Archived: The Ferns

Updated 10 July 2021

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 Care Act 2014.

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 two inspectors.

Service and service type

The Ferns 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.

The service had two managers 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. For the purpose of this report, we will refer to the managers as 'registered manager one' and 'registered manager two.' Since the last inspection, registered manager one was now less involved with the service. Registered manager two was present during our inspection.

Notice of inspection

Notice was given to the service just before our arrival. Short notice was given so we could check the COVID-19 status within the home.

What we did before the inspection

We reviewed information we had received about the service since the last inspection.

During the inspection

We spoke with five people who used the service and three relatives about their experience of the care provided. We spoke with six members of staff including the provider, registered manager two, senior care worker and care workers. We observed interactions between people living at the service and members of staff throughout the inspection.

We reviewed a range of records. This included three people’s care records and five medication records. A variety of records relating to the management of the service, including staff training and quality audits.

After the inspection

We reviewed information requested from the provider during the inspection to validate evidence found, including supervision records and the service improvement plan. We contacted the local authority quality team.

Updated 10 July 2021

About the service

The Ferns is a residential care home providing accommodation and personal care to five people with a learning disability. A maximum of six people can live at The Ferns.

The Ferns is a large terraced home over three floors and has a cellar. Three people had their own bedrooms and two people shared a large bedroom. There was a shared lounge, dining room, kitchen and two bathrooms. Staff used a downstairs room as an office and sleep-in room. This room could also be used by people living at the home during the day, for example to use the games console or pool table.

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

Considerable improvements had been made in all areas following our last inspection. Safety concerns had been addressed and a lot of maintenance work had been completed in the building. Further re-decoration was planned. Quality audits had been reviewed and issues identified were acted upon. Current COVID-19 guidelines were being followed and the staff team used the correct personal protective equipment.

People had been involved in their care plans, which had been re-written in a person-centred way. Risks to people’s safety had been assessed and plans were in place to manage them. People’s end of life wishes had started to be discussed with people but had not been completed and recorded.

People were taking part in more activities as more staffing was available and people interacted well with the staff. Relatives were positive about the support their relatives received at The Ferns. Records were written in a dignified way.

Staff had completed required training, with additional training planned. Staff felt well supported and had regular supervision meetings. People received their medicines as prescribed and their health and nutritional needs were being 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. Where people were able to make some decisions and not others (called variable capacity), the provider said they would use a recognised capacity assessment tools to assess the person's capacity to make each separate decision.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. We have made a recommendation that further support is provided for the staff team so the key principles of 'Right support, right care, right culture' are followed.

Additional staff hours were available to support people to access their local community and activities. Maintenance work had been completed to make the service more homely. A person-centred approach was being promoted by the management team. Discussions had been held in team meetings and staff training had been completed. Daily records were now written in a respectful way. Further support is required to embed this culture in the staff team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 22 January 2021), there were multiple breaches of regulations and CQC took enforcement action. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Where a service has been rated inadequate at the previous inspection, improvements must be made and shown to be sustained within the service to be rated as good. The Ferns have made improvements in all areas where issues had been identified at our last inspection. We will continue to work with the service and the local authority, so the improvements seen at this inspection are sustained.

This service has been in Special Measures since 22 January 2021. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This comprehensive inspection was carried out to follow up on the enforcement action we took following the last inspection.

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 meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.