Fernbrook House

Updated 15 March 2022

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.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 24 February 2022 and was unannounced.

Updated 15 March 2022

About the service

Fernbrook House is a nursing home providing personal and nursing care to people aged 65 and over. The service can support up to 30 people and at the time of the inspection there were 24 people living there. The service is in a residential area and accommodates people in an adapted building across two floors.

People’s experience of using this service and what we found

People were being supported safely by staff who knew them well. However, written guidance to staff around the support people needed, in particular with their medicines was not always accurate or complete. This meant the provider had not ensured people would be protected from risk if they received care from staff who did not know them.

We raised concerns about medicine administration at our last inspection. The registered manager had acted promptly to address areas of risk. However, their improvement plans had not been sustained and quality checks had not picked up the concerns we found at this inspection.

After this inspection the immediate concerns we raised were resolved promptly so that any temporary staff would have the necessary information to support people safely. Further time was needed to ensure the provider used their systems effectively to pick up concerns and act on them.

At our last inspection we had raised concerns about infection control practices. The provider had addressed these issues and started a programme of refurbishment, which was ongoing. The provider and the whole staff team demonstrated a commitment to minimise the risks from COVID-19. There were measures in place to prevent infection and to support people to remain in touch with families and friends.

There was an established registered manager who knew people well and who managed the staff team effectively, for the benefit of the people they supported. Morale was good and there was a positive culture at the service.

There were enough staff to support people safely. Staff worked effectively to ensure people achieved good outcomes. We received positive feedback from relatives about the care people received and observed during our visit to the service that staff supported people with kindness.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 November 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

We issued a warning notice following our last inspection outlining our concerns around medicine. Sufficient improvement had been made at this inspection and we did not need to take action in relation to the notice. However, the provider’s improvement plans had not been implemented fully effectively and the provider was still in breach of one regulation around leadership.

Why we inspected

We undertook this targeted inspection to check whether the Warning Notice we previously served in relation to Regulation 12, (1)(2)(a)(b)(e)(g)(h) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also reviewed the actions taken in relation to the breaches found at the inspection of July 2019. The overall rating for the service has not changed following this targeted inspection and remains requires improvement.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fernbrook House on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.