Ferndown Manor

Ferndown Manor is registered to provide nursing and personal care for up to 75 people. The service provides support to older people, some of whom are living with a dementia. At the time of our inspection there were 49 living at the home. Ferndown Manor is purpose built and accommodates people according to their needs across three separate floors.

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

Significant and sustained improvement had been made at Ferndown Manor since our last inspection. Developments to governance structures, risk management and staffing levels had improved safety within the home.

People and their families told us Ferndown Manor was safe and they felt well cared for. One relative said, “The ambiance at Ferndown Manor is one of a caring family. Apart from the obvious security in place, the carers ensure that my [relative] eats, is comfortable and that I am advised of any issues straight away.”

People had been assessed for potential risks to their health, safety and well-being. Robust systems were in place to ensure assessments were regularly reviewed to ensure people were consistently protected from risks of harm. One person told us, “Yes I feel very safe, I couldn’t ask for more.”

Ferndown Manor had recruited staff safely into the service ensuring staff were of good character. There were enough staff to meet people’s care needs. One person said, “I know the staff well, they know what they are doing and are all nice, I don’t have any problems at all.”

The home was clean and tidy. Systems were in place to protect people from the spread of avoidable infections. Medicines were administered by trained staff and managed safely.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The service was well-led. Staff told us they were proud to work at Ferndown Manor and felt supported by the management team. Comments included: “I love my job and feel proud knowing I’m making a difference in someone’s life”, ”This is the only home I would feel happy sending my own family members too, or even myself when the time comes” and, “I work in a positive working environment which enables all residents to have fulfilling enriched lives.”

Governance systems to manage quality, risks and regulatory requirements were robust and effective. This meant any areas of improvement had been easily identified, and actions taken to drive improvements to consistently deliver good quality of care.

People, relatives and staff told us they found the registered manager and deputy manager’s approachable. They felt listened to and knew if they did raise concerns they would be acted upon.

The registered manager and deputy manager were proud of Ferndown Manor, proud of the staff and proud to deliver person centred care to people living in the home. Leading by example , they told us how they were supporting one person to achieve their wish to try plane wing walking. We were shown a system of flower pictures which, when placed outside people’s rooms communicated to staff when personal care was being delivered, if a person preferred female carers only and when a person needed assistance with their dentures. It was this type of dignified approach that contributed to a positive, open and inclusive culture of the service.

Health and social care professionals told us the home worked in partnership with them to deliver consistent, quality care. One healthcare professional said, “I have been to a few care homes in the area and I can honestly say that this one is one of the better ones.”

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 requires improvement (published 22 July 2021).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

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

A robust process was in place to help ensure visitors did not bring COVID-19 into the home. This included lateral flow tests, temperature checks and confirmation of vaccination status. A relative offered, “They are very good. They are very strict with the rules around COVID.”

We observed people enjoying visits from relatives during the inspection. People told us they had frequent visits from relatives. One person told us, “I see my [relative] most days.”

People told us they were supported to have regular COVID-19 tests. We observed people being supported to isolate when required in line with government guidance. A person said, “They test my [relative] every time they come. It makes me feel good they are testing everyone.”

The home was visibly clean throughout. Staff carried out frequent cleaning including of high touch point areas such as handrails, keypads and door handles. Records were kept of this with these reviewed by the registered manager.

People advised us “staff always wear PPE.” People understood why such measures were in place with one person explaining, “They wear it for protecting them and me against COVID. I feel safe from the pandemic living here. ” A relative said, “I think the home are doing all they can to keep people safe.”

Ferndown Manor is a residential care home providing personal and nursing care and at the time of the inspection accommodated 45 older people. Ferndown Manor can accommodate up to 75 people across three separate floors, each of which has separate adapted facilities.

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

Some relatives raised concerns that some people were not receiving basic care such as oral hygiene. Staff told us they did not always have enough staff to get people out of bed and were not always able to give oral hygiene care as they did not have enough time.

The provider told us they had recently hired a unit manager to work on the nursing floor to support the nurse in the management of the staff and provision of care. We will review this when we return to ensure improvements are made and maintained.

Not all risks had been assessed and daily records reviewed showed a mix of detail in relation to the care delivered to residents. This did not always ensure that people were receiving care as per their care plans. We discussed our findings with the operations manager who confirmed these areas had already been highlighted by their audits and were in the process of being improved. Care staff were scheduled to complete care planning training and new staff were provided with examples of what good records keeping look like to provide a good standard.

At the time of our visit the registered manager was not available. The deputy manager and clinical lead had recently started in post, an operations manager was supporting the home and improvements were already in process. We identified some areas of improvements such as record keeping and communication with relatives and staff. Action plans were being created and continuously updated to drive improvements and we look forward to our next visit to ensure these improvements have been maintained and sustained.

We visited Ferndown Manor following its recovery after COVID-19 affected the service in a devastating way. We received positive feedback from healthcare professionals, relatives and staff regarding the way the provider had managed and provided support to people during these times.

There was a friendly and welcoming atmosphere, people told us they felt safe and well cared for. We observed kind, natural and caring interactions and people looked visibly well cared for and happy. Staff appeared to know people well and people were visible comfortable around staff. Staff told us they felt Ferndown Manor was at the start of change and felt positive about the future of the home.

Medicines were managed safely; staff knew how to safeguard people and lessons were learned when things went wrong. The home was clean, tidy and we were assured infection, prevention and control measures were robust.

