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Fernlea Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 June 2020

About the service

Fernlea is a residential and nursing care home providing accommodation, nursing and personal care to 48 people aged 65 and over at the time of the inspection. The service can support up to 52 people. Fernlea accommodates people in one purpose-built building over two floors.

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

Concerns were raised over nursing practice during the inspection. The provider had not always ensured that nurses caring for people with wounds had the competence, skills and experience to do so safely. The registered manager did not always have a full overview of actions the nurses were taking.

We identified concerns with the administration and management of medicines. People did not always receive their medicines as prescribed.

Risk assessments and care plans were not always fully accurate. Actions stated as required in care plans were not always followed. This put people at risk of unsafe care.

People were well supported to maintain a balanced and nutritious diet. People were very complimentary about the food at the home. Staff received training and supervision, and told us they felt supported in their role.

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.

Feedback from people and their visitors was very positive around the quality of care delivery at the home. People felt they were treated with dignity and respect and had their independence promoted.

There was a very well-resourced and varied programme of both individual and group activities provided for people. People were well supported to maintain relationships and avoid isolation.

There has been a lack of oversight of the operations of the service and this has led to the concerns identified in this inspection. Statutory notifications were not sent to CQC as required. The management team were very responsive to concerns raised during the inspection.

We made one recommendation to ensure people's consent forms were signed by appropriate people.

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 5 June 2019).

Why we inspected

We received concerns in relation to the management of people’s pressure care. As a result, we undertook a focused inspection to review the key questions of effective and well-led only. However, during the initial, focused inspection we found concerns in relation to record keeping and clinical and managerial oversight. This led us to return to the home and conduct a full, comprehensive inspection of the service.

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

Enforcement

We have identified breaches in relation to people’s safety regarding accurate care records, nursing and medicines competencies and clinical and managerial oversight of the service.

Please see the action we have told the provider to take at the end of this report.

Since the last inspection we recognised that the provider had failed to notify us of certain events. This was a potential breach of regulation. Full information about CQC’s regulatory response to this is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas

Safe

Requires improvement

Updated 4 June 2020

The service was not always safe.

Effective

Requires improvement

Updated 4 June 2020

The service was not always effective.

Caring

Good

Updated 4 June 2020

The service was caring.

Responsive

Good

Updated 4 June 2020

The service was responsive.

Well-led

Requires improvement

Updated 4 June 2020

The service was not always well led.