The Ferns

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The provider was in breach of legal regulation in relation to consent.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Staff worked closely with external health and social care professionals to respond in a timely way to any changes in needs or individual presentation. People’s relatives confirmed they were involved in all aspects of their loved one’s care needs and kept well informed of any changes. The provider used social stories to aid communication for those who required it.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. One person required a modified diet due to swallowing difficulties, and we saw their food had been blended into one mixture, rather than each item being presented separately so they could experience different flavours. Staff confirmed they usually placed all foods in a blender and mix them together. This practice does not follow national guidance, which recommends preparing each food type separately to maintain distinct tastes and textures. These concerns were supported by the fact that staff had not received training in dysphagia.

We raised this issue with the management team, who informed us they would be arranging appropriate training for staff.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services They passed on assessment details when individuals moved between services or went to hospital. Staff supported people to attend appointments and take part in any assessments. People also created personal passports which recorded their needs and preferences, helping to reduce anxiety during transitions.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access additional healthcare services when needed. Staff told us about instances where they had observed changes in people’s health. People benefited from having a consistent staff team who people knew well and had developed relationships with them.

The provider routinely monitored people’s care and treatment to continuously improve it. People were supported by staff who engaged healthcare professionals in reviews and assessments to ensure relevant information was incorporated into their care plans. They ensured outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

The provider did not ensure staff worked fully in line with The Mental Capacity Act 2005 (MCA). We were concerned about the lack of mental capacity assessments and best interest decisions (BI) undertaken, relating to several important aspects of people’s care. This included decisions about locking kitchen doors, restricting access to ensuite bathrooms, and withholding certain foods. This could impact on people’s human rights.

We saw some examples where mental capacity assessments and best interest decisions had been undertaken appropriately, such as for flu vaccinations, medication, and care and support, where people lacked the capacity to make these decisions themselves.

We raised our concerns with the management team, who acknowledged the issues and assured us that action would be taken.