Archived: Ferndale Mews

Ferndale Mews is a residential care home providing personal and nursing care to 30 people aged 65 and over at the time of the inspection. The service can support up to 34 people.

Ferndale Mews accommodates people living with dementia across two separate floors, each of which has separate adapted facilities. One floor specialises in providing care to people living with dementia who require nursing care.

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

We received positive feedback about the quality of care and support people received and the overall management of the service from people and their relatives.

People received support from staff who had received appropriate training and support to enable them to carry out their role safely, including the management of medicines. There were enough staff to support people when they needed it.

There was a stable staff team who were knowledgeable about the people living at the service and had built trusting and meaningful relationships with them. When needed regular agency staff were used so staff were familiar with people’s needs.

People and their family members told us that the service was safe. Risks to people and others were identified and measures put in place to minimise harm. Staff knew people's identified needs and risks well and were able to support people.

Staff encouraged people to eat a well-balanced diet and make healthy eating choices. People were supported to access healthcare services; staff recognised changes in people's health and sought professional advice appropriately.

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.

A variety of activities were organised each day for people living at Ferndale Mews, which included trips out.

There was a clearly defined management structure and regular oversight and input from the senior managers. People were positive about the management of the service and told us the deputy manager was very supportive and approachable. Any concerns or worries were listened to, addressed and used as opportunities to make continuous improvements to the service.

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 Good (published 11/03/2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

Our inspection took place on 10 and 11 January and was unannounced.

Ferndale Mews is a care home located in the Ditton area of Widnes, close to local shops, pubs and St. Michael's church. The home provides care for up to 34 older people with dementia. The building is a two storey purpose built home on the same site as Ferndale Court Care Home. All the bedrooms are single with en-suite facilities.

At the time of the inspection a registered manager was in place. 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.

We found that people and their relatives were positive about the care provided at Ferndale Mews. The management had acted on feedback received about the quality of the care and had implemented an action plan. People, relatives, staff and other professionals reported that the service had recently improved. We found that people were well cared for in comfortable surroundings.

The service was safe. There were sufficient numbers of suitably qualified staff to meet the needs of people living at the home. There had been a focus on the recruitment of new staff and the use of agency staff had reduced. New unit leaders had been introduced and staff told us that the organisation of the home had improved.

Staff knew the importance of keeping people safe and appropriate procedures and systems were in place to prevent people from harm and abuse. Staff had received training about protecting people from abuse and harm. The management team had access to and understood the safeguarding policies of the local authority and followed the safeguarding processes.

The home was undergoing significant refurbishment which was near to completion. The environment was conducive to the needs of people living with dementia.

We found that staff were knowledgeable and well trained. They received a thorough induction when they began their employment with the home and on-going training updates. Further face to face training had been planned. We observed that staff engaged in positive conversations and demonstrated skill in supporting people living with dementia.

People's consent was gained before any care was provided and the requirements of the Mental Capacity Act were met.

People and relatives had previously raised concerns about the quality of the food. A new chef had been employed and improvements were being made. The provider was continuing to monitor.

We saw that people were treated in a kind and caring manner. We observed that staff were skilled and patient, treating people with dignity and respect. People were able to make choices about the way they were supported.

The provider had introduced new documentation and people’s care plans were being re-written. We found that the majority of care plans were person centred and detailed. The registered manager had highlighted through audits that some of the care plans needed to be reviewed and improved and action was being taken to address this. Daily charts were not always completed fully or at the time that the care was provided.

We found that there were some activities taking place but that these needed to improve. The registered manager already had plans to make these improvements.

There was a complaints procedure in place and people knew how to complain.

People knew who the registered manager was and felt able to raise any concerns with him. Staff told us that they felt well supported. We saw that regular team meetings were held, as well as supervision meetings to support staff. There were comprehensive quality assurance processes in place and people's feedback was sought about the quality of the care. The provider demonstrated that they were acting on feedback received to make improvements.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives; the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The home was well maintained and a programme of refurbishment was taking place in order to ensure the home was pleasant and safe for people living and working there.

Training records highlighted that staff were up to date with all mandatory training needed to support people living at Ferndale Mews.

The manager advised us that appropriate procedures, including review were in place should anyone need to be subject to a Deprivation of Liberty Safeguard (DoLS) application or plan. DoLS is part of the Mental Capacity Act (2005) and aims to ensure people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom unless it is in their best interests.

Is the service effective?

The people using the service who were able to tell us said that they were happy living in the home. Comments included; “the staff are nice people”, “staff are 10 out of 10”, “staff are lovely” and “cannot fault them”.

We also received positive comments about the home and staff members from the visitors we spoke with. Comments included; “could not find better, staff are very caring and always keep me informed. They are very proactive” and “this is wonderful, always treat [my relative] with dignity and respect”.

The relationships we saw were warm, respectful, dignified and with plenty of smiles and laughter. The staff members we spoke with could show that they had a good understanding of the people they were supporting and they were able to meet their various needs.

Is the service caring?

We observed that staff interacted well with residents. They took time to ensure that they were fully engaged with the individual and checked that they had understood. Before carrying out interventions with the people using the service they explained what they needed or intended to do and asked if that was alright rather than assume consent. They also spoke to people informally and acknowledged with a smile as they passed through the home and went about their daily tasks.

All staff said that they felt supported to do their job and had received regular formal supervision. (These are regular meetings between an employee and their line manager to discuss any issues that may affect the staff member; this would include a discussion of ongoing training needs)

Is the service responsive?

The care plans had been written in a person centred manner. This means that the individualised care plans focused on the person's individual assessed needs and on how they could be met. The care plans focused on providing support to an individual in different aspects of their daily life, for example how the person was to be supported with promoting their independence and any issues regarding their health so that they were kept as healthy as possible.

During the previous inspection that took place on the 6 December we found some issues around care and welfare, particularly with staff using incorrect manual handling techniques, two service users who were wearing heavily soiled clothes and some concerns regarding poor communication between staff and family members. Following the visit in December the provider sent us an action plan explaining how the issues would be addressed. During this inspection we found that the provider had done this and no further concerns in the areas above were identified.

Is the service well-led?

The staff members we spoke to said that the home was well managed and they enjoyed working there. We saw that the provider had a range of checks completed by the manager and staff on a regular basis. This showed that the provider ensured that there was an effective system to regularly assess and monitor the quality of service that people received.

We saw the provider had policies and procedures in place for safeguarding and emergency events. All staff were aware of where to locate them if need be. Staff were able to give us confident and correct examples of what they would do in an event of an emergency, for example, if a service user was unconscious or had suffered a fall.

All medication sheets were clear and consistent, demonstrating good record keeping and safe administration. All medicines were appropriately prescribed for example by their respective GPs. All the medication charts contained the required information about the service user in order to be able to administer medication safely.

We saw the provider undertook several audits to ensure best practice and safety such as falls, medication and care plan audits. We saw the care plan audits gave staff feedback on the care plans they had completed with actions plans of what else they needed to complete.

The people using the service who were able to tell us said that they were happy living in the home. Comments included; 'The staff are very good, I like a laugh and a joke' and 'The people that run it are nice.'

The staff members we spoke with were very positive about the home. One of them said; 'I love it here, it is like a second home.' They were also positive about the new manager. Comments included; 'The home manager is very approachable' and 'I like the new manager.'

Ferndale Mews had a variety of quality assurance systems available to assess the quality of the service it was providing; these included questionnaires that were sent to people using the service and their representatives on a regular basis. HC-One also sought the views of the staff members they employed through a survey called; Our Voice.' We saw the latest newsletter with comments from staff and the action the company had taken.