Fernlea

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

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 the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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. Initial assessments were completed before admission, and risk assessments were updated regularly to ensure they accurately reflected people’s current needs.

People told us staff understood them well. One person told us, “Staff know what I like and don’t like, which makes me happy.” Relatives also described a well‑managed and supportive admission process. One relative told us, “Staff worked really closely with me and my family to ensure a smooth transition for [family member] before [family member] moved into the home. I was worried, but it went really well, I can sleep at night knowing [family member] is being looked after.” Another relative told us, “Staff know [family member] well even though [family member] cannot communicate.”

People’s care plans were up to date, person‑centred and detailed. They clearly recorded people’s health conditions, their preferences, and their communication needs, and showed appropriate involvement from external professionals.

Staff described working closely with healthcare professionals to support joined‑up care. They explained how understanding individuals’ preferences helped them tailor support more effectively, and they demonstrated a clear awareness of the different communication approaches required for different people.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People and relatives told us they were actively involved in discussions about their care and felt listened to. One person told us, “We are always asked to make suggestions about improving our care and home and what could be done better, but there is nothing, it’s brilliant living here. I feel looked after and safe.” This demonstrated that people felt valued and that their experiences informed ongoing improvements.

Staff worked closely with health professionals, and we saw several examples of effective collaboration and acting on professional advice. One professional told us, “I have worked with the service to develop a person‑centred care plan that details the individual’s health and care needs.”

Staff had received up‑to‑date training, including additional specialist training relevant to the needs of people living at the service. Competency assessments had been completed, including medication competency checks, to ensure staff were confident and skilled in delivering safe and appropriate care.

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.

Staff demonstrated a strong understanding of each person’s needs and worked cohesively to deliver coordinated, joined‑up care. One relative told us, “Staff understand [family member] needs very well. They all had additional specialist training to ensure they could look after them, staff have been brilliant. I feel confident that they fully understand [family member] needs, and it is clear that 100% of the staff genuinely want to look after [family member] and improve their health and wellbeing.”

Records demonstrated multidisciplinary involvement in people’s care. One staff member told us, “I value external professionals and family members input.” Other staff described working collaboratively to plan care, review outcomes and ensure people continued to receive the right support.

Professionals told us the service always provided clear, accurate information and was proactive in seeking advice when required. One professional told us, “Staff really know their residents they are always professional and respectful and treat residents as an individual.” Other professionals told us staff followed guidance and maintained strong, respectful professional relationships.

Staff supervision and team meetings were used to reflect on practice and discuss any concern and shared learning.

Staff handovers were thorough and well‑structured. Staff routinely shared updates about people’s health, wellbeing and preferences.

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.

Staff supported people to maintain routine health appointments and ensured they were not missed. One person told us, “Staff take me to the dentist for my appointments.”

People living at the service told us there was always a choice of food, including healthy options, and that menus were discussed at resident meetings. One person told us, “I am always given options with the meals, there are also healthy options.”

People and relatives also told us people could have food when they were hungry; mealtimes were not rigid or restrictive.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff regularly involved people and their relatives in review meetings to ensure care reflected current needs. One person told us, “I am asked if I want to be involved in my care review but I don’t need to, they are doing a good job, I’m happy and feel safe, it’s my home.”
One relative told us, “I speak to staff regularly about [family members] care not just at reviews, the communication is very good and I’m confident the staff are providing good care.”

Care plans and risk assessments were reviewed every 3 months and updated as needed, with evidence of this seen during the inspection. The provider used a range of clinical tools to identify risks and implement measures to reduce them, supporting safe and effective care.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. 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 where people lacked capacity, the provider completed MCA assessments and they were decision‑specific. The provider also applied and monitored DoLS authorisations in a timely and consistent way, ensuring any conditions were checked and incorporated into care plans.

However the service had held Best Interest meetings, but these had not been documented. A Best Interest meeting is held when a person cannot make a big decision for themselves because they lack capacity at that time. Because there were a number of restrictions in place, the manager recognised that the Best Interest paperwork should have been completed. This is now being prioritised, so records are accurate and decision‑making is properly documented

One person told us, “Staff always ask for consent before dressing and washing me.” Another person told us, “Some days I like lying in; staff check on me, but I get up when I want to.”

Staff demonstrated a clear understanding of the requirements of MCA and associated codes of practice.