Ferndown Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated good.

This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People received person‑centred care that reflected their individual needs, strengths and preferences and life histories. Care plans were detailed and personalised, ensuring people were treated as individuals. Staff enabled people to participate in person-centred activities and encouraged them to maintain their hobbies and interests. This approach helped people feel valued, respected and in control of their care.
People and relatives felt that staff understood their needs, preferences and routines. The staff team were focused on maintaining people’s independence, wellbeing and quality of life to ensure care was person centred. Comments from relatives included, “The staff know [my loved one] well and know [their] likes and dislikes” and “The staff have got to know [my loved one] really well over time. They know about all of [their] family.”

Processes and systems were in place to ensure people’s changing needs were met.The managers promoted a person-centred approach, and senior staff were assigned to complete monthly care reviews with people. Changes in people’s needs were responded to and reflected in relevant electronic record systems.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

People had access to healthcare services to support them to maintain good health and ensure they received continuity of care. Records in people's care plans showed visits from health professionals such as GP's, district nurses and tissue viability nurses had taken place. However, processes of safety and continuity of care through a collaborative, joined-up approach to safety were not always consistently applied by all staff or fully embedded in the service.

Appropriate referrals were made to relevant healthcare partners. However, communication with healthcare partners was not always effective and their guidance and instructions after the referral and assessment visit was not always followed by staff. For example, we reviewed care records of 2 people identified as being at high risk of skin integrity breakdown who required regular repositioning. We found repositioning records were not always completed and staff were not following the care and support plans in place for either person exposing both to an increased risk of skin breakdown.

Staff told us they worked in partnership with health and social care professionals to support people’s needs and maintain continuity of care. However, they told us information was not always shared appropriately, including through handovers in between shifts and care records. Comments from staff included, “Handovers are helpful, although occasionally more detailed updates would improve consistency and communication between shifts.” and “There is missing information in care plans.” This meant staff did not always have up‑to‑date information about people.

We received negative feedback from 2 healthcare professionals about communication with the service. One professional told staff were not always available to assist when they visited, and they never had a response to the emails sent to the senior staff after their visits.The provider recognised the need to establish more effective and positive partnership working with external stakeholders. The manager took proactive steps and arranged meetings with local GP surgery and frailty team to improve communication, foster open and transparent collaboration and rebuild professional relationships. We will assess the effectiveness of the improvements implemented at the next inspection.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The home was compliant in meeting the Accessible Information Standard (AIS). People’s communication needs were assessed and reviewed. People’s care plans detailed people’s individual communication needs, such as language, sensory aids such as glasses or hearing aids, and any additional resources that staff might use to help with communication, for example pictures, large font prints or technology. Staff demonstrated a good understanding of people’s communication needs and any aids used to support this.

Information was shared with people. Information was delivered to each person’s room and displayed around the building to inform people of the days planned activities and information relevant to the home.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a policy and procedure in place that set out the steps someone would need to take if they had a complaint, and information on how to complain was available to people and their relatives. Residents’ and relatives’ meetings were held regularly to support people to be actively involved in shaping the service.

People and their relatives we spoke to told us they knew how to but hadn’t needed to make an official complaint. However, they felt confident in the service taking appropriate actions should they raise a concern or complaint, which included looking into the issue thoroughly, communicating what was happening, being open about what had been found out and what the outcome was. Relatives told us: “I’d be happy to speak to anyone, and I feel they would deal with it properly” and “I would raise concerns straight away and I have confidence we would be happy with the outcome.”

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People's care records demonstrated that when they required the support and intervention of external health care professionals, this was provided. Staff escalated health or wellbeing matters and sought advice as needed. Referrals to external health professionals were made in a timely manner for further assessment. People received additional health support from a range of external clinicians such as speech and language therapists, dieticians, tissue viability nurses, community mental health team or occupational therapists. This demonstrated that people had access to the care they needed.

The manager told us they were focusing on establishing a positive working relationship with the local doctor’s surgery. GP visits were requested when needed. The frailty team visited the home to review any concerns escalated by staff and the team’s pharmacist provided support with regular medication reviews.

We received positive feedback from people and their relatives about access to health professionals when needed.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Staff and leaders did not always demonstrate a full understanding of the people who used their service who were most likely to experience inequality in experience or outcomes and did not always take effective steps to minimise barriers to inclusion and positive experiences. We found people’s equality-related needs were not always considered when the premises were adapted or decorated. For example, reasonable adjustments to address potential or actual discrimination within the service were not made for people living with dementia. The physical environment was not decorated or adapted to a consistent standard to meet needs of people living with dementia. Premises and facilities were not designed in an accessible way to promote people’s independence and wellbeing. The provider had not followed good practice guidance to assess how each person living with dementia could orientate themselves in their surroundings. Contrasting colours had not been used, and people did not have photos or personalised items in memory cabinets to easily identify which room was theirs. All bedrooms had only numbers on the doors. There was no clear signage with both words and pictures around the home to show directions. This meant people could not orientate in their environment independently and had to rely on staff assistance.

Although training in promoting equality, diversity, inclusion and protected characteristics was available to all staff they could not always demonstrate a full understanding of potential discrimination and inequality people who used the service may face and how to meet people's equality-related needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were supported to make decisions about their preferences for end-of-life care and to express their wishes around advanced care. People’s advanced decisions and what mattered to them at the end of their life was recorded within electronic care plans in the ‘Death and Dying’ section. These included people’s religious beliefs, cultural and personal preferences. Staff were aware of people’s wishes for the future, for example whether they wanted to go to hospital for further treatment or whether they wished to remain at home. People’s care plans informed staff whether they had a do not attempt cardiopulmonary resuscitation decision (DNACPR). People’s lasting powers of attorney were documented in care plans, should people become unable to make decisions themselves. These decisions were recorded in respect documents, advanced care documents, and in people’s care plans.

Staff received training in palliative care to develop their understanding of caring for people at the end of their lives.