Fernhill Neurological Centre-Inspire Neurocare (Farnborough) Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People told us they were happy living at the home and felt safe and well cared for. One person said, “Generally, it's very good here.” Relatives agreed and said, “I have absolutely no worries about [family member] being here” and “Best thing about this place is that [family member] is completely looked after, and they really care about [them].”

Incidents and accidents, safeguarding concerns and complaints were recorded on the provider’s system. These were reviewed, discussed and analysed to determine any underlying causes or trends and to identify any actions required to improve the service.

The registered manager understood their responsibilities under the Duty of Candour. They told us, “I have not needed to so far, but it’s about recognising where something is going wrong, and it might impact on a person or their family. I am aware of the importance of it, and I do think openness is the most important thing."

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People told us they felt safe at the service. They told us the staff were available if they needed support. Relatives stated they were informed when their family members required support or treatment from different agencies.

The staff team and managers told us they worked well with other professionals to ensure continuity of care, including when people moved between different services. Healthcare professionals told us they had a good working relationship with the service and communication was good. The provider employed a team of healthcare professionals who regularly visited people and provided the support they required, such as a psychologist, occupational therapist and physiotherapist.

Staff told us they were happy working at the home and felt supported and listened to. They said they received training that equipped them to do their job well and care for people who used the service. Their comments included, “We work really well together and I think the residents are very well looked after here” and “We are consulted all the time."

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People said they felt safe from harm and abuse and relatives agreed. One person told us, “I’m happy here. Some brilliant staff who go out of their way to give me positive experiences.”

Staff were aware of their responsibility to safeguard people and who to contact in the event of any safeguarding concerns. One staff member told us, “If I saw any concerns I would report them such as abuse or neglect of care including lack of care records or records showing the right care had not been delivered” and another said, “Yes, I’ve had the training. If we see abuse, financial, physical, emotional, we report it to the manager. I would take it higher if it wasn’t dealt with.”

The provider was proactive in raising safeguarding concerns with the local authority and CQC. They worked with the relevant professionals to investigate concerns when incidents occurred. For example, following a serious allegation against a staff member, the provider had taken appropriate action including suspending the staff member pending investigation and informing the relevant agencies such as the police and the safeguarding team. We saw evidence of this in the documents we viewed during our visit.

The provider understood their responsibilities under the Mental Capacity Act 2005 in ensuring Deprivation of Liberty safeguards (DoLS) applications were submitted as required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People said staff knew their needs and met these safely. There were effective processes in place to help ensure risks to people were assessed and mitigated. Risk assessments were comprehensive and regularly reviewed.

People who used the service had complex neurological conditions which required the staff to be skilled and understand people’s needs fully to meet these. We saw evidence people’s needs were recorded, understood and met.

Some people received their nourishment via a Percutaneous Endoscopic Gastrostomy tube (PEG). This is a feeding tube inserted through the abdominal wall into the stomach to provide nutrition when a person cannot eat or swallow. We saw there were risk assessments in place so any risk, such as site infection, was minimised. The staff responsible to support people with PEG feeding had received appropriate training and had their competencies assessed.

A person was at risk of an asthma attack. Their care plan was clear in relation to what to do to prevent this, for example, encourage the person with deep breathing exercises and to maintain an upright position. The same person was also at risk of choking due to a hypoxic brain injury. We saw evidence that the speech and language therapy team (SALT) was involved as required.

Another person was at risk of Autonomic Dysreflexia (AD) due to spinal cord injury. AD is a potentially life-threatening syndrome involving an abnormal, overreaction of the autonomic nervous system to painful sensory input. The person’s care plan clearly described the risks and symptoms of AD and what actions staff should be taking, for example, assist person to sit up as soon as possible, loosen tight clothing and closely monitor blood pressure. We noted that since the person was admitted in June 2025, their AD symptoms had been well controlled.

The same person was at risk of pressure ulcer. We saw they had been referred to the tissue viability nurse, who regularly visited to monitor and review their skin condition.

Incidents and accidents were recorded and contained details such as a description of events leading up to the incident, action and response and post incident analysis. Each report also highlighted what has been put in place to prevent re-occurrence. Following the incident, an action plan was put in place and care plans and risk assessments were reviewed.

Personal emergency evacuation plans were in place for each person. These contained detailed information about each person and the support they required to safely evacuate the building in the event of a fire or other emergency.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People were supported in a safe and well-maintained environment that met their needs. People and relatives told us they liked the environment they lived in.

