The Ferns 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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to the safe management of catheter care.

This service scored 58 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Initial assessments were carried out before people moved to the service, usually in person by the manager. Care plans were formulated from these assessments and included details of specialist care requirements.

The provider did not plan and deliver people’s care and treatment with them. They did not follow legislation and current evidence-based good practice and standards.

Staff did not always support people in line with their care plans. Staff did not have training in catheter care. This had led to occasions where people did not receive support quickly enough and were put at risk of complications. Management checks had not identified these oversights.

Some people were being monitoring in relation to weight loss, to mitigate the risk high calorie drinks should have been available on the tea trolley, however these were not observed at any point during the inspection.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The culture amongst staff varied across teams. Staff did not always work as a team to ensure all people’s needs were seen to in a timely manner. Staff often told people, ‘In a while’ or ‘I’ll come back soon’, but then did not return to support the person. There had been delays in contacting healthcare professionals due to this approach.

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.

The activities coordinator ran armchair exercise classes. Staff supported people who required specialist diets to have appropriate food. People were given meal choices and if they did not like the menu could choose from other options. There were mixed comments about the food, a person said, “I have complained that they put butter and cream in things even though they know I don’t like it, falls on deaf ears,” while another person said, “The food is ok, you get choices and I have no complaints there.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Daily care records were not completed consistently, meaning it was difficult for the manager to monitor people’s outcomes properly. For example, one person should have urine output monitored but this was not consistently recorded. This meant the person’s health could not be effectively monitored.

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

Staff demonstrated an understanding of the principles of the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS).

We checked whether the service was working within the principles of the MCA, and whether any conditions on authorisations to deprive a person of their liberty had the appropriate legal authority and were being met. DoLS applications had been submitted to the local authority for authorisation and people were cared for in line with authorised restrictions.