Background to this inspection
Updated
22 December 2022
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by one inspector.
Service and service type
This service 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.
Registered manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
The inspection was unannounced.
What we did before the inspection
We reviewed the information we already held about the service. This included the last inspection report and notifications. A notification is information about important events, which the provider is required to tell us about by law. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We used all of this information to plan our inspection.
During the inspection.
During the inspection, we spoke with the registered manager, 4 staff and the director. We carried out observations of people’s care and support and spoke with 2 people for their feedback on the home. We reviewed documents and records that related to people’s care and the management of the service. We reviewed 4 care plans, which included risk assessments. We looked at other documents such as medicine management and infection control.
We continued to seek clarification from the provider to validate evidence found. We spoke with 2 relatives by telephone, for their feedback.
Updated
22 December 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Fern Leaf Carehome (26 Purleigh Avenue) supports people aged 18 or over, some of whom have learning disabilities, or are autistic. The home also supports people who may have dementia or mental health needs. It is registered to accommodate and support up to 6 people. At the time of the inspection, 6 people were living at the home. The home has two floors with adapted facilities and furnished rooms.
People’s experience of using this service and what we found
Right support
The provider had carried out improvements to the home following our previous inspection, to ensure it was safe for people. People had control of how their care and support was arranged. Systems were in place to protect people from the risk of abuse. Risks to people’s health were assessed so staff could support them safely. People’s medicines were managed safely.
The provider recruited staff appropriately and checked they were suitable to work with people. There were enough staff working in the home to support people. Systems were in place to prevent and control infections. Lessons were learned following accidents and incidents in the home.
Right care:
Processes to assess people’s needs to determine if the home was suitable for them were in place. People received care and support that was personalised for their needs. Staff were trained to carry out their roles and received support with their development. People attended health appointments with professionals to help maintain their health. They were supported to maintain a balanced diet and their nutritional and cultural needs were met.
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.
Right culture:
The values and attitudes of staff and managers in the home enabled people to be as independent as possible and feel empowered in their daily lives. People were supported to achieve positive outcomes. The management team learned lessons when things went wrong in the home to ensure people’s dignity, privacy and human rights were respected at all times. People were supported to integrate into the local community and be as independent as possible. They pursued their interests and were supported to avoid social isolation. For example, we saw people go out to day centres and take part in activities. Systems were in place to manage complaints. People’s communication needs were met. Feedback was sought from people to help make continuous improvements to the home.
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 the service was Requires Improvement, (published on 24 January 2022) and there were breaches of regulation.
We issued requirement notices to the provider for breaches of regulation 15 (Premises and equipment), and regulation 17 (good governance).
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
At our last inspection we recommended that people's end of life care wishes was explored. At this inspection, we found the provider had acted on this recommendation and had made improvements to ensure end of life care planning was in place.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection and following concerns raised about the safety of the service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.