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Inspection carried out on 5 February 2019

During a routine inspection

Fern Court 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.

Fern Court can accommodate up to 13 people who have a learning disability, mental health condition and Autism. At the time of our inspection 12 people were living there. Accommodation was divided between two houses; the annexe could provide en suite accommodation for up to four people with a living room, kitchen and dining area. People living in the annexe had full access to the facilities in the main house. People living at Fern Court had their own bedrooms with en suite facilities and had access to a shower and bathroom. They shared two lounges and a dining room. The grounds around the property were accessible. A shed in the garden was being converted into a sensory environment.

Fern Court had been developed and designed in line with the values that underpin the Registering the Right Support, Building 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 lived as ordinary a life as any citizen.

This inspection took place on 5 February 2019. At the last comprehensive inspection in August 2016 the service was rated as Good overall. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There was a registered manager in post. They had been registered with the Care Quality Commission (CQC) in 2015. 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.

People’s care and support was individualised, reflecting their personal wishes, routines and lifestyle choices. They were treated with kindness and care. They had positive relationships with staff, who understood them well. People sought out the company of staff. Staff knew how to keep people safe and how to raise safeguarding concerns. Risks were assessed and encouraged people’s independence. There were enough staff to meet people’s needs. Staff understood and respected people’s diverse needs. People who became anxious were helped to manage their emotions. Staff recruitment and selection procedures were satisfactory with the necessary checks being completed prior to employment.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. They made choices about their day to day lives. People and those important to them were involved in the planning and review of their care and support. They chose the activities they wish to take part in. People went horse riding, swimming, trampolining and to the cinema. They went on day trips, to social clubs and a local place of worship. People kept in touch with those important to them. People used information technology to keep in touch with relatives.

People’s preferred forms of communication were recognised. Staff were observed effectively communicating with people, taking time to engage with them. Good use was made of easy to read information which used photographs and pictures to illustrate the text. People had access to easy to read guides about safeguarding, complaints, activities and men

Inspection carried out on 15 August 2016

During a routine inspection

This inspection took place on the 15 and 16 August 2016 and was unannounced. The home was last inspected on 12 and 13 November 2015 where we found a breach of regulation in relation to staff recruitment.

Fern Court is a care home for up to 13 people with learning disabilities and autism. At the time of our inspection visit there were 11 people living at Fern Court.

Fern Court had a registered manager in post. 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 improvements to staff recruitment procedures. Risks to people’s safety were identified, assessed and appropriate action taken. People’s medicines were safely managed. People’s individual needs were known to staff who had achieved positive relationships with them. People were treated with kindness, their privacy and dignity was respected and they were supported to develop their independence and keep in contact with relatives. People were involved in the planning and review of their care and took part in a range of activities.

Staff received support to develop knowledge and skills for their role and were positive about their work with people. The registered manager was accessible to people using the service and staff. There were improvements to systems to check the quality of the service provided including questionnaires for people using the service, their representatives and staff.

Inspection carried out on 12 & 13/11/2015

During a routine inspection

The inspection took place on the 12 and 13 November 2015 and was unannounced.

Fern Court is a care home for up to 13 people with learning disabilities and autism.

Fern Court had a registered manager. 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.

People were not protected against the risk of being cared for by unsuitable staff because robust recruitment procedures were not being applied. Although safety checks were in place for the environment of the home there was no evidence of a check for the electrical wiring.

There was a lack of current checks on the quality of the service by the registered provider. This placed people at risk of receiving care and support that was not safe.

People were protected from abuse by staff who understood safeguarding and safeguarding reporting procedures. People’s medicines were safely managed and they were supported by sufficient numbers of staff.

People received support from caring staff with the knowledge of people’s individual needs. People’s privacy and dignity was respected and their independence was promoted. People’s rights were protected by the correct use of the Mental Capacity Act (MCA) 2005. People’s health care needs were met through regular healthcare appointments and liaison with health care professionals.

People received personalised support that enabled them to take part in activities of their choice. One person had chosen to start playing tennis and this had been arranged for them. There were arrangements in place for people to raise concerns about the service.

The registered manager was approachable to people using the service, their representatives and staff.

