Archived: Fern Bank Residential Care Home

We last inspected the home in August 2014. At that inspection we found that the service was meeting all the regulations we assessed.

Fern Bank is a private care home, which has been owned and managed by the same family for over thirty years. It is a large detached Victorian House, situated opposite a park, approximately one mile from Oldham town centre. Fern Bank is registered to provide care and support for up to 26 people who have mental health needs or physical disabilities related to the ageing process and supports people who are over 50 years of age. At the time of our inspection there were 25 people living at the home, two of whom had a diagnosis of a dementia type illness. Although Fern Bank is a care home, the service calls itself a ‘therapeutic community’. It's philosophy is based on the concept of ‘normalisation’. The statement of purpose describes “normalisation,” as being brought about through ‘’social interaction with trained staff and support from fellow people who use the service’’ and explains that the giving and receiving of positive feedback promotes self-esteem and improves people who use the service’ social and emotional well-being.

The home offers three types of accommodation: single rooms with en-suite facilities, shared rooms with en-suite facilities and reablement studio apartments with a bedroom, bathroom and kitchen.

When we visited the service a registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to Deprivation of Liberty Safeguards (DoLS).

You can see what action we asked the provider to take at the back of the full version of this report.

Two people who use the service who had a diagnosis of dementia did not have the required Deprivation of Liberty Safeguard in place (DoLS).

The service was in the process of updating and reformatting all risk assessments and care documentation.

Staff had a good understanding of safeguarding procedures, how to identify signs of abuse and what action they would take to protect vulnerable people in their care.

From our observations we saw that there were sufficient, appropriately trained staff available to support people in the home and recruitment checks had been carried out on all staff to ensure they were suitable to work in a care setting with vulnerable people.

Medicines were stored correctly and administered by staff who had received appropriate training and been assessed as competent to safely administer medication.

The building and furnishings were maintained and decorated to a high standard and environmental checks were up-to-date. The home was clean and free from unpleasant odours and systems were in place for the prevention and control of infection.

Staff had received an induction and had undertaken a variety of training to ensure they had the skills and knowledge required for their roles. Staff received regular supervision which ensured that the standard of their work was monitored.

People were supported to eat and drink sufficient amounts to meet their needs and were actively involved with planning the choice of food offered.

We observed that staff were kind and caring. Through talking with staff and people who use the service we found that people were treated as individuals and that staff really knew each person and responded to their needs in a caring manner. Staff offered encouragement and spoke in a positive way to people who use the service in order to help improve their self-esteem.

People were supported to maintain good health and where needed specialist healthcare professionals were involved with their care.

Activities were at the heart of the daily life of Fern Bank and a range of varied activities, suggested by people who use the service, was available.

People using the service, relatives and healthcare professionals were able to express their opinions about the service through regular surveys about the quality and standard of care provided. The home had a complaints procedure and people we spoke with knew how to make a complaint if they needed to.

Quality assurance processes such as audits were in place to ensure that the service delivered a high standard of care. However, they had not identified that DoLS were needed for two of the people who used the service.

Staff worked well together and there was a positive culture among staff. The management team was forward thinking and keen to promote Fern Bank as a happy and positive place in which people with mental health problems could live.

to answer five key questions; is the service safe, effective, caring, responsive and well led?

As part of this inspection we spoke with five people who use the service, two visitors, the

registered manager, the registered provider and three care staff. We also reviewed records

relating to the management of the home which included, five care plans, daily care records,

and five staff records.

Below is a summary of what we found. The summary describes what people using the

service, their relatives and the staff told us, what we observed and the records we looked

at.

Is the service safe?

The premises were clean, well maintained and had procedures in place for responding to foreseeable emergencies to reduce the risks to people at the home.

There was a staffing rota in place and everyone we spoke to including staff, visitors and people living in the home all felt there was enough staff on duty at any time. All staff felt they received plenty of training and felt competent to do their job. A person living at the home told us 'Staff always help you straight away.'

Is the service effective?

People's needs were being met at the home. We found that people's needs were assessed and care files included information about people's diagnosed health conditions and also their preferences. This meant they received care that protected their welfare and safety.

People and their relatives told us the food was good and there was a choice at meal times. One person said, "The food here is very nice and you can choose the menu."

Is the service caring?

People told us they were happy with the care they received at the home. One person said, "I felt at home as soon as I came here, it is like a little village." We observed that staff providing people's care were gentle and encouraging.

People appeared to be treated with dignity and the staff could tell us what they were able to do to maintain a person's dignity. One told us, "They (the staff) always knock on your door before coming in.'

Is the service responsive?

People's needs had been assessed before they moved to the home. People's records identified personal preferences and choices and the support that needed to be provided. The home worked with other services to ensure all care needs were met for the person such as a community psychiatric nurse or chiropodist.

People who lived at the home and that we spoke to all felt that they could approach staff and the manager about anything and that they would be listened to and acted upon. Staff felt the manager was very supportive and her door was always open to them.

Is the service well-led?

The manager completed regular checks and audits of medication, infection control systems and other aspects of safety and care at the home. Records showed incidents and accidents, complaints and quality audits were reviewed by the manager.

Staff had an induction programme and appropriate checks were in place. Staff felt listened to and supported by their team leader or manager.

Each person using the service had an up-to-date care plan. People could contribute to their care plan, as could appropriate relatives and staff members. Comments about the care provided included 'I am listened to', 'I couldn't fault it' and 'The staff are great'.

The provision of meals and drinks was good. Menu choices were discussed with people who used the service. Two people cited the 'very good food' as being amongst the best things about Fern Bank.

The building was clean, tidy and well maintained. People could personalise their own rooms.

There were enough staff on duty to help ensure people's identified needs could be met.

There was a written complaints procedure. People using the service who we asked, told us they would feel comfortable raising a complaint if necessary.

Without exception, people who we spoke to were positive about the care and support provided at Fern Bank. People using the service told us that they believed they were treated with respect and they had their dignity and privacy maintained.

Staff understood the individual needs of people living at the home. People were involved in discussions about their care and support, and their views and opinions were valued.

People were safe living at Fern Bank insofar as they were protected from abuse and exploitation. Staff understood their responsibility to be vigilant and if necessary take action to protect the interests of the people living at the home. People's safety was also enhanced by appropriate recruitment and vetting procedures being followed.

There were effective processes in place to monitor the quality of the service being provided.