Fernbank Residential Home

Fernbank Residential Home is a care home providing accommodation and personal care for up to 46 older people, some who may also be living with dementia. There were 42 people living in the home at the time of our inspection. The service was one adapted building laid out over three floors with a new extension having been built.

People’s experience of using this service and what we found

People told us they felt safe living at the home and that staff were kind and considerate towards them. Risks to people had been assessed and actions put in place to mitigate these. People were supported by enough, qualified staff who had received training that was specific to the needs of the people they cared for. Infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. People medicines were managed and administered safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager ensured that quality assurance systems were completed to monitor people’s safety and care, and to drive improvement. The registered manager encouraged feedback from people, staff and professionals involved in people’s care. Staff worked closely with health professionals and external agencies to promote good outcomes for people. People spoke positively about the registered manager.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 10 October 2019).

Why we inspected

We received concerns in relation to falls management and staff’s response to incidents. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained at good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service and what we found

People and relatives spoke highly of the service they received at Fernbank. People and relatives made comments including; “The care here is marvellous. They get nothing but praise from me”, “It’s good here. They are very supportive. I’m very happy” and “I am delighted. They do a wonderful job here. She is so well looked after.” The service had strong person-centred values and placed people’s wellbeing at the heart of their work. People received personalised support which met their needs and preferences.

Risks to people’s health, safety and wellbeing were identified, assessed and acted upon. People were protected from potential abuse by staff who had received training and were confident in raising concerns. There was a thorough recruitment process in place that checked potential staff were safe to work with people who may be vulnerable to abuse and avoidable harm.

People received their medicines as prescribed by their doctor and there were processes in place to manage the ordering, storing and disposal of medicines. Incidents and accidents were investigated, and actions were taken to prevent reoccurrence. Fernbank was clean, welcoming and pleasantly decorated. Staff received training and supervision to meet the needs of the people living in the service.

Staff knew people well and worked hard to enable them to share their views, make choices and live active lives as independently as possible. People were fully involved in the planning and delivery of their care.

People’s needs were assessed and care was planned and delivered to meet legislation and good practice guidance. People’s support plans contained personalised information which detailed how they wanted their care to be delivered. Staff worked hard to provide people with varied activities and stimulation that met their interests.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported by kind and caring staff who worked hard to promote their wellbeing. Staff were proud to work for the service and treated people with respect and dignity. The service promoted equality and diversity and worked hard to meet all of people’s individual needs.

There was strong leadership at the service. People and staff spoke highly of the registered manager and there was a positive culture at the service with people and staff feeling their voices were listened to.

There were effective quality assurance systems in place to assess, monitor and improve the quality and safety of the service provided.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was Good (published March 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Fernbank Residential Home provides accommodation, nursing and personal care for up to 32 people, including people living with dementia. There were 24 people accommodated there on the day of our inspection.

The service had a registered manager in post. A registered manager is a person who has registered with the CQC 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.

People were safe. The registered manager and staff team were all knowledgeable about safeguarding issues and protected people from harm. Where concerns had been raised previously, the registered manager worked with the local authority safeguarding team and made changes where these were needed. The staff team knew how to raise and report concerns if they witnessed, suspected or were told about any bad practice or abuse. All staff had received training in safeguarding adults. Medicines were administered to people safely.

Risks relating to people's care were assessed and reviewed each month. Staff were familiar with risks associated with people's care and records showed that control measures that had been put in place to minimise risks to people where appropriate.

The accommodation provided was to a good standard, with a variety of pleasantly decorated and well furnished lounges and seating areas. The building was safe and well maintained. The property was in the process of being extended and as such had additional signage to improve safety and highlight potential hazards. Other risks associated with the building and working practices were assessed and steps taken to reduce the likelihood of harm occurring. The home was clean throughout.

Any risks to people's health and welfare were assessed. The care plans included instructions on how to reduce or eliminate the chances of injury. Where people needed to be assisted to move, their moving and handling needs were assessed and a moving and handling plan was written.

Staffing numbers on each shift were calculated to ensure each person's care and support needs could be met. Staff were provided with regular training and were supported by their colleagues and the registered manager to do their jobs.

The registered manager and the staff team were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were asked to give consent to care, support and treatment. Where people lacked the capacity to do this, staff worked within best interest decision making procedures.

People enjoyed their food and were provide with a varied and balanced diet. People's health needs were met and they had access to external professionals as required.

Staff were kind and caring and understood people's needs. People were involved in decisions about their care. People's privacy and dignity was respected.

People using the service and staff spoke well of the registered manager and they felt the service had good leadership. Good communication was evident between staff working different shifts. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.

People who used the service told us they liked living in the home. "Staff are kind and caring and always help me when I call them". "I have a lovely room and they keep it so clean". People were given control to make lifestyle choices and we saw evidence that care was directed around the needs and choices of the people living in the home.

The home was clean and hygienic and staff were aware of their responsibilities regarding infection control. The staff we spoke with told us they liked working in the home. They said they had received the training and supervision necessary to undertake their roles.

We saw staff offered care and support to people who used the service in a sensitive, caring and professional manner. We looked at the provider's quality assurance systems and found a range of monitoring processes in place to monitor the quality of the service provided.

We found that people were protected from the risk of abuse and unsafe care. People told us they felt safe living at Fernbank. Staff members had received appropriate safeguarding training and were knowledgeable about these procedures. Background checks were done on members of staff to ensure they were of good character.

We spoke with two members of staff who told us they received appropriate training and support in their roles. We saw that staff had received yearly refresher training in key areas of health and caring for people. Staff also received regular supervisions, appraisals and had support from their managers and colleagues. Staff expressed high job satisfaction and one member of staff commented, "I love it."