23 October 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.
This comprehensive inspection took place on 18 September 2018 and was unannounced. A second day of inspection took place on 19 September 2018 which was announced. The inspection team consisted of one adult social care inspector.
Before the inspection we reviewed the information we held about the service. This included the notifications we had received from the provider. Notifications are changes, events or incidents the provider is legally required to let us know about. 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.
We contacted the local authority commissioning team, the safeguarding adult’s team and the local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
During the inspection we spoke with eight people living at the service and six visitors. We also spoke with the registered manager who was also the nominated individual and owner. We also spoke with the team leader, four care staff, the activity co-ordinator, the administrator, the chef, a kitchen assistant, laundry and domestic staff. Following the inspection, we rang the deputy manager as they were unavailable during the inspection site visits.
We reviewed three people's care records and five people's medicine records. We also reviewed two staff recruitment files and records relating to the management of the service.
We looked around the building and spent time in the communal areas. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
23 October 2018
This inspection was carried out on 18 September 2018 and was unannounced a second announced day of inspection took place on 19 September 2018.
Ferguson Lodge is a residential care home providing personal care for 46 people some of whom may be living with a dementia. At the time of the inspection 43 people were living at the home.
At our last inspection we rated the service Good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection is written in a shorter format because our overall rating of the service has not changed since the last inspection.
At this inspection we found the service remained Good.
Why the service is rated Good.
The staff team treated people, and their relatives, with kindness, compassion and respect. Relationships were warm, friendly and caring. There was lots of laughter and smiles and everyone was relaxed in each other’s company. Staff were observant and responded to people’s needs in a timely and respectful manner.
People and their relatives had been involved in writing care plans and one page profiles so staff got to know the person and some of their history. This was useful in developing relationships and planning activities that were meaningful for people.
The provider had effective systems to ensure people were safe. Any identified risks had been assessed and minimised to keep people safe.
Safe, values based recruitment processes were used and there were enough staff to meet people’s needs.
There was a focus on good nutrition and hydration. All meals were freshly prepared using only fresh ingredients. This had a positive impact on people’s health and well-being.
People remained registered with their family doctor if they chose to and were supported with access to other healthcare professionals if needed, including dentists, podiatry, district nurses and specialist consultants.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
Staff understood safeguarding procedures and any concerns in relation to harm, accidents and incidents were logged and investigated. Lessons learnt were a key element to analysing any incidents or concerns which were used to develop the quality of the service.
Staff managed medicines safely and audits were used to ensure safe systems of ordering, storing, administering, recording and returning medicines were used.
The provider ensured there were enough, trained and well supported staff to meet people’s needs in a safe way.
An electronic system was used to make sure staff training was up to date. Staff attended training relevant to people’s needs including nutrition, dementia care and care of the dying person. In addition, staff attended moving and handling training, first aid, safeguarding and mental capacity training.
The premises were safe and dementia friendly. Appropriate checks of fixtures, fittings and equipment were completed. Thought and consideration had been given to the environment to support people to identify specific rooms whilst also maintaining a homely and welcoming atmosphere.
Everyone we spoke with said the service was well run and there were no areas that needed to improve. There were no complaints and any minor concerns were responded to immediately and shared with staff, where appropriate, so lessons could be learnt.
Systems were in place to monitor the quality of the service provided and action plans were used to drive improvements.
The registered manager was focused on innovation and sustainability using technology to good effect to ensure effective and efficient systems were in place.
A sister service known as ‘Home Care Services – Care Hub’ was available for people living in the local community. People who received respite care at Ferguson Lodge and some relatives of people living at Ferguson Lodge also used the service if they needed some support with meals or maintenance. This meant there was support available by a trusted organisation known to people. This service does not provide personal care and therefore is not registered or regulated by the Commission.
Further information is in the detailed findings below.