A Warrington care home has been rated inadequate for safety with an overall rating of requiring improvement following a recent inspection by the Care Quality Commission (CQC).
It followed an unannounced inspection of the Florence Mill Care Home on Egerton Street, Warrington over three days in July which recognised some improvements had taken place since a new provider had taken over, although there was not a registered manager in post at the time of the inspection.
Florence Mill Care Home provides nursing and/or personal care for up to 150 older adults across four individual units; some of whom were living with dementia. At the time of the inspection, 109 people were living in the home.
The report highlighted people’s experience of using the service and what the inspection team found.
A summary of the inspection stated: “People’s medicines were not always managed safely. We found concerns in relation medicines for two people with diabetes and four people had not received their prescribed medicines for at least three days due to no stock. We also found issues with records relating to the monitoring of some people’s identified risks. These concerns placed people at risk of avoidable harm.
“The provider had recognised staffing issues that pre-dated them taking over the service and had completed a recent recruitment drive to address this. However, this meant many of the staff were new or agency staff resulting in people receiving care that was not always person-centred or meaningful.
“Whilst governance systems had been effective at identifying issues, they had not been robust enough to make the necessary improvements needed. The provider and manager had recognised the need for improvements to be made and had been working hard to implement changes.
“People’s needs had been assessed in line with best practice guidance. However, the issues relating to risk monitoring records and personal hygiene records meant we could not always be certain people were receiving the care they needed.
“Risks to people’s health and wellbeing had been assessed and guidance was available for staff to follow in order to support people safely. Staff had received safeguarding training and people told us they felt safe living at Florence Mill.
“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 supported this practice.
“We received mixed feedback from people and family members about the overall care and support people received. Some felt staff were kind and caring and interacted well whilst others felt interactions were limited and not meaningful.
“Staff felt the overall service and the support they received had improved since the new provider had taken over and the new manager commenced in post. People and family members had also recognised improvements but felt further changes were needed.”
The last rating for the service under the previous provider was requires improvement, published on 21 July 2021.
The inspection was prompted due to concerns received about the overall standard of care people received and the clinical oversight of the service.
The inspection team looked at infection prevention and control measures under the Safe key question. They 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.
They found evidence that the provider needs to make improvements.
The summary went on to say: “We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
“We will continue to monitor the service and will take further action if needed.
“We have identified breaches in relation to the safe management of medicines, risk monitoring records and governance systems.
“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.”
A full copy of the report can be read by CLICKING HERE
After being contacted by Warrington Worldwide Dr Radhika Sisodia said on behalf of Florence Mill Care Home: “We have put action plans in for all aspects of the report and have completed and ongoing checks are compliant. We strive to look after our residents with Kindness, Compassion and Dignity.”
The action plan includes the following.
For Safety these include:
All unit managers/nurse in charge to check all charts during ward rounds 3 times daily
Staff in charge must request all charts at 19.00hrs and 07.00hrs and initial to confirm all supplementary charts have been completed and care has been delivered as plan
Family/friends must ensure they inform the nurse of any diet and fluids given to the resident. This must then be recorded on the charts.
Diabetic information and prescribed thickener must be recorded on these charts
This action is not negotiable
This information must be cascaded to all the team 1-1 and reiterated during team meeting
Medicines management
All staff -To undertake the Blue stream academy training for diabetes management
Qualified staff must undertake their competencies in diabetic management and apply to practice
Staff to ensure all insulin-dependent residents receive priority monitoring/administration prior to starting any medication round
Each resident must have their own BM machine and this must be calibrated according to manufactures guidance
Clinical skills
All qualified staff must ensure they have undertaken relevant training and had their competencies signed
Senior staff must ensure all training is up to date during monthly staff reviews
Staff must Liaise with dietitian? peg nurse if support required i.e. trouble shooting, training etc
Staff must follow infection control measures as per manufacturing guidance/policy
Caring
All staff must ensure all residents are treated with respect and dignity i.e. Engage in conversation Ask the residents preference Do not leave residents exposed Ensure bath/shower Unit managers/nursing staff (Clinical lead oversight) 09.08.22 10.09.22
Look at the residents general appearance and ensure they look clean and wee kempt Complete all supplementary care charts as noted above Senior staff to ensure processes are followed
Responsive
Ensure weekly activity planes if followed Encourage residents to partake by; Activity coordinators must; Completing the ‘about me’ on CMS Know what the residents hobbies/likes and dislikes Ask the families information Learn about their past.
Create outdoor events i.e. trips out, entertainment, family events, walks in the grounds, days out with families Continue to offer 1-1s i.e. reading, talking, history etc.
