23 January 2018
During a routine inspection
At our last inspection on 15 December 2016, we rated the service overall Good. The key questions Effective, Caring and Responsive were rated good. The key questions Safe and Well-Led were rated Requires Improvement with a repeated breach of Regulation 12 of the HSCA Regulated Activities 2014. People’s medicines were not always managed safely.
We asked the provider to complete an action plan to show what they would do and by when to make improvements. The provider submitted an action plan to us about the measures they were taking to address the concerns found at the previous inspection.
At this inspection, we found that the improvements had been fully embedded into practice and all key questions are now rated as Good.
Fenners Farm House 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.
Fenners Farm House accommodates people in one building, which has been extended and adapted in some areas.
The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.
There was a registered manager in post. 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.
Staff worked with people to identify goals and manage risks in a way that enabled people to develop confidence and skills whilst ensuring that they were safe. The provider took a proactive approach to incidents and which meant that they were deescalated quickly and systems were in place to respond to concerns. Staff understood their roles in safeguarding people from abuse.
There were sufficient numbers of staff to meet people’s needs and the provider had carried out checks to ensure that staff were suitable for their roles. People received their medicines safely. Trained staff administered medicines and the provider managed medicines in line with best practice and regularly audited them. The provider had systems in place to ensure the risk of the spread of infection was reduced and people lived in a clean home environment.
People were supported to access healthcare professionals when required with support from staff.
Staff had received appropriate training for their roles. Staff received one to one supervisions and there was an appraisal process in place. Regular meetings took place that involved staff, people and relatives in decisions about the service. People were asked for consent and care was provided in line with the Mental Capacity Act (2005).
Staff knew people well and interacted with them with kindness and compassion. Staff were respectful of people’s privacy and dignity when providing care to them. People were supported to maintain relationships that were important to them.
Care was planned in a person-centred way. People had their own records to document their care and activities using pictures and photographs. Care planning had achieved positive goals for people and helped them to develop skills and try new things. Care plans were regularly reviewed and any changes to people’s needs were actioned by staff. People were supported by allocated staff that oversaw their care and helped to identify choices and preferences. People and relatives were routinely involved in care planning.
People had access to a range of activities that suited their needs and interests. The provider had a clear complaints policy in place and had a proactive approach to feedback to identify improvements.
The provider carried out regular checks on the quality of the care that people received, this included visits from stakeholders independent of them. There was a variety of audits in place to monitor quality and the provider had sent surveys to relatives to gather feedback from them. The provider maintained accurate an up to date records and had notified CQC of important incidents and events. Staff felt supported by the registered manager, team spirit and morale was very positive.