Ferndown Nursing Home

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 assessment for 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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Assessments of people’s needs were not always comprehensive, and people’s care plans had not always considered the full range of their diverse needs, including psychological and emotional well-being. Assessments were not always up to date to reflect people’s current needs. Different parts of people’s care and treatment were not efficiently coordinated to ensure all their needs were consistently monitored and met. For example, we found 1 person was prescribed ‘when required’ medication to support them with symptoms of anxiety. This was not mentioned anywhere in their care plan. In the past this person had pressure sores on their body and had been prescribed creams to maintain skin integrity. Due to anxiety, they were frequently refusing to take their medicines or have creams applied to vulnerable parts of their body. However, this was not cross referenced within their care plan and staff worked with minimal guidelines on how to support their wellbeing with no suggested strategy to encourage them. This meant people were at risk of not having their needs met and health deterioration. The manager took immediate action to address this.

People and their representatives told us they were not always involved as fully as possible in their needs assessments to ensure all needs were captured and understood. Support was not always provided where needed to maximise their involvement. Comments from relatives included, “I am not involved in [my loved one’s] care plan” and “They discuss [or loved one’s] care plan informally with us, nothing formal. I would like more involvement.” The manager told us they were aware of this however it continued to be a work in progress.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

Care and support were planned and delivered in line with current evidence-based guidance, standards, best practice and legislation. However, this was not always effectively monitored to ensure consistency of practice and that it was fully embedded in the service. We received mixed feedback from people and their relatives regarding meeting people’s hydration and nutritional needs. A relative told us that staff not always followed safe swallowing plan for their loved one. They told us, “Several times when [my loved one] moved in I had to remind them he can’t have jelly and some of the food wasn’t suitable for [them]”. While 1 relative told us food “could be better”, another said it was “excellent and all home cooked”.
Most people's care plans outlined their food and drink preferences. Their care plans identified the level of support people needed from staff to prevent malnutrition and dehydration, and this information was available to the staff working in the kitchen. There was guidance to support people to eat safely when they were at risk of choking or needed their food to be a certain consistency. Systems were in place to monitor people's nutritional intake and weight, and risks associated with dehydration and malnutrition.
When required, people’s nutritional and fluid intake had been monitored. However, these systems were not always effective to prevent dehydration. We reviewed handover records on the day we visited which demonstrated 16 out of 20 people did not reach their fluid intake targets for the day. One person did not have any fluid intake recorded all day and other’s daily fluid intake was recorded as little as 155ml and 200 ml a day. This potentially put people at risk of dehydration and health deterioration.

Staff worked closely with a range of health professionals, including the GP, speech and language therapist and dietitian, to ensure people’s needs were assessed and reviewed appropriately.

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.

The provider established effective systems and processes for referring people to external services and to maintain continuity of care. Plans for transition, referral and discharge considered people’s individual needs, circumstances, ongoing care arrangements and expected outcomes. This meant people’s care was effectively coordinated, to ensure they received timely and consistent support and treatment. Relatives confirmed they were satisfied their family members were supported to access healthcare appointments as needed. Comments included, “They will get the GP to see [my loved one] and they ask me for things like vaccines.”

Staff worked with health and social care partners to prevent or reduce the need for admissions to hospital. Health passports and transition plans were available on the provider’s electronic record system. For example, when people needed hospitalisation, they held hospital and communication passports. This meant all relevant staff could access the information they needed to understand people’s needs and appropriately assess, plan and deliver their care, treatment and support.

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.

Care staff encouraged people to make healthy lifestyle choices such as increasing their physical activity or maintaining a balanced diet to promote their wellbeing. Some people had identified their own health goals such as accessing the community independently, which staff supported them to achieve.

Staff encouraged people to regain or maintain skills, for example by promoting activity and safe community access. Comments from staff included, “Residents are always encouraged to participate in activities, to mobilise in and around the home. Those who love outings with friends and family always do so” and “If they would like to go to the shops, attend church, visit family, or take part in activities outside the home, we do our best to support this where possible.”

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.

The provider established processes for monitoring the effectiveness of people’s care, treatment and support and ensured actions were taken to continuously improve it.

The provider actively sought and considered feedback from people and their relatives when monitoring individual outcomes. Results were used to drive improvement. There were regular residents’ and relatives’ meetings where people expressed their opinions, wishes and preferences. People and their relatives confirmed they received care that met their needs and they achieved positive outcomes from living at the home. One relative told us, “We had a meeting 2 days ago and we discussed everything with the manager. That day we had some feedback on some of the points we had raised.”

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

The provider had established effective systems and processes to ensure people’s human and legal rights were always respected and they had maximum choice and control over their lives. Staff demonstrated good understanding and working knowledge of the key requirements of the Mental Capacity Act (MCA) including Deprivation of Liberty Safeguards (DoLS). People were involved in decisions about their care and treatment as much as possible and staff ensured all practicable steps were taken to help people make their own decisions.

People’s mental capacity to make decisions was assessed whenever necessary. When people did not have the capacity to make a particular decision, they were given the information they needed in an accessible format of their choice, and where appropriate, their family, friends, legal representatives or advocates were involved. All decisions were taken in people’s best interests ensuring staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.