Archived: Fernbank House

Updated 21 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was a planned inspection based on the rating at the last inspection.

Inspection team:

The inspection as completed by one adult social care inspector.

Service and service type: The service is a 'care home'. People in care homes receive accommodation and personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at on this inspection.

The service is registered care home providing personal care without nursing for up to 12 people who had conditions associated with frailty, old age and dementia.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The first day was unannounced and the second day was agreed with the registered manager.

What we did:

Before the inspection we used information, the provider sent us in the Provider Information Return. (PIR) Providers are required to send us key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We looked at information we held about the service including notifications they had made to us about important events. We also reviewed all other information sent to us from other stakeholders for example the local authority and members of the public.

During the inspection we;

• Spoke with six people living at the service.

• Spoke with two staff, the home manager and the registered manager.

• Spoke with three visiting relatives.

• Reviewed three care plans and daily records, including records relating to medicines.

• Checked records of accidents, incidents, complaints and compliments.

• Reviewed three training and personnel records.

• Checked a sample of audits and quality assurance records.

Updated 21 March 2019

About the service:

Fernbank House is a small residential care home that was providing personal and nursing care to ten people at the time of this inspection. 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.

People’s experience of using this service:

People enjoyed living at Fernbank House, they felt safe and well cared for. One person said “Its home from home here. I really love it.”

Care and support was well planned and promoted people’s independence, choice and diversity. This was because prior to a new person being admitted, the registered manager or senior member of staff completed a pre- admission assessment.

Staff understood what was important for each person and how best to deliver safe and effective care. Staff had good training to ensure their competencies and help them understand the needs of people who were fail, elderly and living with dementia. Staff felt they were well supported to do their job.

Detailed risk assessments were in place to support people to take positive risks and remain safe.

Staff understood how to safeguard people from abuse. Recruitment processes had improved since the last inspection to ensure only staff who were suitable to work with vulnerable people were employed.

People were supported to maintain good health through ensuring regular check-ups and good liaison between the community nurse team and GP’s. People had access to podiatry, opticians and other allied health professionals as needed.

People enjoyed a good variety and choice of meals. Drinks and snacks were offered throughout the day. People were complimentary about the meals available. One person said “The food is five stars, you really couldn’t ask for better. If you don’t like what’s on offer you can ask for something else.”

Staffing levels were sufficient to meet people’s needs and staff had the right skills and support to deliver high quality care and support. Since the last inspection, night staffing had increased to two waking night care workers.

There was effective leadership. The registered manager was also the registered provider. They spent several days per week at the service, but had delegated the day to day running of the service to a home manager. They worked together to ensure everyone understood their role and responsibilities.

Medicines were being safely managed. People confirmed they had their medicines on time and were asked about whether they needed any additional pain relief.

The staff said there was good team working. The staff team were stable and they did not have to rely on agency staff to fill gaps or sickness in the rotas.

People’s views were sought and actions taken to improve where possible, such as changes to menu choices. The ethos and values of the service were embedded into everyday practice. People were treated with kindness and respect. Their privacy and dignity was upheld and their diverse needs were fully considered.

Good governance ensured records and the environment were well maintained. There was learning from any accident and incidents, although the service would benefit from completing monthly audits on these. We have made a recommendation in respect of this.

Improvements had been made to ensure environmental and fire safety checks were being completed and recorded regularly. Recruitment processes had improved so that new staff were only employed once checks and references had been received.

We have made one recommendation in respect of how accident and incidents are reviewed.

The service met the characteristics for a rating of "good" in all the key questions we inspected. Therefore, our overall rating for the service after this inspection was "good". More information is in the full report.

Rating at last inspection: REQUIRES IMPROVEMENT (January 2018)

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.