The Flowers Care Home Limited

Updated 9 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors.

Service and service type

The Flowers Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Flowers Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We observed how people were being cared for to help us understand the experience of people who could not tell us about their experience. We spoke with 3 people who used the service, 3 relatives and 7 members of staff including care workers, housekeeping, assistant managers and the registered manager. We reviewed a range of records. This included 5 people's care records and multiple people's medicine records. We looked at 3 staff recruitment files. A variety of records relating to the management of the service were reviewed.

Updated 9 August 2023

About the service

The Flowers Care Home Limited is a residential care home providing personal care to older people and people living with dementia. The Flowers Care Home Limited accommodates 23 people in one adapted building. At the time of our inspection there were 14 people using the service.

People’s experience of using this service and what we found

The service had an inconsistent approach that sometimes put people’s safety and well-being at risk. The provider did not always manage risks well. Medicines were not always managed safely.

Staffing levels were generally safe although staff were sometimes stretched.

Robust recruitment checks were completed before staff started working at the service. The service had systems which safeguarded people from abuse.

The provider promoted safety through good hygiene practices and the service was regularly cleaned. The provider’s approach to visiting did not meet government guidance when we carried out our first site visit because they were restricting visitors. The registered manager took swift action to address this.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service usually supported this practice.

There was a lack of consistency in how well the service was managed. Care was not always person centred. Systems to assess and monitor the service were not always effective and did not drive the required improvements. Care recording was inconsistent and did not always provide important information about how people’s needs were being met.

Feedback about the management team and staff was generally positive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was requires improvement (published 10 August 2022). The service remains rated requires improvement. This service was rated requires improvement at the last inspection and the inspection in October 2019. This service was rated inadequate at the inspection in October 2021.

Why we inspected

The inspection was prompted in part due to concerns received about staffing arrangements, and management of risk and medicines. A decision was made for us to inspect and examine those risks.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Flowers Care Home Limited on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management, medicines management and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.