Fosse Healthcare - Nottinghamshire

During our assessment, we have identified breaches in relation to staffing. We assessed all 8 quality statements in the safe key question and found areas of good practice and concern. Though the assessment of these areas indicated areas of good practice since the last inspection, our rating for the key question remains requires improvement. A sudden recent reduction in staff numbers had resulted in an increase in late calls and expectations on staff to complete more call. People have felt their concerns about this were not being listened to. People and those important to them were supported to raise concerns when they didn’t feel safe. However, people and relatives did not always feel concerns would be acted on. When concerns had been raised, managers reported these to the relevant agencies and action was taken to safeguard people from further risk. There have been occasions when the provider was asked by the local authority safeguarding to make improvements. Staff assessed and reviewed safety risks to people and made sure people, and those important to them participated in making decisions about how they wished to be supported to stay safe. Staff received relevant training to meet the range of people’s needs at the service. Staff received support through supervision and appraisal to support their continuous learning and improve their working practice. Managers checked the suitability of staff to ensure they were suitable and fit to provide care. People’s medicines were managed well; however, there were occasions when time critical calls were between 30-60 minutes later than planned, which could impact people’s health and safety. Staff understood how to reduce the risk of the spread of infection. We have asked the provider for an action plan in response to our concerns.

We assessed 3 quality statements in the safe key question and found areas of good practice and concerns. The scores for these areas have been combined with scores based on the rating from the last inspection. People were supported to have choice and control and make decisions about how their support was provided. They were encouraged and helped by staff to do as much as they could for themselves, to maintain their independence. People were supported to understand their rights and how the service would make sure these were respected. Some people were concerned that their request not to have male care staff was often ignored. Staff did not feel valued or listened to. Staff morale and satisfaction levels with their role were low. Some felt this could impact on the care provided to people.

During our assessment, we have identified a breach in relation governance. We assessed 2 quality statements in the well-led key question and found areas of good practice and concern. The scores for these areas have been combined with scores based on the rating from the last inspection, which was good. Though the assessment of these areas indicated areas of concern since the last inspection, our rating for the key question remains good. There were governance and management procedures in place. The safe running of this service had been affected by a sudden reduction in staff. Measures are in place to address this before this had a serious impact on people’s care. However, staff wellbeing has been affected. Staff understood their roles and responsibilities but did not feel that the concerns they raised were understood, valued, and would be acted on. Staff had lost faith in the management team. Managers accounted for the actions, behaviours, and performance of staff. Data or notifications were consistently submitted to external organisations as required. There were robust arrangements for the availability, integrity and confidentiality of data, records, and data management systems. Information is used effectively to monitor and improve the quality of care. We have asked the provider for an action plan in response to our concerns.