the needs people had or all the actions staff had to take to meet people's needs.” from the report
- 01What has been corrected since the inspection for the 15 risk assessments that inspectors found concerning?
- 02How do you now check that staff are trained and competent to support people with diabetes, epilepsy, skin problems and pressure ulcer risks?
- 03What changes have been made to medicines guidance, MAR records and stock checks, including for PRN and covert medicines?
- 04How are food choices and daily food and fluid intake now recorded and reviewed?
- 05What repairs have been completed, including the windows, patio paving and reported sewage overflow, and how are new maintenance issues logged?
This was an unannounced inspection covering all five key questions, the care and premises, and infection prevention and control; the findings reflect the situation during the May 2021 visits. This explanation was written from the published report of 18 September 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 The Fountains Care Centre
3 rated inspections over 3 years: the service has held its Good rating throughout.
- February 2022Goodcurrent ratingup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2021InadequateSafe: InadequateEffective: InadequateCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- December 2020Inspected but not ratedSafe: Inspected but not rated
- December 2020Inspected but not ratedSafe: Inspected but not rated
- December 2018GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2017
Registered with the Care Quality Commission on 10 July 2017.
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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