What issue did the care home have?
Firstly, there were no governance systems in place, leading to a lack of oversight and accountability. This absence of effective management was further exacerbated by the lack of evidence demonstrating proper monitoring and supervision. The care home had low staff morale, excessive agency usage, and a lack of strong leadership with no deputy manager in place, whilst the relationship with the CQC Inspector had become fractured, indicating strained communication and cooperation. Care plans were found to be inadequate, failing to accurately reflect the needs of the residents and lacking essential risk assessments, such as missing epilepsy care plans. Medication-related issues were prevalent, resulting in a score of 5 (the lower the score, the better) on the medication audit conducted by the Clinical Commissioning Group (CCG). In light of these issues, the care home had a Notice of Decision (NoD) in place and was at risk of entering a Notice of Proposal (NoP), leading to an embargo on admissions.
According to the CQC, they were also found to be in breach of:
Regulation 9 – Person-centred care
Regulation 10 – Dignity and respect
Regulation 11 – Need for consent
Regulation 12 – Safe care and treatment
Regulation 17 – Good governance
Regulation 18 – Staffing.
How did Fulcrum Care help?
The care home recognised the need for expert assistance to address its challenges. Fulcrum Care Consulting proposed a comprehensive solution to address the home’s issues, placing an experienced consultant in the service to support and mentor the management team for three days a week. Fulcrum Care also agreed to take on the role of the Nominated Individual (NI) to assume responsibility for the care home.
To tackle the care home’s challenges, Fulcrum Care implemented various strategies with monthly visits and audits. These included introducing governance systems to improve overall operations and ensure compliance with regulations. A thorough audit of staff files to identify areas of improvement and environmental issues, such as repositioning checks, were addressed promptly. The care plans underwent a significant overhaul to accurately reflect residents’ needs, including the implementation of missing care plans and risk assessments. Moreover, the care home’s heavy reliance on agency staff was examined and reduced to improve stability and continuity of care.
What were the results for the care home?
The intervention by Fulcrum Care Consulting yielded positive results for the care home within a relatively short period of time. In just ten weeks, the home witnessed a significant turnaround in its outcomes and Fulcrum’s diligent efforts led to the resolution of several issues and breaches identified during the CQC inspection.
The care home’s medication management, previously deemed unsafe, was transformed, resulting in an improved rating of 2/10 from the CCG. Whilst the CQC, who had been closely monitoring the care home’s progress, began acknowledging the significant improvements, with a future inspection expected to result in an improved rating.
As a result of the successful collaboration, the care home’s NoP was squashed and the relationship with both the local authority and the CQC improved, leading to a more constructive and supportive engagement. After regaining the confidence of the governing bodies, the home is now able to admit two residents a month.
Overall, the care home underwent a remarkable transformation from a struggling facility with poor outcomes to one that now operates with effective systems in place. Fulcrum Care’s expertise and intervention has put the home on a path toward enhanced quality of care, compliance, and improved relationships with regulatory bodies, and whilst not at the end of its journey, it is heading in the right direction.
If your care home needs help from a team of dedicated care experts, please get in touch.