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Inspection Summary


Overall summary & rating

Good

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 help

Inspection areas

Safe

Good

Updated 17 April 2018

The service was safe.

Risks to people were routinely assessed and appropriate plans were implemented to keep people safe.

Staff took action following incidents to reduce the risk of them reoccurring.

There were sufficient numbers of staff to keep people safe. The provider had carried out checks to ensure that staff were suitable for their roles.

People received their medicines safely. Systems were in place to ensure medicines were stored and managed in line with best practice.

People were protected by the prevention and control of infection.

Effective

Good

Updated 17 April 2018

The service was effective.

People were supported by staff that were trained to carry out their roles.

Staff prepared food with people that matched their preferences as well as their dietary needs.

People�s legal rights were protected because staff followed the Mental Capacity Act 2005.

The provider assessed people�s needs holistically and in line with best practice.

People were supported to access healthcare professionals.

Caring

Good

Updated 17 April 2018

The service was caring.

People were supported by staff that were observed to be caring, kind and compassionate.

People were supported to maintain important relationships.

Staff routinely involved people in their care and promoted people�s independence.

People�s privacy and dignity was maintained when staff provided care to them.

Responsive

Good

Updated 17 April 2018

The service was responsive.

People�s care was planned in a person centred way and care plans were accessible to people.

The registered manager reviewed people�s needs regularly and where changes were identified they actioned them.

People had access to a range of activities that reflected people�s needs and interests.

People and relatives were informed of how to complain.

Suitable provision had been made in the event of a person requiring end of life care. To have a comfortable, dignified and pain-free death.

Well-led

Good

Updated 17 April 2018

The service was well-led.

Meetings took place that involved people, relatives and staff in the running of the service.

There was an open culture and people benefited from staff understanding their responsibilities so that risks and regulatory requirements were met.

The provider undertook a range of audits to check the quality of the care that people received.

Staff maintained up to date records and the provider notified CQC of important events, in line with the responsibilities of their registration.