Archived: Fernwood

Updated 27 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Fernwood is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Fernwood has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

We visited the home on the 17 November 2017. This was an announced inspection. When planning the inspection we took account of the size of the service and that some people at the home could find visitors unsettling. As a result, this inspection was carried out by one inspector without an expert by experience or specialist advisor. Experts by experience are people who have direct experience of using health and social care services. We contacted the home the evening before our visit to let them know we would be coming. We did this because staff were sometimes out of the home supporting people who use the service and we needed to be sure that they would be there.

Before the inspection the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed other information we held about the service. We considered information which had been shared with us by the local authority, looked at safeguarding concerns that had been raised and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection we spoke with the registered manager and two members of staff. People were not able to tell us their views of life at Fernwood so we observed the support delivered in communal areas to get a view of care and support people experienced. This helped us understand the experience of people living at Fernwood. There were only two people using the service and we looked at both people’s support plans and risk assessments along with other relevant documentation.

We reviewed the records of the home. This included staff recruitment files, training and supervision records, medicine records, accidents and incidents, quality audits and policies and procedures along with information in regard to the upkeep of the premises.

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.