Ferndene Care Home

Ferndene Care Home is a residential care home providing personal and nursing care to 38 older people and people living with dementia at the time of the inspection. The care home can accommodate 48 people in one purpose-built building.

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

People using the service were safe. The provider had systems and processes in place to protect people from abuse and staff were aware of their responsibilities in keeping people safe. The risks to people’s safety were regularly assessed and there were measures in place to reduce these risks. The registered manager had processes in place to learn from accidents and incidents to further reduce risk to people living at the service.

People were supported by adequate numbers of safely recruited staff who had received appropriate training for their roles and were supported with regular supervision from their line managers.

People’s medicines were well managed, and people were protected from the risk of infection as the staff maintained good infection, prevention and control practices.

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 lived in a well-maintained environment supported by staff who treated them with respect and dignity. They and their relatives were involved in the development of their care plans to ensure they received personalised care.

People were supported to maintain relationships with family and friends. The service followed government guidance when welcoming visitors into the service and people were encouraged to take part in social activities of their choice.

The registered manager took complaints or concerns about people’s care seriously and responded to complaints in a positive way following the providers complaints procedure.

There were effective quality monitoring processes in place to support good standards of care. People, relatives and staff told us the manager was open, approachable and responsive. Staff felt supported by them.

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 requires improvement (published 19 May 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this inspection to follow up on action we told the provider to take at the last inspection. We undertook a focused inspection. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-led which contain those requirements.

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 found no evidence during this inspection that people were at risk of harm. Please see the Safe, Responsive and Well Led sections of this full report.

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 changed from Requires Improvement to Good. 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 Ferndene Care Home 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.

Ferndene Care Home is a residential care home providing personal and nursing care to 45 people aged 65 and over at the time of the inspection. The care home can accommodate 45 people in one purpose-built building.

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

Quality Monitoring systems were in place, they were not always effective and failed to identify some of the shortfalls found at inspection.

Infection control measures had failed to identify environmental issues placing people at risk. Following the inspection action was taken to improve systems and processes.

Medicines were administered in people’s preferred way. Medicines management was not always effective, meaning stock was not always accounted for.

Safe recruitment processes were in place. Staff received training relevant to their role with their competency checked regularly. However, additional training needs were identified following the inspection.

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 24 October 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections, however, they had not been in breach of the regulations.

Why we inspected

We received concerns in relation to risk management and leadership. 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.

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

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the assessment and management of potential risks to people's safety, infection control management and organisational governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. 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.

¿ Infection control policies had been updated to reflect current national guidance. Information and guidance were available to staff, relatives and people living in the service relating to COVID-19 and infection control.

¿ Staff were trained in infection prevention and control (IPC). This included donning and doffing training, this is how to put on and remove Personal Protective Equipment (PPE).

¿ The provider ensured there was sufficient stock of PPE in place including masks, visors, gloves, aprons and hand sanitiser. PPE stations were located throughout the service. Staff had access to PPE and were observed wearing this in line with national guidance.

¿ A room had been isolated and allocated for staff to use when entering and leaving the building. Staff used the room to change in and out of their uniform and don their PPE when starting a shift.

¿ There was an enhanced cleaning programme in place at the service and the service was visibly clean and well maintained. The housekeeping team wiped high use touch points throughout the day to reduce the spread of infection.

¿ A recent outbreak of COVID-19 at the service had been managed well and the plans in place to support people had been utilised safely. The service supported people to isolate in their bedrooms to reduce the spread of the infection.

¿ The service followed the current guidelines for care home testing, an enhanced testing regime was implemented during the outbreak. This was to ensure if people or staff had contracted COVID-19, it was identified, and measures put in place in a timely way.

¿ People admitted to the service were supported in line with government guidance on managing new admissions during the COVID-19 pandemic. The provider put in place risk assessments clearly identifying people at high risk of COVID-19 and the measures in place to support them. This meant staff had clear guidance on how to support people during COVID-19.

¿ People were supported to keep in touch with their relatives and friends through telephone and video calls. The provider had also built a visiting pod with screening to minimise the risk of spreading infection and to enable people to continue to receive their visitors in a comfortable and safe way.

