Fern Care Services Limited

Updated 28 February 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by one inspector and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type:

This service is a domiciliary care agency. At the time of the inspection, the services provided personal care to adults living in their own homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

Our inspection was announced. We gave the provider notice as we needed to be sure someone would be available to support us with the inspection.

What we did:

Before the inspection, we reviewed relevant information that we had about the service including any notifications of safeguarding or incidents affecting the safety and wellbeing of people. A notification is information about important events, which the provider is required to tell us about by law. We checked the last inspection report and the action plan that was subsequently sent after the inspection to ensure concerns we found at the last inspection had been addressed.

We requested the service completes a Provider Information Return (PIR). A PIR is a form that asks the provider to give some key information about the service, what it does well and any improvements they plan to make. We sought feedback from professionals that the service was involved with.

During the inspection we spoke with the registered manager, recruitment manager and the care coordinator. We reviewed documents and records that related to people’s care and the management of the service. We reviewed five people’s care plans, which included risk assessments, and five staff files, which included pre-employment checks. We looked at other documents such as medicine, training and quality assurance records.

After the inspection, we spoke to five people receiving care from the service, six relatives and five staff members.

Updated 28 February 2019

About the service:

The service is based in the London Borough of Barking & Dagenham. The service provided personal care to adults living in their own homes. The CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do, we also take into account any wider social care provided. At the time of our inspection, 28 adults used the service and there were 21 staff.

People’s experience of using this service:

• Since the last inspection, we found a number of improvements had been made.

• Most risks had been identified and assessed, which provided information to staff on how to reduce these risks to keep people safe.

• Quality assurance and monitoring systems had been introduced since our last inspection to make continuous improvements.

• Assessments for people who may lack capacity had not always been carried using the principles of the Mental Capacity Act 2005. We made a recommendation in this area.

• There were sufficient staffing levels to support people. Staff had been trained in safeguarding vulnerable adults and knew how to keep people safe.

• There was a safe recruitment process in place to ensure staff were suitable to support people.

• Staff had the knowledge, training and skills to care for people effectively.

• Staff received supervision and support to carry out their roles.

• Staff knew what to do if people were not feeling well.

• People needs and choices were being assessed regularly through review meetings to achieve effective outcomes.

• People told us that staff were friendly and caring.

• People were treated in a respectful and dignified manner by staff who understood the need to protect people's human rights.

• People had been involved with making decisions about their care.

• Care plans were person centred and included clear information on how to support people.

• People were aware of how to make complaints if they wanted to and staff knew how to manage complaints.

• Staff felt well supported by the management team.

• The service met the characteristics for a rating of ‘Good’ in all the key questions we inspected. Therefore, our overall rating for the service after the this inspection was ‘Good’.

• More information is in our full report.

Rating at last inspection:

• At the last inspection on 19 February 2018 the service was rated ‘Requires Improvement’. Our last report was published on 24 March 2018. We identified two breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 relating to risk assessments, medicine management and good governance.

Why we inspected:

• This was a planned inspection based on the rating of the last inspection. The inspection was part of our scheduled plan of visiting services to check if improvements had been made and the safety and quality of care people received.

Follow up:

• We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.