Fernery House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the service met people’s needs.

At our last inspection we rated this key question good. At this assessment the rating has changed to requires improvement.This meant people’s needs were not always met.

The service was in breach of legal regulation in relation to person centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service did not make sure people were at the centre of their care and treatment choices and they did not work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People's care had not always been planned and delivered in a way that was personalised to their needs and promoted their wellbeing in line with the principles of Right Care Right Support Right Culture. Despite care documentation including person-centred information about people’s likes, dislikes, and the best ways to support them, these were not consistently reviewed and updated regularly, when people achieved goals and when their needs or aspirations changed. Due to the service migrating to an electronic care planning system, there was confusion amongst the staffing team of where care documentation was accessible from.

While most people had keyworkers in place, 1 person had not been allocated a keyworker since moving into the service over a year prior and mostly had input from agency staff. People were not always empowered to develop their own care and support plans with support from staff as engagement with keyworkers was inconsistent.

People did not consistently receive responsive, personalised care and support that met their needs. For example, referrals had been made by the service to the provider’s positive behaviour support team, most of them in July 2025, however not all these referrals had been addressed to ensure people were receiving support from staff who had up to date guidelines.

Most people required either 1:1 or 2:1 support to access the community. People had designated days for going out in the community on a rota basis so they could have the safe support required to do certain things they liked. While we had examples of very good outcomes for some people, these were not consistent for everyone living at the service.

The service was accommodating and made efforts to support a person to have a small amount of time in the community weekly, whilst their funding for 2:1 support was being reviewed. However, we observed that while in the home, the person was not receiving a lot of interaction from staff, spending significant amounts of time with the TV on or looking through magazines. One evening they were supported to retire to bed at 18.50 and we observed staff gave them their supper snack not long after they had they dinner. The acting manager explained that this was not the person’s usual routine and were going to look into why this happened.

While staff knew people they mostly worked with, not all staff knew all people well and there was a high reliance on agency staff. For a person who had been mainly supported by agency staff, some employed staff told us they were relying on guidance from agency staff in supporting that person.

Feedback from relatives was predominantly positive, with recommendations to enhance daily routines and promote independence in activities. A relative told us; “Excellent, we’re very grateful for all they [staff] do. [Person] seems happy. I speak weekly to [person] and I ask if [they are] happy and [person] says yes. Only thing I worry about is if they spoil [person] too much!”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff worked collaboratively with other professionals to provide consistent care and evidence we saw demonstrated communication with external services and professionals

A health care professional told us; “[Staff member] is very encouraging, engages well with both [person] and myself, and takes notes of everything [person] does during the session.“

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs. However, these were not always consistently used by all staff.

People had good communication passports in place. We observed staff verbally communicate well with people. Staff were very aware of 1 person’s communication needs and preferences and were supporting them well in line with these.

Some people had communication books in place, with images and symbols to aid, for example, choice making, however staff were not actively using these.

We saw good examples of social stories being used by the acting manager to review people’s mental capacity to consent to annual vaccinations and widgets to allow people to show their pain levels.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They did not always involve people in decisions about their care or tell them what had changed as a result.

Feedback from people had not been sought for a sometime through any process such as feedback forms or house meetings.

There were no systems in place to proactively seek feedback from relatives and professionals.

People’s relatives told us they knew who to speak with to raise concerns and complaints. A relative told us; “I have raised a few concerns not major like safeguarding, pretty frequent conversation with [acting manager] about [person], [they] have been consistent and know [person] well. I feel comfortable raising any criticism with them.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People had access to services and there was joint working between the service and other health and social care agencies. Despite some gaps in documentation, records of people’s health appointments provided us with an overview of when people had received treatment.

The acting manager talked to us about the support they were providing 1 person in order to get used to visits to medical services such as the GP.

People had equal access to the shared environment which was available to them.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

We were concerned that the provider was not consistently adhering to right support, right care, right culture. People who had a primary diagnosis of a learning disability did not live in a tailored environment and their opportunities (ordinary life principles) were not always equally promoted.

People were not always encouraged to share their views and be involved in developing the service. For example, regular resident meetings and keyworker sessions were not taking place.

While we saw some good examples of people experiencing care and treatment that upheld their rights and helped reduce barriers, this was not consistent for everyone. For example, a person with particular communication requirements, was supported in their preferred way and systems were implemented to support the person when key staff were not on shift, which made their experience more inclusive and personalised. However, for another person, staff were not consistently using their identified and suggested communication methods to ensure they had the same experience.

Relatives told us they felt comfortable speaking directly to management staff if they had concerns.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Advanced care planning commenced with the service, together with end-of-life planning. Evidence of explicit information provided a good narrative.