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Archived: Fern House Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 3 October 2018

During a routine inspection

We carried out an inspection of Fern House on 3 and 4 October 2018. The first day was unannounced.

Fern House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Fern House provides accommodation and care and support for up to six people with a learning disability. The service does not provide nursing care. There were five people living in the home at the time of the inspection.

At the time of our inspection, we were informed the ownership of the home was changing from Mr Shaun Martin Brelsford & Mrs Amanda Jane Brelsford to Affinity Supporting People Limited. Appropriate applications had been forwarded to CQC for consideration. This meant new systems and records were being introduced at the time of our inspection.

Fern House is a large mid terraced house, situated in a quiet residential area close to Burnley town centre. There is an enclosed patio/garden area to the rear of the home. Street car parking is available.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission 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.

At the last inspection on 18 and 19 October 2017 our findings demonstrated there were three breaches of the regulations in respect of risk management processes, medicines management and lack of compliance with the Mental Capacity Act 2005. The service was rated Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do to improve the service to at least good and to identify the date when this would be achieved.

During this inspection, we found some improvements had been made to address the breaches in regulation. However, whilst we did not consider the provider to be in breach of the regulations, we found further development was needed in the management of age related risks, the environment and with the management of people’s medicines.

This is the second consecutive time the service has been rated Requires Improvement.

We were aware the proposed new provider was committed to an extensive programme of development which would improve people’s lives. This included changes to the environment, policies and procedures and to the records and systems. During this inspection, we found changes were in progress.

The management of people’s medicines had improved and shortfalls noted at the last inspection had been addressed. However, improvement was needed with regards to the ordering process to ensure people's medicines were always managed safely. The registered manager acted on this at the time of our inspection to prevent this from re-occurring. Staff administering medicines had received training and were deemed competent to do this safely. Policies and procedures had been revised and would guide staff with good practice.

People were happy living in the home and were happy with the facilities provided. They had personalised their bedrooms as they wished and we saw personal touches in the communal areas. However, we found the general cleanliness of the home could be improved and improvements were needed to the environment. We noted that a development plan was in place and extensive refurbishment was due to commence this

Inspection carried out on 18 October 2017

During a routine inspection

This inspection was carried out on 18 and 19 October 2017. The first day of the inspection was unannounced.

Fern House is owned by Shaun and Amanda Brelsford. It is a care home which is registered to provide care and accommodation for up to six adults with a learning disability and does not provide nursing care.

Fern House is a large mid terraced house in a residential area in Burnley. There are communal rooms; including a lounge and a dining kitchen. All the bedrooms are single and two had en-suite shower facilities. There is an enclosed patio/garden area to the rear of the home. Street car parking is available at the front of the premises. At the time of the inspection there were five people accommodated at the service.

The service was managed by a registered manager. A registered manager is a person who has registered with the Care Quality Commission 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.

At our last inspection on 30 June 2015 the overall rating of the service was ‘Good.’ However the service was ‘requires improvement’ in one domain. We therefore made a recommendation on ensuring service is appropriately decorated to meet the needs of the individuals accommodated. At this inspection we found sufficient improvements had been made.

At this inspection we found the provider was in breach of three regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. They related to the provider having unsafe processes for the management of medicines, insufficient risk assessments and risk management processes and a lack of compliance with the Mental Capacity Act 2005. You can see what action we told the provider to take at the back of the full version of the report.

We found there were management and leadership arrangements in place to support the day to day running of the service. However the providers need to have better oversight of the service and improved checking systems, to make sure the service is safely and effectively run.

Recruitment practices made sure appropriate checks were carried out before staff started working at the service. There were enough staff available to provide care and support and we were told staffing arrangements were kept under review.

Staff were aware of the signs and indicators of abuse and they knew what to if they had any concerns. Staff had received training on safeguarding and protection matters.

Systems were in place to maintain a safe environment for people who used the service and others. However we found some matters were in need of attention.

We found people were supported to make their own decisions and choices. They were effectively supported with their healthcare needs and medical appointments. Changes in people’s health and well-being were monitored and responded to.

People were satisfied with the meals provided at Fern House. Arrangements were in place to offer a balanced diet. People were actively involved with devising menus, which meant they could make choices on the meals provided.

People made positive comments about the care and support they received from staff. We observed positive and respectful interactions between people using the service and staff.

Arrangements were in place to gather information on people’s backgrounds, their needs, abilities, preferences and routines before they used the service.

Each person had a care plan, describing their individual needs and choices. This provided guidance for staff on how to provide support. People’s privacy, individuality and dignity was respected.