There were effective systems in place to monitor and regularly check the safety and upkeep of the premises. The management team and staff worked together to help ensure any potential risks were identified and addressed promptly such as faulty equipment or trip hazards. Safety checks were completed daily and weekly in all areas of the home to ensure safe systems were in place. These included water temperatures, fire safety checks and kitchen equipment. They also responded promptly to any reports from the staff where repairs were required.

Equipment used to support people was suitable, well maintained and stored securely. The provider had an up-to-date emergency plan in place to help ensure people were supported in the event of an adverse event.

The building was spacious and modern and built to a high standard with wide corridors and handrails throughout. Most of the doors were wide enabling a bed to be pushed in and out. There were many comfortable areas for sitting and chatting. The lounge was well set out, with doors leading out into a garden. People could personalise their bedrooms as they wished.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider carried out checks on the suitability of staff before they started working at the service. Systems in place included checks on new staff’s identity, eligibility to work in the United Kingdom, Disclosure and Barring Service (DBS) checks. DBS checks provide information including details about convictions and cautions held on the Police National Computer. This information helps employers make safer recruitment decisions.

The registered manager told us they discussed staffing levels in their daily risk review meeting and reviewed staffing levels with the specialist services director at the point of every admission or discharge to help ensure there were always enough staff to meet people’s needs. However, they told us they were planning to use a dependency tool going forward, as the service developed and more people were admitted.

Staff told us they were happy working at the home, felt supported and listened to. They said they received training that equipped them to do their job well and care for people who used the service. A staff member stated, “I have had training online and face to face. I have been on induction for 3 weeks and still ongoing. Training in PEG is still being assessed by the RGNs. I’m still getting to know the clients” and another said, “I have had training in brain and spinal injury, PEG feeding, end of life care, providing quality care, identifying a deteriorating person and communication.”

An induction book was given to new employees. This was designed to provide them with information they may need to start their new role. Information included the company’s vision and values, introduction to the service and the team. Induction included a welcome and introduction to the home and people who live there, health and safety and training the provider identified as mandatory, such as safeguarding, infection control, moving and positioning, communication and health and safety.

Throughout the induction process, new staff were introduced to training specific to the needs of people using the service, such as dysphagia (dysphagia is a medical term for difficulty swallowing), Oomph (An approach to boosting the physical, emotional and mental health of those living in care) and introduction to the wellbeing team.

The new staff undertook a period of shadowing more experienced members of staff and were assessed to ensure they were ready to work unsupervised. The registered manager told us, “I try to meet up with new starters after 2 weeks, so I can see how they are and how things are going.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People told us they felt safe from the risk of infection because premises and equipment were kept clean and hygienic, and relatives confirmed they did not have any issues with cleanliness of the service.

The service was kept clean, tidy and well maintained. Care staff wore appropriate protective personal equipment (PPE) when supporting people to help protect them from cross infection. A member of staff told us, “I am trained in infection control. I always use PPE and follow procedures for laundry disposal and handwashing.”

Appropriate systems were in place in relation to infection control. The provider ensured staff had access to PPE and were trained in the use of this. The provider’s infection prevention and control policy was up to date. Information about the risk of infection was shared appropriately with people using the service and visitors. The managers and senior staff carried out audits to ensure high standards of cleanliness.

Although we found overall that people received their medicines as prescribed and in line with their care plan, there were some shortfalls identified during our inspection.

PRN (when required) protocols were generally present, however, there were inconsistencies noted. For example, one person’s PRN protocol for Morphine incorrectly listed the maximum dose frequency and Paracetamol suspension was recorded as having an incorrect high daily dose limit. In one person’s case, repeated instances of a medicine being unavailable were recorded, without evidence of escalation. Daily checks for transdermal patches were not documented although a body map was present. Another person’s record lacked start and stop dates for antibiotics, and no PRN protocol was in place for prescribed oxygen. Care plans referenced emollients containing paraffin, but associated fire risk assessments were not available at the time of inspection.

Following feedback, the provider took prompt action to make the necessary improvements and sent us evidence of this.

Medicines were generally administered in line with prescribing instructions and records showed that allergy status was consistently documented. Nurses were responsible for all medicines administration and had completed relevant training, including PEG competency, medicines administration system training, and shadowing prior to assessment. Annual competency reassessments were in place.

Medicines were stored securely in a locked treatment room with medicines trolleys and a controlled drugs cabinet. Room and fridge temperatures were being monitored, although there were some gaps noted in the fridge temperature log for June.

Safe disposal systems were followed when required. Monthly medicines audits were undertaken by nursing staff and a medicines management policy was in place, accessible via the intranet.

The clinical room was observed to be clean and organised. Staff were responsive and compassionate during interactions with people and relatives. MHRA drug alerts (drug safety notices) were seen to be managed appropriately, with a system in place for dissemination and review.