Fernleigh House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating remained good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

There was a documented process to follow to support people to move into the service in a safe and person-centred way. A relative shared their family member had been supported over several months to move into Fernleigh House and described this as, “Meticulously planned.” They shared their relative had been involved and supported throughout.

Information was provided to health professionals to inform clinical decision making and enable understanding of people’s care and support needs. For example, if a person needed to go to hospital in an emergency, detailed written information was provided. This helped communicate essential information to staff who may be unfamiliar with the person’s needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The registered manager raised concerns to the appropriate authorities and completed investigations when these were required. During the assessment a person who used the service said, “I’m safe, staff help me stay safe.” A relative we spoke with said, “I never have to worry about [family member] safety now, the way they look after him means I don’t have to.”

Staff were able to confidently explain the reasons they may make a safeguarding referral to the safeguarding authority and how they would do this. A staff member commented, “I’ve never had to safeguard anything, but I would. It would be my priority.”

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes/hospitals, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found DoLS applications were submitted appropriately. Mental capacity assessments were carried out and best interest meetings and discussions were documented. This helped ensure any restrictions were lawful.

The provider worked with people to understand and manage the individual risks they faced by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were completed to identify individual risks, and these were reviewed when required. Care records contained information on how risks could be minimised. For example, we saw risk assessments that supported people to remain safe in the local community. This minimised the risk of avoidable harm and supported independence and safety. A family member shared they had been empowered to understand the support their relative required to minimise risk and provided training and equipment to support. This demonstrated the service worked with people and those important to them to identify and minimise risks.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Equipment was serviced to help ensure it was safe to use. For example, regular checks were carried out on water temperatures and window restrictors.

There was a fire risk assessment to help manage the risk of fire and people had individual Personal Emergency Evacuation Plans (PEEPS). This helped ensure staff knew the support people needed if they needed to evacuate the service in an emergency.

People were supported in a homely environment and people’s private spaces could be decorated to their own tastes. People’s safety was supported by appropriate security arrangements and the garden was a well maintained and safe area for people to enjoy.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider followed recruitment procedures to ensure all required checks were completed before staff started work at the service. Enhanced Disclosure and Barring Service (DBS) checks were carried out. DBS checks provide information about convictions and cautions held on the police national computer. The information helps employers make safer recruitment decisions.

People were supported by sufficient staff who were known to them and could meet their needs and chosen routines. There was a detailed induction to enable staff to learn about people’s needs and preferences. Staff had regular meetings and training to support their development and skills. A relative commented that staff were, “Highly trained,” and, “They have the expertise to look after [family member].”

Staffing was arranged so people could pursue their individual interests and develop their skills with help from staff who understood their goals and promoted choice and independence. Relatives gave consistent feedback that people were supported by staff who knew them well and raised no concerns with the staffing provision at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People were supported in an environment that was visibly clean and well maintained. Cleaning schedules were available to ensure cleaning was consistently carried out and checks on the cleanliness of the service took place.

Staff had access to personal protective equipment and appropriate cleaning products were accessible to staff for use when needed.

The kitchen was clean and well organised. Food was stored safely and was labelled and dated on opening. This helped ensure food was safe for use.

The provider always made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff always involved people in planning, including when changes happened.

Medicines were managed exceptionally well to promote people's health, wellbeing and independence. Medicines were stored securely, administered safely by competent staff and reviewed regularly to ensure they remained appropriate and effective. Staff took a highly person-centred approach, working closely with people, their families and healthcare professionals to achieve the best possible outcomes.

The service demonstrated excellent practice in line with the NHS England STOMP (Stopping Over Medication of People with a Learning Disability and Autistic People) initiative. Staff recognised subtle changes in one person's behaviour that were affecting their daily life and worked proactively with healthcare professionals to arrange a medicine review. As a result, a prescribed medicine was discontinued. This led to a significant improvement in the person's wellbeing, reducing distress behaviours, enabling them to return to their preferred routines, take part in activities they enjoyed and go on family holidays again.

In addition, the registered manager researched a person’s condition and the impact of the medication they were prescribed when this became unavailable. The outcome of detailed care planning and implementation of strategies to help the person manage without the medication was shared with relevant health professionals. The person had displayed no distress behaviours, strategies had a positive impact and as an outcome the person’s diagnosis was removed and the medication was permanently stopped. This led to referrals to other health professionals so the person could be correctly diagnosed and could access the correct medical support for their needs. This showed how the service went beyond safe medicines management to achieve meaningful and life-enhancing outcomes for people.