People were supported with their hobbies and interests, including activities in the local community and to keep in touch with their relatives and friends. Their well-being was monitored and reviews of their needs were held.

There were proce

Inspection carried out on 21 November 2014

During a routine inspection

We undertook an unannounced inspection on 21 November 2014. Fern House provides accommodation and support to people with a learning disability. The service can accommodate up to six people. At the time of our inspection six people were using the service.

At our last inspection on 23 July 2013 no breaches of regulations or concerns were identified at the visit.

CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). We found the location to be meeting the requirements of DoLS. People using this service and their representatives were involved in decisions about how their care and support would be provided. The registered manager and support staff understood their responsibilities in promoting people's choice and decision-making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

The service had a registered manager who had been in post for some time. A registered manager is a person who has registered with 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.

The people using the service told us they felt Fern House was a good place to live. When asked why, they said it was because of the staff and the support provided to them. People told us staff were available when they needed them and they were able to obtain the support they required.

There was a safe environment for people who used the service but there was a need to re- decorate some areas, particularly on the ground floor of the accommodation.

Staff were knowledgeable in recognising signs of abuse and the associated reporting procedures.

Medicines were securely stored and administered. Assessments were undertaken to identify people’s health and support needs and any risks to people who used the service and others. Plans were in place to reduce the risks identified.

People had individual personal plans that were centred on their needs and preferences. Care plans were developed with people who used the service to identify how they wished to be supported and decide upon goals they wanted to achieve whilst at the service.

We found staff recruitment to be thorough and all relevant checks had been completed before a member of staff started to work in the home. Staff had completed relevant training for their role and they were supported by the management team.

Staff had the skills and knowledge to support people who used the service. Staffing levels were flexible to meet the needs of people, and could be increased to support people to go out if they preferred to have staff with them.

Staff were supported by their registered manager and were able to raise any concerns with them. Lessons were learnt from incidents that occurred at the service and improvements were made when required. The registered manager reviewed processes and practices to ensure people received a high quality service.

Inspection carried out on 23 July 2013

During a routine inspection

Some of the people we spoke with had lived at Fern House for many years. They told us: "The staff are great and are very caring." "We are helped to things that we enjoy and have a very full life". We were told that the service users felt "safe and cared for".

Throughout the inspection we saw staff were regularly interacting with people who lived at the home, helping them to go out to appointments and undertake various other personal tasks.

People were not left alone for long periods and were given time to spend quietly, if preferred. We saw that staff treated people with respect and communicated with them regularly.

We reviewed information about two people's care. We found that the staff understood people's care needs and how to protect them from risk and harm. Records we looked at showed people's needs were assessed and care and treatment was planned and delivered in line with the individual care plan. We found that the care plans were accompanied by risk assessments and risk management plans to ensure people were protected from unsafe care practices.

We found that there were effective systems in place for the safe storage and administration of medicines.

We saw that there were effective recruitment procedures in place to ensure that people who used the service were protected from harm through good staff recruitment processes.

Inspection carried out on 12 December 2012

During a routine inspection

We reviewed records including details of the last survey conducted with relatives of people who had used the service previously. These indicated that there was a good satisfaction response from all of those contacted.

We found that people were given a choice about what care and support they received. Staff had been trained in assessing people's mental capacity and people's right to make decisions about their care and support for themselves.

Medical and personal needs for each individual were noted in their care plans. Staff were trained in handling medical emergencies and were briefed on the specific medical needs of individuals using the service.

Appropriate numbers of skilled staff were assigned to each shift to meet the particular needs of the individuals using the service. Staff received appropriate training in providing care and support, as well as specific training in caring for people with a learning disability.

Accurate records were kept of what medications people had taken and when. Care plans contained full details of people's medical and personal needs, their preferences for how they wanted to be cared for and supported, as well as what care and support had been provided.

Inspection carried out on 22 July 2011

During a routine inspection

People told us that that they were provided with a good standard of care. They were involved in the planning of their care and were supported with their medication. They said that they were given choices. Their views were respected and staff encouraged them to be part of the local community and to use the local facilities for education and leisure.

People we spoke with told us that they were safe and comfortable and "love my own room". Others told us about their hobbies and how staff had helped them to do things they enjoyed, like attending music classes, day trips and holidays.

We saw that the people living in the home are involved in planning their care and are in control of how their support is provided for them.

Everyone we spoke to said they received the support they needed with their physical healthcare. People said they got on well with the staff and they felt well supported by people working at the home.

Reports under our old system of regulation (including those from before CQC was created)