Whilst we saw improvements were being made to provide a safe and well-led service, the service will need additional time to ensure their systems and processes become embedded and remain robust.

We discussed the ongoing improvements required with the regional director and operations manager. The team were open and transparent. Shortfalls were being identified by the introduction of monthly audits and the team at Ferndown Manor were working on action plans to improve.

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 requires improvement (published 7 January 2020) The service remains rated requires improvement.

Why we inspected

The inspection was prompted in part due to concerns received about the safe care and treatment of people and the management of the service. A decision was made for us to inspect and examine those risks. 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.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Ferndown Manor is a residential care home providing personal and nursing care to 49 older people, some living with a dementia, aged 65 and over at the time of the inspection. The service can support up to 75 people.

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

Some people had cognitive and sensory impairments that limited their ability to identify risk. Staffing levels and staff deployment meant they were not always visible leaving people without staff nearby and at risk of avoidable harm. Risks to people from environmental hazards had not always been assessed to ensure people’s safety.

Changes in leadership and the absence of a registered manager had impacted negatively on staff morale. Lack of consistent leadership had left staff feeling unsupported. Quality assurance processes had identified these issues and an improvement plan was in place which included additional staffing and the appointment of key senior staff, including a manager.

Staff understood their role in recognising and acting upon any concerns of abuse of poor practice. Recruitment processes were robust and included employment and criminal record checks to ensure employees were suitable to work with older people. People received their medicines safely.

The home were honest and open about any accident or incident that had caused or placed a person at risk of harm. People, their families and the staff team had opportunities through regular meetings to share ideas and be involved in developing the service.

People were supported by staff who had completed an induction and had on-going training and supervision that enabled them to carry out their role. Both care and catering teams understood and ensured people had their eating and drinking needs met. Working with other health and social care professionals ensured people received the best outcomes. People received appropriate healthcare for both planned and emergency events. The environment met people’s needs for accessible space, inside and outside, and had space for both private and social time.

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.

People had care plans that detailed their individual care needs and lifestyle choices. Staff were knowledgeable about people and how they were able to communicate which meant they were able to involve people in decisions about their care. A range of activities were organised that reflected peoples interests and abilities. A complaints process was in place that people and their families were aware of and felt able to use and that they would be listened too. People had an opportunity to be involved in end of life care planning which reflected their cultural and spiritual wishes.

People and their families described the care as good and spoke positively about the staff. We observed people being involved in decisions about their day to day lives with staff enabling people to be as independent as they were able. People had their privacy and dignity respected.

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 2 May 2018).

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the management of the service. A decision was made for us to inspect and examine those risks.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The home had a registered manager. 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.

Ferndown Manor is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The home is registered to provide care for up to 75 people.

People described the care as safe and were supported by staff who understood how to recognise signs of abuse and the actions needed if abuse was suspected. There were enough staff to meet people’s care and support needs. Staff had been recruited safely including full employment history and disclosure and barring checks. Induction and on-going training provided staff with the skills needed to carry out their roles effectively. Staff were supported and had opportunities to meet with senior staff and discuss their role and professional development.

People had their risks assessed and actions were in place to minimise the risk of any avoidable harm. This included risks associated with swallowing, falls, skin damage and malnutrition. Staff were able to explain to us how people’s needs and choices were met and their role in reducing risks people lived with. Staff had completed infection control training and demonstrated practice that reduced the risk of avoidable infections. When things went wrong lessons were learnt and actions put in place to improve safety.

People had their medicines ordered, stored, administered and recorded safely. When people self-administered their medicines risk assessments were in place which were regularly reviewed to ensure safety.

Pre admission assessments were completed and formed care and support plans that were reviewed regularly. The plans were individual and reflected people’s individuality. Staff understood people’s care and support needs and how they chose to spend their day. People had their eating and needs understood by both care and catering staff which included special diets, allergies, and likes and dislikes. Menus were varied, offered choices and provided well balanced meal options. Positive relationships had been developed with other professionals such as district nurses and chiropodists enabling effective health outcomes for people. People were supported with both planned and emergency access to healthcare when it was required.

The environment had a range of public and private areas for people to spend their time. The design promoted independence with braille buttons on hand rails to alert people the rail was ending to wheelchair accessible raised garden beds. Outdoor space provided a secure environment with lots of sitting areas. People had opportunities for social gatherings at a café and bar area, cinema and a lifestyle room with a range of equipment.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People felt involved in decisions about their care and every day life’s. Staff were kind and had friendly, fun relationships with people and demonstrated a good understanding of how people were able to communicate. They cared for people whilst respecting their dignity and privacy and supported people to live as independently as they were able. People had opportunities to discuss their end of life wishes and care and support plans reflected people’s spiritual and cultural needs.

If people needed to make a complaint they were aware of the process and felt the registered manager was a good listener and would put things right. A complaints log was kept and records showed that when complaints had been received they were investigated in a timely way and outcomes shared with the complainant.

A range of activities were provided seven days a week and included one to one events, group activities in the home and trips out into the community. People past history, hobbies and interests were known to staff and used to provide meaningful activities.

The management team promoted an open door culture were visible around the home and knowledgeable about people and the service. Staff spoke positively about their roles and the organisation and felt appreciated. Staff were well informed about changes as they happened as there were structured communication processes that were effective. A range of meetings with staff, people and their families provided opportunities for engagement and involvement in service development. Quality assurance systems were robust and effective in identifying areas of service delivery that required improvement. Partnerships with other agencies and organisations enabled appropriate sharing of information that in turn provided seamless care for people.