Fernside

Fernside is a small residential care home without nursing that provides support for up to 4 people aged 18-65 with complex medical, physical and learning needs. It is located in a purpose-built bungalow with a large level access garden. At the time of our inspection the home was providing support to 4 people.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People who were able to, told us they felt safe and happy at the home. People looked happy, calm, and content when spending time with staff. Relatives and health professionals felt people were well cared for and safe. A familiar and consistent group of care staff meant they knew people well.

Risks to people were assessed and regularly reviewed. Positive risk taking was encouraged.

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.

Right Care:

People could communicate with staff and understand information given to them because staff supported them consistently and understood their individual communication needs. Staff demonstrated a good understanding of the signs and symptoms that may indicate a person is experiencing poor care and abuse and knew how to report this appropriately. They felt confident appropriate and timely action would be taken by the registered manager. People received their prescribed medicines appropriately from trained staff and had regular reviews to ensure they remained effective.

Right Culture:

There was an open, supportive and homely culture at Fernside. Staff felt supported by management and their colleagues. They were encouraged to take on new skills and qualifications to help further improve the care people received. Relatives and professionals spoke highly of the registered manager who they saw as approachable, receptive and engaged with securing good outcomes for people. The home worked well with other organisations such as GP surgeries, day centres, epilepsy team and physiotherapists.

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 12 April 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fernside on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

Staff had completed infection, prevention and control (IPC) training and had their competencies checked regularly. Personal protective equipment (PPE) was used correctly and in good supply. The building and equipment were clean and in good repair.

Families were kept up to date with changing government guidance for visiting and processes in place reflected good practice. Visiting was by appointment only and included a COVID-19 rapid test which gave a positive or negative reading after 30 minutes. Activities outside the home had included meeting family or friends for walks in outside open spaces.

People had been admitted to the home safely. Risk assessments reflected government guidance alongside a person’s well-being. Families and community care workers had been involved in admission arrangements, including participation in COVID-19 testing.

Staff and people were participating in regular COVID-19 testing and vaccination programmes. Easy read information had been produced for people. Families and health professionals were involved in best interest decisions ensuring consent met legal requirements.

IPC policies and procedures were in line with government guidance and auditing processes were effective at ensuring compliance.

Fernside is a small residential care home without nursing that provides support for up to 4 people aged 18-65 with complex medical, physical and learning needs. It is located in a purpose built bungalow with a large level access garden. At the time of our inspection the home was providing support to four people. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This is the first care home for provider Tailored Transitions Ltd. The service was created by the registered manager and the nominated individual. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A nominated individual is a person who is responsible for supervising the management of the regulated activity that takes place at the location. Both the registered manager and nominated individual are registered learning disability nurses with a total of 14 years’ experience in the care sector.

The care service at Fernside has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. Registering the Right Support CQC policy

There were enough staff to keep people safe and meet people’s individual needs. There was a safeguarding policy and procedures in place to protect people from abuse and harm. Staff understood their responsibilities to safeguard people and knew how to raise concerns both internally or externally if required. Staff had a good understanding of people’s individual risks and how to manage them positively without being unduly restrictive. There were processes in place to ensure safe recruitment of staff to reduce the risks to people living at the home.

People were supported by staff with the skills, knowledge to meet their individual needs. There were processes in place to ensure staff had a robust induction to the service. Staff competency was monitored on an ongoing basis through observation, appraisal, and supervision. Staff received mandatory and bespoke training that enabled them to meet people’s complex needs. Staff understood the principles of the Mental Capacity Act 2005 (MCA 2005) and how it applied to the people there. This provides protection for people who do not have capacity to make decisions for themselves.

Staff interacted with people in a kind, inclusive and positive way. There was a relaxed and happy atmosphere at the home with staff observed giving their time and responding to people in a patient and timely way. People’s right to privacy and dignity was respected. People were supported to maintain relationships with relatives and friends and actively participate in community events. Staff demonstrated a good understanding of the people living there including their backgrounds, needs, abilities, preferences and wishes. People’s support needs were identified, assessed and documented in personalised care plans.

People’s care needs were assessed, monitored and regularly reviewed with their involvement, people important to them and healthcare professionals. The provider had established excellent relationships with healthcare professionals and relatives who were contacted and involved in a timely way to meet people’s complex and changing needs. Relatives felt listened to and involved in their loved one’s lives. Visiting professionals said the staff were pro-active and were always open to trying support alternatives wherever this was in people’s best interests. People’s desire for independence and meaningful activity was met through a varied range of activities tailored to their abilities and tastes. This allowed them to lead full and active lives and play a role in the local community.

With involvement from families and healthcare professionals, people had been supported to obtain bespoke technology which had enabled shared interactions, skill development a sense of achievement. People received support in a way that acknowledged and promoted equality and diversity. It recognised their needs as individuals, as part of a family, and as part of a small community of people living in the same home. The provider had a complaints policy and relatives knew what to do should they need to complain. When issues were raised staff were receptive and made changes to resolve things.

The management had the skills, knowledge, vision and drive to manage the service well and to identify where it could be improved. They were able to draw on their experience as registered learning disability nurses and this had generated confidence in them from relatives, staff and healthcare professionals. There were systems and processes in place to effectively monitor and evaluate the service provided. The managers viewed the home as a learning environment and this was demonstrated through a culture of shared learning across the team. The management were supportive, visible and open to ideas from staff.