Background to this inspection
Updated
3 February 2015
This inspection was completed by one inspector and a specialist advisor. A specialist advisor is a person who has experience of this type of service.
Before our inspection we looked at and reviewed the provider’s information return. This is information we have asked the provider to send us about how they are meeting the requirements of the five key questions we always ask.
We spoke with one person who was living at the home, two relatives, seven members of the care staff team, including the unit manager and the registered manager.
Not everyone who used the service was able to speak with us. This was because some people had complex care and communication needs.
We looked at four people’s records and other records that related to people’s care. We also looked at other records relating to the running of the service, such as service user quality assurance survey questionnaires, staff recruitment and supervision records.
This report was written during the testing phase of our new approach to regulating adult social care services. After this testing phase, inspection of consent to care and treatment, restraint, and practice under the Mental Capacity Act 2005 (MCA) was moved from the key question ‘Is the service safe?’ to ‘Is the service effective?’
The ratings for this location were awarded in October 2014. They can be directly compared with any other service we have rated since then, including in relation to consent, restraint, and the MCA under the ‘Effective’ section. Our written findings in relation to these topics, however, can be read in the ‘Is the service safe’ sections of this report.
Updated
3 February 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, and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service. This inspection was unannounced.
Nottingham Neurodisability service Fernwood is part of Huntercombe Services Nottingham. It is a high dependency unit and provides care for up to 20 adults with acquired brain injury and other complex neurological conditions.
A registered manager is currently employed at the service. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider.
At the last inspection which took place on 8 July 2013 we asked the provider to make improvements to ‘Respecting and involving people who use services’ and to ‘Staffing’. We found at this latest inspection that the provider had made the improvements in line with the action plan they provided us with. Nineteen people lived at the service at the time of our inspection.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We saw that there were proper policies and procedures in relation to the MCA and DoLS to ensure that people who could not make decisions for themselves were protected. We saw that people were encouraged to make decisions for themselves where they were able to. Where people were unable to do this the service considered the person’s capacity under the MCA. We saw records that showed a person’s relatives and health care professionals had been involved in a best interests decision process for that person.
The registered manager and unit manager provided good leadership and support to the staff. They were also involved in day to day monitoring of the standards of care and support that were provided to the people that lived at the service.
The provider had a robust recruitment process in place. Records we looked at confirmed that staff were only employed by the service after all essential safety checks had been satisfactorily completed. Staff we spoke with told us that they had not been offered employment until these checks had been confirmed. Records viewed confirmed this to be the case.
The provider had good systems in place to keep people safe. Assessments of the risks to people from a number of foreseeable hazards had been developed and reviewed. We saw that staff followed these guidelines when they supported people who used the service. An example of this was where people required a hoist to transfer them, staff used a dedicated sling that was for the person’s sole use.
People’s needs and choices had been clearly documented in their care plans. We saw that regular activities had been provided for people and were suitable to meet individual identified choices and preferences.
During our observations over the course of the day we saw that people were treated with kindness and compassion. Visitors we spoke with and people that we contacted by telephone, all told us that the people were supported by kind and caring staff. Staff were able to tell us about the people they supported, for example their personal histories and their interests.