Inspection carried out on 20 March 2014

During an inspection to make sure that the improvements required had been made

We did not speak with people who used the service. Due to their complex needs they had not been involved with the staff recruitment procedures that we checked. This was a follow up inspection to check compliance following a previous inspection. We found improvements to procedures for recruiting staff.

In this report, the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. We have advised the provider of what they need to do to remove the individual's name from our register.

Inspection carried out on 7 November 2013

During an inspection in response to concerns

In this report, the name of a registered manager appears who was not in post and not managing the regulated activity at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. We have advised the provider of what they need to do to remove the individual's name from our register.

We used different methods to help us understand the experiences of people using the service because some people had complex needs which meant they were not able to tell us their experiences. We reviewed policies, spoke with staff, checked the premises and looked at staff records.

Concerns had been raised with us prior to the inspection about a lack of evidence to support the provider being a financial appointee for some people, a lack of training around challenging behaviour and a lack of risk assessments for staff with a criminal record.

We found the provider had followed appropriate steps to become the financial appointee for people. Staff knew how to support people when they were anxious and physical restraint was only used as a last resort. Staff had received training to help them support people when they were distressed.

The provider had made improvements to the premises and infection control procedures in line with the action plans to address previous non-compliance.

We found some recruitment checks were not being completed, including the risk assessment of employing staff with a criminal record.

Inspection carried out on 24 April 2013

During an inspection to make sure that the improvements required had been made

We found that meetings were being held with people using the service to gain their views. We also found that people had plans in place for their health care needs and their wishes about their care and support. Work had been carried out in relation to infection control audits although we found issues in the way the laundry was being operated. In addition we found that although some maintenance work had been done since our last visit, other areas were still in need of attention. We found that suitable arrangements were in place for storing and administering medicines. We spoke to one of the people using the service and they told us that they were given their medicines on time.

We found improvements to staff recruitment and improved staffing levels at weekends. The person we spoke to told us how they were able to go out of the home on trips and commented that the staffing levels at weekends were, “much better”. Staff were receiving appropriate support through training and supervision. We also found that quality monitoring systems were in place that included seeking the views of people using the service. When we asked for them, documents and records were produced promptly.

Inspection carried out on 21 February 2013

During an inspection to make sure that the improvements required had been made

We did not speak to people who used the service. This was a follow up inspection to check compliance with warning notices.

Inspection carried out on 30 January 2013

During an inspection in response to concerns

We used a number of different methods to help us understand the experiences of people using the service, because most of the people using the service had complex needs, which meant they were not able to tell us their experiences.

We found that the management of medicines needed to be improved so that people were protected against the risks associated with the handling and administration of medicines.

Inspection carried out on 14, 15 November 2012

During a routine inspection

We spoke to people using the service as we toured the premises. However we were not able to ask them specific questions about the service. This was because of their communication difficulties or their decision not to speak with us.

We found that the views of people about how the service was delivered were not always being sought. However we found that assessments were in place relating to consent and a person's metal capacity.

Some people did not have Health Action Plans in place and this had been highlighted at a previous inspection. We also found that the service had not reported allegations of abuse to us or to the local authority.

Some records relating to staff were missing including training records so we were not able to check if staff had received suitable training. We also found that effective recruitment procedures were not being used. Staffing at weekends may have prevented people from taking part in activities outside of the home.

Work needed to be carried out to the environment of the home as well as measures to protect people against the risks from infection.

Effective checks were not being made on the quality of the service provided.

Inspection carried out on 6, 7 April 2011

During a routine inspection

We interviewed a number of the staff, they told us the following about the service;

I enjoy working here it’s a good staff team and the people in the home are great.

People get to complete lots of activities on a regular basis, these include; Bowling, out for meals, one to one time with staff, using public transport to access the local community (shops, pubs and other places), swimming, crazy golf, playing pool, laser tag, walking, picnics, shopping, attending local social clubs, ball games, arts and crafts. People get to do something every day.

A couple of the people in the home enjoy cooking and work with staff to bake cakes or cook meals.

There is a good range of meals available and staff use cook books with pictures to help people choose what they would like to eat. The food is fresh and people have a good diet.

People living in the home said;

It’s a nice place to live

The food is good and we choose what we have to eat.