Fern House

Updated 7 October 2021

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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors, a medicines 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

Fern House is a ‘care home’. 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 service also provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented at Fern House and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

The service did not have a manager registered with the Care Quality Commission. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The service was in the process of recruiting a new manager.

Notice of inspection

This inspection was announced. We announced the inspection from the car park shortly before going on site. This was because we needed to check the arrangements in place for preventing and containing transmission of COVID-19 prior to entering the building. Inspection activity started on 10 August 2021 and ended on 20 August 2021. We visited the service on 10 August 2021. The other dates were spent reviewing information off site and making phone calls to people, relatives and staff.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority commissioners and safeguarding team and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

While on site we spent time with people in the communal areas observing the care and support provided by staff. We spoke with six people who used the service about their experience of the care provided and seven relatives. We spoke with ten members of staff including the director of operations, the quality manager, the deputy manager and care staff.

Discussions with people who used the service, relatives and staff were conducted either on site or via telephone calls. We reviewed a range of records. This included three people's care records and seven people’s medicine records. We looked at two staff recruitment files. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 October 2021

About the service

Fern House is a purpose-built complex which consists of a residential care home providing accommodation and personal care for up to 30 older people and 49 extra care housing apartments where some people are provided with personal care from staff onsite. At the time of our inspection there were 19 people living in the care home and 26 people living in the extra care housing apartments who were receiving personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Improvements had been made since the last inspection. Medicines management had improved, although systems needed to be embedded and developed further. We have made a recommendation about guidance for staff and records relating to topical and when required medicines.

The management of risks to people had improved although accident and incident monitoring required further development. Effective systems were in place to manage any allegations of abuse and to ensure these were reported to the appropriate authorities. Lessons were learned when things went wrong and information shared with staff.

There were enough staff to meet people’s needs. Recruitment processes ensured staff were suitable to work in the care service. People lived in a clean and pleasant environment. Robust infection control procedures were in place which helped keep people and staff safe during the COVID-19 pandemic.

People, relatives and staff spoke positively about the service. Comments included; “I would recommend this home without hesitation. It’s safe care and [family member’s] very happy there. We're completely satisfied with everything” and “I would recommend this home as you get well looked after, fed well and my room is bright and airy. There is a big family atmosphere and I feel at home here.”

Leadership and management had improved. A new manager was being recruited and the director of operations was currently running the service alongside the deputy manager. People, relatives and staff spoke positively about the management team and the improvements made in the last six months. New governance systems had been implemented which included more robust provider oversight and monitoring. The provider had an ongoing action plan and was committed to ensuring improvements made were sustained and developed further.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 24 February 2021). At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 24 February 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

We carried out an announced inspection of this service on 15 and 29 January 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, safeguarding and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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.