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This report from the Care Quality Commission (CQC) provides an overview of Francis House, a residential home offering personal and nursing care to seven young adults with life-limiting conditions. The inspection, conducted on September 3rd, 2019, assessed the service against five key questions: Safe, Effective, Caring, Responsive, and Well-led. Overall, the findings indicate that residents generally experience a positive and supportive environment, with staff demonstrating a good understanding of their needs and a commitment to their well-being.

On safety, the home ensures residents are protected from harm, with risks identified and managed. While fire alarm checks were previously monthly, they are transitioning to weekly. The service has improved its water safety checks with a new external provider. Staff are safely recruited, and while there are usually sufficient staff, staffing levels sometimes dropped to three from the planned four during periods of annual leave, which could impact activity access. Medicines are administered safely, and financial records are generally well-maintained, though one instance of unrecorded spending was identified and addressed.

In terms of how effective the care is, residents receive support that promotes their quality of life. Staff are well-trained and supported, with specific training for individual needs. Care plans contain comprehensive medical information and guidance for staff, and referrals to health professionals are made when needed. Residents are supported to maintain a balanced diet, though recording the addition of thickeners to fluids was an area for improvement, which has since been addressed with a new record form. The home itself is fully adapted to meet residents' needs, fostering a sense of home rather than an institution.

When it comes to caring, residents feel safe, respected, and well-supported by kind and compassionate staff. There's a low staff turnover, leading to strong relationships. The service actively supports residents' diverse needs, including cultural and religious festivals, and promotes their independence. Residents and their families are involved in agreeing and reviewing care plans, ensuring their views are heard. Communication needs are well-assessed, with clear guidance for staff to support individuals with varying communication abilities.

Regarding how responsive the service is, care plans are personalised and detailed, guiding staff to meet residents' specific needs. While skin integrity was not an issue, the frequency of re-positioning for residents in bed was not always clearly defined in care plans, an area the manager committed to addressing. Residents and families are actively involved in care planning and reviews. The service also supports residents in participating in various community activities and maintaining relationships, although this is easier when staffing levels are at their planned capacity.

Finally, on how well-led the service is, the registered manager demonstrates good oversight through visibility, regular checks, and audits. Incidents are recorded and reviewed to prevent re-occurrence. While most residents can continue to access respite care at the sister organisation, Francis House Children's Hospice, end-of-life care decision information was not consistently available to the staff team at Francis House, presenting a point for development.