Archived: Fortis Green

Updated 6 October 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 24 August 2015 and was unannounced. The inspection was carried out by two inspectors. Before the inspection we reviewed the information we held about the service including notifications received by the Care Quality Commission.

During the visit we spoke with five people using the service, two mental health recovery workers, a locality manager and a visiting health care professional. The registered manager was on leave at the time of our visit. We looked at the care records and risk assessments for six people living at the service and recruitment, supervision and training records for six staff.

We looked at audits for maintenance, infection control, control of substances hazardous to health and legionella water temperature checks. We checked fire safety including equipment, testing of the alarm, lighting and the regularity of fire evacuation tests, and information relating to incidents, and complaints. We reviewed audits and minutes of residents meetings and staff team meetings.

Updated 6 October 2015

We inspected the service on 24 August 2015. The inspection was unannounced. Fortis Green is a recovery house, run by the National Schizophrenia Fellowship, also known as Rethink Mental Illness, where up to seven people who are experiencing a mental health crisis can stay for a short period for support. The service is located in a large terraced house, on two floors with access to a front and back garden.

At our last inspection on12 November 2013 the service was found to be meeting the regulations we looked at, but there was no registered manager. There is now a registered manager in post. 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 2008 and associated Regulations about how the service is run.

All referrals to Fortis Green are made by the Barnet, Enfield and Haringey Mental Health Trust’s Crisis Resolution and Home Treatment Teams (CRHT), who provide treatment to people during their stay at the service. Some people come to the recovery house after leaving hospital for further recovery and support before they return home.

People using the service informed us that they were satisfied with the care and services provided. They said that they were treated with dignity and respect and we observed good quality interactions between staff and people using the service. Staff were fully aware of people’s needs as a result of working with people using the service and information provided by the staff from the CRHT. People’s needs were carefully documented within detailed care plans.

Risk assessments had been carried out and these contained guidance for staff on protecting people. Most people felt safe in the home for the majority of the time, but some said that they were affected by the behaviours of other people using the service.

People’s health care needs were closely monitored and attended to. Staff were caring and knowledgeable regarding the individual care needs and preferences of people. The home had

arrangements for encouraging people to express their views and experiences regarding the care and management of the home. People’s preferences were recorded and arrangements were in place to ensure that these were responded to.

The home had an activities programme but did not always provide a varied range of activities or adequate information regarding local community resources so people could access adequate social, leisure and therapeutic stimulation.

Staff had been carefully recruited and provided with training, but lacked training in some identified areas to enable them to care effectively for people. Staff had the necessary support and supervision from their managers. They knew how to recognise and report any concerns or allegations of abuse. There were enough staff to meet people's needs.

The home had comprehensive arrangements for quality assurance. Regular audits and checks had been carried out by senior staff. We found the premises were clean and tidy. The home had an infection control policy and measures were in place for infection control. There was a record of essential inspections and maintenance carried out. However sometimes people had to wait for repairs to be made to their environment.

The CRHT took responsibility for the distribution of medicines and undertook risk assessments about people’s ability to manage their own medicines. The necessary documentation was in place and suitable storage of medicines was provided.

At this inspection there was one breach of regulation in relation to risk assessing the impact of people’s behaviours on others using the service, and we have made a recommendation relating to staff understanding of the complaints procedure. You can see what action we told the provider to take at the back of the full version of the report.