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During this inspection we found that improvements had been made.

We also found some issues of concern at our previous inspection in relation to the management of medicines and we made a recommendation for them to introduce systems to support the safe administration of medicines. This issue had not been sufficiently addressed by the time of this inspection. The service is registered to provide accommodation and support with nursing and personal care to a maximum of 43 adults. The service had a registered manager in place. Medicines were not always administered in a safe manner. Staff did not always receive up to date training in relevant topics to support them in their role.

Quality assurance and monitoring systems were not always effective. You can see what action we told the provider to take at the back of the full version of this report. Systems were in place relating to safeguarding people that used the service.

Checks were carried out on new staff before they began working at the service. Risk assessments were in place which included information about how to mitigate any risks people faced. The service operated within the Mental Capacity Act and people were supported to make choices where they had capacity to do so.

This included choices about what people ate and drank and people told us they were happy with the food provided. However, not everyone received their meal while it was still hot. People had access to health care services as required. People and relatives told us staff behaved in a caring manner and that people were treated with respect. Staff understood how to promote peoples dignity.

People were involved in developing their care plans which were regularly reviewed. People had access to various activities. People knew how to make a complaint. People that used the service and staff told us they felt the management team was open and supportive. The service had various quality assurance systems in place, some of which included seeking the views of people that used the service.

We carried out an unannounced comprehensive inspection of this service in August at which breaches of legal requirements were found. They did not respond to complaints appropriately. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook a focused inspection on the 7 and 13 May to check that they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to these topics.

Folkestone Nursing Home provides accommodation for up to 43 people who require support with their nursing and personal care. The home mainly provides support for older people and people living with dementia. There were 29 people living at the home at the time of our inspection. The previous registered manager of the service resigned in January The current manager began working at the service on the 9 March They told us they had made an application to register with the Care Quality Commission.

Overall we found improvements had been made at this inspection and we have revised our rating of the service from inadequate to requires improvement. You can see what action we have asked the provider to take at the end of this report. The service did not have appropriate arrangements in place for the safe management of medicines.

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However, they took action to address the issues of concern we raised with regard to medicines. The service had safeguarding procedures in place and staff knew how to respond to allegations of abuse. There were enough skilled and knowledgeable staff working at the service. Staff had undertaken training about dementia and demonstrated a good understanding of how to support people who had dementia.

People knew how to make a complaint and the service had an appropriate complaints procedure in place. People and staff told us they found the manager to be approachable and accessible. The service had various quality assurance and monitoring systems in place. We carried out this inspection under Section 60 of the Health and Social Care Act 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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. The inspection took place over two days and was unannounced.

At this inspection we found that improvements had been made to record keeping but that some people were still receiving poor care. The service is a nursing home that provides accommodation and support with personal and nursing care to older people. The home specialises in providing care to people with dementia. The service is registered with the CQC to provide care for up to 43 people. There were 39 people using the service on the first day of our inspection and 42 on the second day.

The service has a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. The service also had a nominated individual in place. They were the line manager to the registered manager and shared in the day to day management of the service with the registered manager. Staff had undertaken training about safeguarding adults.

However, the service had not always responded appropriately to allegations of abuse as they had not always referred incidents to the relevant local authority adults safeguarding team. Only two people were subject to Deprivation of Liberty Safeguard authorisations although other people had restrictions placed upon their liberty. This was because agency staff did not know people well and permanent staff had to spend a lot of time supporting the agency staff. Staff undertook various training covering health and safety and moving and handling.

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Most care and nursing staff had only undertaken basic training about dementia although we were told the service was taking steps to address this. People were provided with adequate amounts of food and drink and they had a choice of food at meal times. People had access to health care professionals as appropriate.

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People told us that staff were caring and we saw staff interacted with people in a polite and friendly manner. Relatives were involved in developing care plans for people where people lacked capacity. However, we found instances were care plans were not followed or where they did not contain sufficient information about how to support people in a safe manner.

There was only limited opportunity for people to engage in social and leisure activities in the home.



The service had a complaints procedure in place but complaints were not always dealt with in a timely manner. Most of the people, relatives and staff expressed dissatisfaction with the management at the home. Not sure how to start? Our useful online dating assistant is on hand to walk you through the simple process of creating your profile and much more, or you can talk to one of our dedicated team for help.