¿ Since the outbreak the provider had maintained a no visiting policy with arrangements in place to support people who were receiving end of life care to ensure relatives could access the home, including full PPE supplied. The provider kept their visiting policy under review to ensure they supported people to keep safe.

Ferndene Nursing Home is a residential care home providing personal and nursing care to 43 people aged 65 and over at the time of the inspection. The care home can accommodate 45 people in one purpose-built building.

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

The risks to people’s care were assessed and measures were in place to mitigate these risks. Staff had access to personal protective equipment and followed national guidance around donning and doffing. Measures were in place to reduce the risk of infection to people living at the service. A quality monitoring process was in place however it had failed to identify some of the issues we found at inspection. People’s medicines were not consistently managed in a safe manner. Medicine administration records (MAR) showed people had not received their medicines in a timely manner.

People were supported with adequate numbers of staff who had received training for their roles. Staff were recruited safely. The service was clean and there were effective cleaning schedules in place being followed by the housekeeping staff.

The registered manager responded to and undertook learning from any safeguarding concerns raised to them. Staff knew how to keep people safe from abuse and were confident to raise concerns with the registered manager or external agencies. When required notifications had been completed to inform us of events and incidents.

People and their relatives knew how to raise a complaint and would feel confident to do so if needed.

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 report published 5 May 2020.

Why we inspected

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 coronavirus and other infection outbreaks effectively.

We undertook this focused inspection to follow up on concerns we had received. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements. The ratings from the previous comprehensive inspection for those key questions were not looked at on this occasion 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 was Requires improvement

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

The provider has taken positive steps to mitigate the risks to people’s safety when we highlighted concerns to them.

Ferndene Care Home is a residential care home providing personal and nursing care to 43 people aged 65 and over at the time of the inspection. The service can support up to 48 people.

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

Care plans required development to ensure they reflected people’s diverse needs and preferences. Managers were aware of this and had developed a plan to review and improve all care plans in the service. Care was delivered by staff who understood the needs of people they were supporting. People knew how to complain and raise concerns and were listened to. People were given the opportunity to take part in regular activities of their choosing. The activities coordinator was committed and keen for people to try new things.

The service did not currently have a manager registered with the Care Quality Commission. Two managers had recently been recruited, a general manager and a clinical manager. Both had begun the process of applying to be registered with the commission. They had clear plans about how they were going to develop and improve the service. Staff were complimentary about the support they received from them. People and relatives were complimentary about the management and staff culture within the service. Systems were in place to ensure the safety and quality of care was monitored and checked regularly. The managers and staff team had developed positive partnerships with other health and social care professionals and were building strong links in the community.

People were protected from abuse by staff who were trained to recognise and report signs of its occurrence abuse. Systems designed to reduce risk were in place to ensure peoples safety. Medicines were managed appropriately. People received their prescribed medicines safely from competent staff who were trained. Systems to audit the administration of medicines were effective and had identified shortfalls, as a result medicines administration had improved recently. Enough staff were employed to meet people’s needs. Staff were recruited safely and in line with current regulations. Accidents and incidents were reported and recorded, measures were taken to improve and learn.

People’s needs were assessed prior to moving into the service. Nutritious food and fluids were available. People were given the support they needed to eat and drink and told us the food was of good quality and they enjoyed the meals on offer. The layout of the building promoted inclusion and people moved around the home safely. Care staff received regular training to support them in their roles. Nursing staff told us they were supported to maintain their professional registration . 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.

Staff were observed throughout the inspection to be caring, thoughtful and kind. People and relatives consistently told us staff were kind and caring and they were treated well. People were given the opportunity to express their views regularly and were involved in their care. Staff were knowledgeable about how to maintain privacy and dignity.

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 10 December 2018) and there was a breach of regulation. Since this rating was awarded the registered provider of the service has changed. We have used the previous rating to inform our planning and decisions about the rating at this inspection.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The provider registered this service with us on 5 February 2019, this was a planned inspection based on the date it was registered.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.