Fernlea

Updated 21 October 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the home in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fernlea is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. Fernlea is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

There was a registered manager in post, but they were not available for the inspection. However, there was a home manager available who was in the process of registering with CQC.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the home since the last inspection. We sought feedback from the local authority and professionals who work with the home. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who lived in the home and observed how staff interacted with people in communal areas. An Expert by Experience made phone calls after the site visit and spoke with six relatives. We spoke with six members of staff including care staff, senior care staff, a deputy manager, the manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records, including three people’s care records and multiple medication records. We looked at three staff recruitment files in relation to safe recruitment. A variety of records relating to the building safety were viewed in addition to management records including policies and training records.

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.

Updated 21 October 2022

About the service

Fernlea is a residential care home providing care and support to autistic people and people with a learning disability. The home can accommodate a maximum of 13 people in one adapted building. At the time of our inspection there were ten people living in the home.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support

People were supported with their care needs in this home, but the environment needed improvements in the décor to be more reflective of the people living there as well as to help with effective hygiene. People were having their own rooms decorated, and had input in this, but this process was on-going. 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 to maintain their health and wellbeing and had their choices respected.

Right Care

Staff received safeguarding training and could tell us how they protected people from abuse. However, improvements were needed to staff training as staff had not had specific training around the needs of people living in the home. Medicines were safely managed and the manager acted on feedback when areas of improvement were identified during the inspection. Some people wanted more meaningful activities to take part in on a regular basis. People who wanted to go on holiday were supported to pursue this.

Right Culture

Each person had a care and support plan. However, improvements were needed when recording information in care plans to ensure their language was appropriate and empowering to people living in the home. People felt the management was approachable and they would be able to raise concerns with them. Staff felt supported in their role and felt able to report concerns to management if they should arise. Most staff were familiar with people and their needs as they had been there for many years which helped with consistency in care. The home had recruited to all vacant posts to reduce agency use.

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 25 September 2018).

Why we inspected

We received concerns in relation to staff training around mental capacity, specific health conditions and restrictions. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 home 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 changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fernlea on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to staff training and quality assurance systems at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.