Archived: Felbury House

Updated 17 February 2021

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 based on the information we held about the service.

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 two inspectors.

Service and service type

Felbury House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before inspection

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

During the inspection

We spoke with five people who used the service about their experience of the care provided. We spoke with five members of staff including the registered manager and care staff.

We reviewed a range of records. This included four people’s care records. A variety of records relating to the management of the service, including policies and procedures were reviewed. We observed practices and interactions between people using the service and staff.

After the inspection

We looked at policies and quality assurance records. We received feedback from four relatives and five healthcare professionals.

Updated 17 February 2021

This inspection took place on 5 September 2018 and was unannounced.

Felbury House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The home can accommodate a maximum of 30 older people. There were 27 people living at the home at the time of our inspection. The home is operated by Grey's Residential Homes Ltd. The provider also operates a care home for a maximum of 24 older people in Woking, Surrey.

There was a registered manager in post at the time of our inspection. The registered manager had been appointed since our last inspection and completed their registration with CQC in February 2018. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

At the last inspection on 3 August 2017, we found the provider was breaching regulations in relation to safe care and treatment, person-centred care, consent and governance. People’s care was not always provided in line with the Mental Capacity Act 2005 (MCA). We served a warning notice about this issue. Suitable steps were not always taken to minimise the risks involved in people’s care. Medicines were not always stored in a safe environment and there was not enough guidance for staff about some people’s medicines. Some people had needs that were not reflected in their care plans, which meant staff did not have guidance to follow about how to meet these needs. The provider's quality monitoring systems were not effective in identifying shortfalls. After the inspection, the provider sent us an action plan telling us how they planned to make improvements.

At this inspection, we found that improvements had been made in all these areas. People’s care was provided in a safe way that was responsive to their needs. Medicines were managed safely and people’s rights under the MCA were respected. Effective quality monitoring systems had been developed, which had improved the management oversight of the service.

The provider, registered manager and staff had worked together to achieve these improvements, which had resulted in tangible benefits for people. For example, the number of falls had significantly reduced due to the falls prevention measures implemented at the home. These included exercises to improve balance and mobility and considering how people’s medicines may affect their risk of falls.

The provider, registered manager and staff had all attended training in the MCA to ensure they understood its principles and application. The tools used to assess people’s capacity had improved, which meant they were effective in identifying when people may need support to make decisions. People’s care plans were personalised and reflected all aspects of their care. Staff had clear guidance to follow about how to provide the care and support people needed.

The areas in which the home performed well at the last inspection continued to be its strengths. People and relatives praised the caring nature of staff, including when people neared the end of their lives. Many people and their relatives highlighted the welcoming, family atmosphere as an aspect of the home that they valued highly. People had developed positive relationships with the staff who cared for them and enjoyed their company. Many staff had worked at the home for some years and knew the people they cared for and their relatives well. Friends and families were encouraged to be involved in the life of the home

The provider and registered manager formed a strong leadership team and provided good support to staff. Staff were committed to providing high quality care and felt valued by the provider and registered manager for the work they did. Staff had the training and support they needed to perform their roles. They worked well as a team to ensure that people received good care.

The provider and registered manager encouraged feedback from people and their relatives and used this to improve the service. Residents’ and relatives’ meetings took place regularly and satisfaction surveys were distributed and collated. If complaints were made, they were investigated and responded to appropriately. Action was taken to address any concerns complainants raised. Staff and professionals involved in the home were also encouraged to give their views about how the service could improve.

Staff treated people with respect and supported them to maintain their independence. People had access to a wide range of activities and outings and to be involved in their local community. Staff ensured that no-one became socially isolated. People enjoyed the food provided and their views were considered when menus were planned. Relatives also provided positive feedback about the quality of the food and said they were encouraged to join their family members for meals. People’s nutritional needs were assessed and any specific dietary requirements were communicated by care staff to the chef.

People’s healthcare needs were monitored and they were supported to access medical treatment if they needed it. Staff had established effective working relationships with health and social care professionals to ensure all aspects of people’s care were addressed.

Staff were always available when people needed them. The provider’s recruitment procedures helped ensure that only suitable staff were employed. Staff attended safeguarding training and knew how to recognise and report abuse. Checks were carried out regularly to ensure the home and any equipment used in providing people’s care was safe. There were plans in to ensure people’s care would not be interrupted in the event of an emergency.

Further information is in the detailed findings below.