Archived: Fenwick

Fenwick is a care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Fenwick provides accommodation and support to up to three people with a learning disability. At the time of our inspection three people were using the service.

The building comprises three bedrooms, lounge, kitchen and dining area. The laundry was outside and there was a rear garden. One bedroom had en-suite facilities of a bath and toilet. There was a communal bathroom and toilet.

There was a registered manager. 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.

Parts of the building required repairs and maintenance. People were protected from the risk of harm. Staff understood the safeguarding procedures on identifying and reporting abuse. People received care that minimised harm from known risks. Risk assessments and management plans were reviewed and updated to ensure staff provided care in a safe manner. Staff managed incidents in an appropriate manner and learnt from them to prevent a recurrence.

People were supported by a sufficient number of skilled and experienced staff. Staffing levels were adequate to meet people’s needs in a safe manner. People received care from staff who had undergone appropriate recruitment procedures to ensure their suitability to provide support. People’s medicines were administered and managed safely. Staff knew how to minimise the risk of infection and a recurrence of incidents and accidents.

People underwent an assessment of their needs before they started using the service. Health and social care professionals were involved in planning people’s care delivery which ensured that support provided met best practice guidance. Staff felt supported in their roles and in addition received training and supervision. People received care in line with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were involved in making decisions about their care. Staff obtained people’s consent to care and support and made decisions in each person’s best interests when they were unable to do so. Staff respected people’s privacy and dignity. People were supported to maintain relationships that mattered to them. People enjoyed taking part in a variety of activities at the service and in the community.

People’s care plans underwent reviews to ensure they remained appropriate to meet their needs. Staff responded to changes in people’s health and well-being and involved health and social care professionals in a timely manner. The provider ensured people had information in line with the Accessible Information Standards.

People had access to healthcare services and were supported to maintain good health. People received food that met their preferences, dietary and cultural needs.

People using the service and their relatives had opportunities to share their views about the quality of care delivery. The registered manager acted on the feedback to develop the service.

People’s care delivery was checked and audited to identify any shortfalls. Improvements to the service were made to address gaps identified. The provider carried out quality assurance checks and surveys to develop the service.

The registered manager worked in close partnership with other agencies to ensure that people received appropriate and effective care.

We have made a recommendation on the management of the premises.

At the last inspection on 1 December 2014, the service was rated as Good.

This inspection took place on 13 April 2017 and was unannounced. At this inspection, we found the service remained Good.

People received safe at the service. Staff were able to identify and report potential abuse to keep people safe. Staff had received safeguarding training and understood the procedures to follow to report concerns on people’s safety.

Risks to people were assessed and plans put in place to monitor and minimise the likelihood of harm without unnecessarily restricting their freedom. There were effective plans for dealing with emergencies and accidents at the service.

People’s needs were met by a sufficient number of skilled staff deployed on each shift. Additional staff were made available to support people to attend healthcare appointments, outings and provide one to one support when needed. Appropriate recruitment procedures reduced the risk of people receiving care from staff unsuitable for the role.

People received their medicines safely and in line with the provider’s policy. Medicines management procedures were safe and effective. Staff were trained and competent to manage and administer people’s medicines appropriately.

People’s care was delivered effectively because staff were trained and skilled for their roles. Staff were supported in their role, received supervision, and undertook training to equip them with the skills necessary to provide effective care. Staff knew people well and understood their communication needs and had information on how to provide their care.

People who lacked mental capacity to consent to arrangements for necessary care or treatment can only be deprived of their liberty when this is in their best interests and legally authorised under the MCA. The procedures for this in care homes and hospitals are called the Deprivation of Liberty Safeguards (DoLS). Staff understood and promoted people’s rights as required by the MCA and DoLS requirements. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the support this practice.

People enjoyed the food provided at the service and were offered a choice about what to eat and drink. People’s health needs were met and staff made referrals to healthcare professional when necessary.

Staff had developed positive relationships with people and provided their care with kindness and compassion. People and their relatives were involved in planning and making decisions about their care and their choices were respected. Staff treated people with respect and promoted their dignity and privacy.

Staff assessed people’s needs and developed plans to meet their individual needs. People’s care was regularly reviewed to ensure they received care responsive to changes of their health. People and their relatives had information about how to make a complaint and were confident any concerns raised would be resolved. Feedback about the service was used to drive improvement at the service.

Relatives and staff had positive views about how the service was focused on providing person centred care and how the service was run. Regular checks and audits monitored the quality care people received at the service and findings were used to make improvements.

Further information is in the detailed findings below.

We found that people were enabled to make day to day decisions about their care and support. We found that people's agreement was sought before care was provided to them. People had care plans which included plans to meet their nutritional needs appropriately and they were provided with nutritious and suitable food and drink. Records about people and their needs were accurate and available for staff.

We saw evidence that the provider operated an effective recruitment process to ensure that only suitably qualified, skilled and experienced people were employed at the service.

We found that the home was clean and hygienic and that procedures were in place to prevent the spread of any potential infections.

We spoke with one person's relative who visited the home regularly. We got positive comments about the service and they complimented how the staff and the manager communicated with them. They were satisfied with the care that was provided and felt that they all worked together for their relative.

We also spoke with a speech and language therapist who worked with the staff to improve people's communication skills. The therapist complimented the service and its staff as they followed the guidelines that were provided and co-operated well with them.

We found that people's needs were assessed and detailed person centred care plan were developed. Staff received ongoing training and followed the care plans and guidelines from other professionals to meet people's needs. The provider monitored the service to ensure people's well-being and that the quality of the service is adequate.