Archived: The Fearnes

' Is the service caring?

' Is the service responsive?

' Is the service safe?

' Is the service effective?

' Is the service well led?

This is a summary of what we found-

Is the service safe?

Care was planned to meet people's needs. Where a need was identified a plan was in place to meet this need. For example, one person's care record stated that they required the assistance to change position. This plan detailed the equipment required and the numbers of staff. However, the provider may find it useful to note that one person who required the use of a hoist to change position did not have a moving and handling plan. This person additionally had two hoist slings in use of differing sizes which staff confirmed were being used. We raised this with the manager at the time of inspection and the incorrect hoist sling was removed. We checked that a new moving and handling plan had been written at the end of this inspection. We spoke with four care staff who were aware of people's needs and how these should be met.

CQC monitors the operation of the Deprivation of Liberty Safeguards which apply to care homes. No applications had been submitted, however the provider had a policy and relevant staff understood how an application should be made. The provider considered restrictions placed upon people living at the home. However, the restrictive care provided to one person had not been fully considered or documented. The manager told us that they would urgently review this person's care.

Is the service responsive?

People accessed the services of healthcare professionals as required. One person told us, 'I can see the doctor if I want to. I have seen the optician and chiropodist also.' A person's relative said, 'She can see the doctor if she needs to. The chiropodist comes and sees her feet.' We spoke with a visiting healthcare professional who told us that the home made appropriate referrals and that staff followed their advice regarding the care and treatment of people.

The provider had made arrangements to deal with emergencies. For example, we found that an evacuation bag was present in the home which contained items such as foil blankets and waterproof covers to use in the even the home needed to be evacuated. The home operated a managers on call system out of hours.

Is the service caring?

People were treated with consideration and respect and their privacy was maintained. We spoke with one person and the relatives of two people. One person told us, 'The staff are very friendly.' One person's relative said, 'They are all very kind.' Another person's relative commented, 'They are very polite.' Staff communicated with people in a sensitive and considerate manner. For example, we saw a member of staff reassuring one person who was upset and crying. We observed another member of staff sat at a table supporting a person with their meal. The staff member waited until the person had finished what was in their mouth before offering more food. We saw that bedroom and bathroom doors were kept closed when people were being supported with personal care and staff knocked on doors before entering.

Is the service well led?

The provider undertook a variety of audits to check the quality of their service. For example, we looked at audit reports relating to infection prevention and control, dining experience and privacy and dignity. We found that actions had been taken as a result of this monitoring. For example, and infection control audit had identified the need to have equipment to clean up spillages. We saw that the home had these available. We spoke with the chef who told us that they used the feedback of people and staff to influence the menu. They told us they also looked at the amount of food waste to assist them in their assessment of what to put on the menu.

People felt able to make suggestions and complaints about their care. We spoke with one person and the relatives of two people. One person told us, 'I can make complaints and they listen. I complained that they never tell me when my visitors are coming. The manager has apologised.' A person's relative said, 'I would feel able to complain. They listen.' We saw that the complaints process was displayed in the reception area of the home. We found that the home recorded and responded to complaints and shared compliments about the service. The manager told us that a relatives and residents meeting had been arranged for the weekend following the inspection.

In this report the registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. A manager was in place at the time of this inspection who told us they were in the process of applying to become the registered manager.

Is the service effective?

Peoples' needs were assessed and care was planned and delivered to meet their needs. We spoke with one person and the relatives of two other people. One person told us, 'The carers are brilliant' A person's relative said, 'They look after her well.' Another person's relative commented, 'They are very good to her and very helpful.' This relative also remarked, 'They work as a team, they all muck in.'

We spoke with three visiting relatives, one visiting GP, a visiting social care professional and four care staff to obtain their views about the home.

We observed where appropriate the care and support people received. We looked at relevant documents and records. We also observed the day-to-day activities and working practices in the home.

We saw that people received the support they required in accordance with their agreed plans of care and staff knew about people's specific needs.

The provider had arrangements in place that ensured people were protected from the risks of inadequate nutrition and hydration.

The merger of two residential units in the home had resulted in a crowded and noisy communal lounge used by people in the reconfigured unit.

There were systems in place that ensured equipment available and used to promote people's independence and comfort was effective and safe to use.

There provider had arrangements in place that ensured there were enough staff on duty at all times with the skills and experience to meet people's needs and the quality of the service provided was monitored and improved where necessary.

People were not always protected against the risk of unsafe or inappropriate care because their records were not always accurate and completed.

At the time of our inspection visit there were 25 people accommodated at the home.

We spoke with three people in order to obtain their views about the service they received.

We were unable to speak with most people who lived at the home because of their physical and mental frailty. We therefore also gathered evidence of people's experiences by looking at relevant records and observing what was going on. We also talked with the relative of one person.

We looked at documents that showed individuals' or their representatives consented to the care and treatment the service provided to people.

We saw that people who worked at the home supported and helped people appropriately and promoted their dignity and independence.

There were arrangements in place that ensured the home was clean and people were protected from the risk of infection.

We saw that staff received training and management support that enabled them to carry out their roles.

The provider had systems in place that ensured the quality of the service was monitored, procedures were followed properly and identified where improvements could be made.