Archived: Fenners Farm House

Updated 17 April 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 was planned to check 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.

The inspection took place on 23 January 2018 and was unannounced. We also returned on the 31 January 2018. The registered manager was given notice of the second date, as we needed to spend specific time with them to discuss aspects of the inspection and to gather further information. One inspector carried out the inspection.

Before the inspection, we gathered information about the service by contacting the local and placing authorities. In addition, we reviewed records held by CQC, which included notifications, complaints and any safeguarding concerns. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing potential areas of concern at the inspection.

We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.

Due to the nature of people's complex needs, we were not able to ask everyone direct questions. We spent time observing people in areas throughout the home to see interactions between people and staff. We observed people as they engaged with their day-to-day tasks, the care they experienced, including the breakfast and lunchtime meal, medicines administration and activities.

As part of our inspection, we spoke with the registered manager, the deputy manager, four care staff and a visiting community occupational therapist. We also spoke with six people who used the service, observed the care that people received and how staff interacted with people. After the inspection, we spoke with two relatives. We reviewed care plans for three people, medicines records and the records of accidents and incidents. We looked at mental capacity assessments and applications made to deprive people of their liberty.

We looked at two staff recruitment files and records of staff training and supervision. We saw records of quality assurance audits. We also looked at records about food, activities and minutes of meetings of staff and residents.

Updated 17 April 2018

The inspection took place on 23 January 2018 and was unannounced. We also returned on the 31 January 2018. The registered manager was given notice of the other date, as we needed to spend specific time with them to discuss aspects of the inspection and to gather further information. Fenners Farm House is a residential care home providing support to up to nine people. At the time of our inspection there were eight people living at the service. People living at the service had learning disabilities, physical disabilities and some people were living with dementia.

At our last inspection on 15 December 2016, we rated the service overall Good. The key questions Effective, Caring and Responsive were rated good. The key questions Safe and Well-Led were rated Requires Improvement with a repeated breach of Regulation 12 of the HSCA Regulated Activities 2014. People’s medicines were not always managed safely.

We asked the provider to complete an action plan to show what they would do and by when to make improvements. The provider submitted an action plan to us about the measures they were taking to address the concerns found at the previous inspection.

At this inspection, we found that the improvements had been fully embedded into practice and all key questions are now rated as Good.

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

Fenners Farm House accommodates people in one building, which has been extended and adapted in some areas.

The care service 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.

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.

Staff worked with people to identify goals and manage risks in a way that enabled people to develop confidence and skills whilst ensuring that they were safe. The provider took a proactive approach to incidents and which meant that they were deescalated quickly and systems were in place to respond to concerns. Staff understood their roles in safeguarding people from abuse.

There were sufficient numbers of staff to meet people’s needs and the provider had carried out checks to ensure that staff were suitable for their roles. People received their medicines safely. Trained staff administered medicines and the provider managed medicines in line with best practice and regularly audited them. The provider had systems in place to ensure the risk of the spread of infection was reduced and people lived in a clean home environment.

People were supported to access healthcare professionals when required with support from staff.

Staff had received appropriate training for their roles. Staff received one to one supervisions and there was an appraisal process in place. Regular meetings took place that involved staff, people and relatives in decisions about the service. People were asked for consent and care was provided in line with the Mental Capacity Act (2005).

Staff knew people well and interacted with them with kindness and compassion. Staff were respectful of people’s privacy and dignity when providing care to them. People were supported to maintain relationships that were important to them.

Care was planned in a person-centred way. People had their own records to document their care and activities using pictures and photographs. Care planning had achieved positive goals for people and helped them to develop skills and try new things. Care plans were regularly reviewed and any changes to people’s needs were actioned by staff. People were supported by allocated staff that oversaw their care and helped to identify choices and preferences. People and relatives were routinely involved in care planning.

People had access to a range of activities that suited their needs and interests. The provider had a clear complaints policy in place and had a proactive approach to feedback to identify improvements.

The provider carried out regular checks on the quality of the care that people received, this included visits from stakeholders independent of them. There was a variety of audits in place to monitor quality and the provider had sent surveys to relatives to gather feedback from them. The provider maintained accurate an up to date records and had notified CQC of important incidents and events. Staff felt supported by the registered manager, team spirit and morale was very positive.