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Archived: Fernwood Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 27 February 2018

Fernwood provides residential care for up to three people with learning disabilities. There were two people living there at the time of our inspection. People needed support with communication and were not able to tell us their experiences, so we observed that they were happy and relaxed with staff. One person had physical disabilities that they needed staff support with.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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. The owner is also the registered manager of the home.

This is the third time the home has been rated requires improvement. At the last inspection in August 2016, a number of breaches of regulations were identified and requirement notices were issued. Breaches were in relation to a lack of good governance, person centred care and not having suitably qualified and competent staff. Following the inspection we met with the provider to discuss their report. We asked the provider to complete an action plan to show improvements they would make, what they would do, and by when, to improve the key questions in safe, effective, responsive and well lead to at least good.

This comprehensive inspection took place on 17 November 2017 to check the provider had made suitable improvements to ensure they had met regulatory requirements. We found that appropriate actions had been taken and issues had been addressed. The provider was now meeting the regulations and although still rated requires improvement in two areas, significant improvements had been made. However, further improvements were still needed in relation to person centred activities and record keeping to ensure they were embedded into everyday practice.

Appropriate checks had taken place before staff were employed to ensure they were able to work safely with people at the Fernwood. People’s needs were effectively met because staff had the training and skills they needed to do so. Staff were well supported with induction, training, supervision and appraisal. Staff knew how to safeguard people from abuse and what they should do if they thought someone was at risk. People’s medicines were managed safely.

People were treated with dignity and respect by kind and caring staff. Staff had a good understanding of the care and support needs of people and had developed positive relationships with people.

People had enough to eat and drink and the menus were varied and well balanced. Appropriate referrals were made to health care professionals when needed and people were supported to attend health appointments, such as the GP or dentist.

People were encouraged to be involved in decisions and choices when it was appropriate. Mental Capacity Act 2005 (MCA) assessments were completed as required and in line with legal requirements. Staff had attended MCA and Deprivation of Liberty Safeguards (DoLS) training.

There was good leadership in the home and the registered manager had an open door policy which staff valued. The organisation had effective systems to monitor and review the quality of the care provided. Further information is in the detailed findings below.

Inspection areas

Safe

Good

Updated 27 February 2018

The service was safe.

People's medicines were stored, administered and disposed of safely.

There were risk assessments in place and staff had a good understanding of the risks associated with the people they supported.

Staff understood the procedures to safeguard people from abuse.

There were enough staff that had been safely recruited to meet people's needs.

Effective

Good

Updated 27 February 2018

The service was effective.

Staff received training and supervision to ensure they maintained and developed their knowledge and skills.

The manager and staff had a good understanding of mental Capacity assessments (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were given choice about what they wanted to eat and drink and ate food they enjoyed.

People were supported to have access to healthcare services and maintain good health.

Caring

Good

Updated 27 February 2018

The service was caring.

People were treated with respect and dignity.

Staff knew people well and treated them with kindness and warmth.

Staff talked to people in a way they could understand.

Responsive

Requires improvement

Updated 27 February 2018

The service was not consistently responsive.

There was a lack of assessment to determine appropriate activities to meet one person�s needs.

People received support that was responsive to their needs because staff knew them well.

People�s support plans contained guidance to ensure staff knew how to support them.

Well-led

Requires improvement

Updated 27 February 2018

The service was not always well-led.

There were no effective systems for auditing care plans.

People spoke positively of the improvements that had taken place since the last inspection. Staff felt supported and listened to.

There were effective systems to monitor the quality of the care provided.