Fernside Hall Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People’s needs were assessed prior to them going to live at the service and an initial, temporary care plan was developed for staff to work from until they got to know the person and their needs better. However, an initial care plan for a person recently admitted to the service, lacked some details that were important in making sure staff provided the right care. The care plan was also inaccurate in some areas. The registered manager made sure this was reviewed when we pointed out the issue, but this should have been identified and addressed by staff prior to our assessment.

Work was ongoing to make sure the involvement of people or, where appropriate, their relatives, was fully reflected in their assessments of needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

At our last assessment we identified issues with people not being provided with the diets they needed. This had been addressed and people’s specific dietary needs and preferences were clearly documented in related care plans, and kitchen staff were fully aware of them. Information from a dietician had been included in the nutritional care plan for a person living with diabetes.

People we spoke with agreed there was always choice, but we received some mixed feedback about the quality of the food with some people describing it as ‘excellent’ and others saying it was not so good when the regular cook was not in. The area manager told us this issue had been addressed, with improved kitchen staff arrangements about to start.

Recognised clinical tools were used to assess people’s needs and information about specific conditions including kidney disease, diabetes and heart disease had been downloaded and included in people’s care plans to help staff’s understanding.

The provider worked well across teams and services to support people.

The registered manager had met with staff from the local GP surgery to discuss and explore how they could work in partnership to provide better support to people. This had been successful particularly in relation to ordering and managing people’s medicines. A weekly telephone ‘ward round’ was completed for any non-urgent issues to be discussed with the GP. Staff worked with the district nurse team when people required their support and advice. The local authority told us the provider’s engagement had been ‘excellent’ and said they were fully committed to improving the service.

At our last inspection we identified issues with information sharing between staff working at the service. A new handover document had been introduced which was used to make staff aware of any changes to people’s health and wellbeing.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

Staff worked well with partners to promote people’s health and wellbeing. Requests for support from appropriate health and social care professionals were made as needed. A multi-disciplinary approach was in place to support a person to move to a setting more appropriate to their needs.

Care plans included good detail about people’s health care needs and the support they needed to meet them.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Since our last assessment a lot of work had been done to make sure care plans were up to date and reflective of people’s needs. Some care plans needed further work as they had been developed to cover multiple areas of need which made it difficult for the reviews to be specific. For example, a single care plan for 1 person covered personal care, continence, oral care and skin integrity. The area manager agreed that individual care plans should be developed for each area of need and said this was already being addressed. A relative told us they were involved in the review of their family member’s care plans to check they were effective.

Fluid intake charts were completed well, but it was not always clear what action had been taken when records suggested people were not drinking enough. The registered manager told us they were monitoring and addressing this.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

Where people had been assessed as lacking capacity to make decisions about their care and treatment and had Deprivation of Liberty Safeguards [DoLS] including requirements known as conditions in place, care plans had been developed to inform staff about the conditions and what they needed to do to make sure they were met. Where Lasting Powers of Attorney were in place, this was clearly documented so that staff knew who to involve in planning people’s care and making decisions about their health and wellbeing.

Decision specific mental capacity assessments were completed and where people lacked capacity records were made of decisions made in their best interests. People had been informed about the CCTV used in the service and appropriate consents were in place.