Fern Lodge

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 – 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. This is the first inspection of this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (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 to develop care plans. Care plans were largely clearly written, with a good level of detail and positive descriptions about people and how they wanted to be supported. For example, 1 person had a specific night-time routine with how they would like to get ready for bed. This was clearly recorded for staff to follow.

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. Our observations showed people could choose what they would like to eat and when, from the options on offer. For example, deciding which toppings they would like on their jacket potato. A relative said, “Absolutely good, first-class meals. [Staff] give choice, they come in and ask [person].” We recommended leaders consider how to document people’s involvement in designing the menu. The management team told us they would act on this feedback.

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. Professionals were engaged in reviews and assessments to ensure relevant information was incorporated into people’s care plans. This included, for example, the learning disability team, occupational therapists, speech and language therapists (SaLT), specialist epilepsy nurses, as well as GP and dentistry input. This led to good outcomes for people. A professional told us, “This specific provider is one of the best ones” in relation to meeting people’s highly individual and complex care needs.

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. People had health action plans to support them to remain healthy and well. There was access to active leisure activities, for example, we saw 1 person going out to the swimming pool on the day of our visit. People also regularly attended trampolining and visited local parks. There was also a large garden for people to enjoy.

The provider routinely monitored people’s care and treatment. For example, some people’s weight was monitored to check for weight loss or gain. These monitoring forms required some improvement, to capture whether the information showed any trends and when a referral to the dietician would be required. One person’s relative told us they were worried about a person’s recent weight gain, which could impact on the person’s wellbeing. The manager made a referral to the dietician, updated staff, and changed the recording form to show how information gathered as part of monitoring processes would be used to improve outcomes for people. Further enhancements were also required to show how the service monitored people’s quality of life, as some daily care notes contained more basic information. The manager told us they would act on this feedback.

The provider told people about their rights around consent and respected their rights when delivering care and treatment. Our observations showed people were offered choice, independence and control by staff. Mental Capacity Assessments (MCAs) had been completed to check whether people could consent to all aspects of their own care and treatment, and to show decisions made in people’s best interests. One person relatively new to the service did not yet have MCAs in place, but this was completed by staff during the CQC assessment period. Some people were subject to Deprivation of Liberty Safeguards (DoLS). However, although referred to in care plans, there was no effective oversight mechanism for DoLS in place across the service. The manager took action to remedy this straight away during the inspection.