We carried out a review of the data available to us about Fearnley House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Fearnley House, you can give feedback on this service.
Fearnley House is a care home without nursing, which provides accommodation and personal care for up to four adults living with a learning disability or autism. At the time of the inspection there were four people living at the service. The service is situated in a busy residential area of Old Windsor, Berkshire. The home is a bungalow house with four bedrooms, a communal bathroom, lounge, kitchen and dining room. The service is located next door to another home in the provider’s care group.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
Family members and community professionals consistently praised the quality of the personalised care and support provided by people living at Fearnley House.
People experienced safe care. Risks to people were identified and managed safely by staff who understood their responsibilities to protect people from abuse and avoidable harm. Enough staff with the required skills and knowledge provided people with safe care. People received their medicines safely, as prescribed, from staff who had completed the required training and had their competency assessed to do so.
Staff maintained high standards of cleanliness and hygiene in the home, in accordance with the provider’s infection control policy. We observed staff followed good food hygiene practice when preparing and storing food. Safety concerns were consistently identified by staff who took prompt action to ensure people were protected. Accidents and incidents were reviewed by the registered manager to identify trends and to ensure necessary learning was shared with staff.
People received effective care and support which consistently achieved successful outcomes and promoted a good quality of life. Staff felt valued and well supported by the management team through a system of effective training, competency assessment, supervision and appraisal. Staff consistently delivered care in accordance with people’s support plans and recognised best practice.
People experienced genuine choice and support to eat and drink enough to maintain a balanced diet and good health.
Staff were kind, compassionate and responded in a timely and caring way when people experienced physical pain, discomfort or emotional distress. Staff knew people’s interests and preferences and supported them to access community activities of their choice and to pursue education opportunities, which enriched the quality of their lives. People were supported to maintain relationships with people close to them, through personal contact and use of technology.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
The service was well-led, based on an open culture and the provider’s values, including honesty, compassion and dignity. The management team monitored the delivery of care against these values.
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 (report published 20 April 2017).
Why we inspected: This was a planned, comprehensive inspection.
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.
At the last inspection, the service was rated good.
At this inspection we found the service remained good.
Why the service is rated good:
People were protected from abuse and neglect. The service had good assessment, mitigation and documentation about risks to people. This helped prevent people from any harm. There was safe deployment of staff to ensure people’s care was safe.
Staff received appropriate support to perform their roles. The service was compliant with the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.
We found the staff were very kind and loved their roles. We saw that staff listened to what people had to say and held meaningful conversations with them. This included using alternate means of communication. People’s right to privacy was respected and staff demonstrated dignity in the care they provided.
We found care plans were very person-centred and contained appropriate details. People’s preferences, wishes and aspirations were identified and documented. Staff helped people to have an active life in the community. We made a recommendation about the provision of sensory equipment for people.
The service had a positive workplace culture. There was good oversight of the service’s care from the registered manager and the provider’s representatives. The provider ensured that the quality of the care was regularly assessed. Where care to people could be improved in any way, the provider made appropriate changes to enable this.
Further information is in the detailed findings below.
The inspection took place on 16 December 2014 and was unannounced.
Fearnley House is a care home without nursing for up to four people with a learning disability or autistic spectrum disorder. At the time of the inspection four people lived at Fearnley House. The people living at Fearnley House had a range of support needs. All of the people living at Fearnley House required support of staff when they were away from the home.
The home is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. At the time of the inspection the manager was not registered with CQC. They had recently been appointed and were in the process of submitting their application to become a registered manager.
People using the service were happy; they were seen to be smiling and relaxed during the inspection. Two of the three relatives we spoke with told us they were very happy with the support and care provided at the home. However, there had been several changes in manager at Fearnley House over the last year and relatives told us this had had a negative impact on their family members. Two relatives said they were involved fully in the care of their family members and that communication was good.
Relatives told us and we observed that staff treated people with kindness and respect. Support was focussed on individuals and designed to meet the specific needs and preferences of people living in the home. There were systems in place to manage risks to people and staff were aware of how to keep people safe by reporting concerns promptly through procedures they understood well. The provider had robust recruitment procedures in place to ensure only staff of suitable character were employed.
People who could not make specific decisions for themselves had their legal rights protected.
People’s support plans showed that when decisions had been made about their care, where they lacked capacity, these had been made in the person’s best interests. Staff understood their responsibilities and knew how each person indicated their consent.
Staff were trained appropriately to meet people’s needs. New staff received induction, training and support from experienced members of staff. Staff felt well supported by the manager and said they were listened to if they raised concerns. Staff spoke with conviction about the values and ethos of the service and understood their responsibilities. People’s medicines were managed safely and staff had received appropriate training in the safety of medicines. Their knowledge and skill was assessed regularly.
People and their relatives were involved in planning and reviewing the support they required. People were encouraged to be as independent as possible and they worked toward agreed goals to achieve this. There was a programme of activities planned to meet the individual needs and preferences of people living at Fearnley House. Links with the community were maintained and people were encouraged to use community facilities such as public transport, leisure centres, town centre shops and cafes, social clubs and colleges.
The quality of the service was monitored regularly by the manager and provider. Feedback was encouraged from people, visitors and stakeholders and used to improve and make changes to the service. Complaints were recorded, investigated and responded to in line with the provider’s policy.
We saw staff interacted respectfully with people. They checked that they supported people with their consent. Staff understood when it was appropriate to take a best interest decision and the process to follow when this was required.
We spoke with three relatives of people who use the service. They were highly satisfied with the level of care their loved ones received. One person told us 'I can't praise the staff highly enough.' Another stated 'The care is exemplary. Staff are marvellous.'
Staff were aware of the support and care needs of each person. They referred to care plans and discussed people's preferences with them. They were aware of risks that could potentially harm people and took appropriate actions to reduce identified risks.
The home was clean and clutter-free. People were assisted to access all areas of the home by use of ramps where necessary. A maintenance and servicing programme ensured the home was kept in a good state of repair.
Staffing levels were sufficient to meet the care needs and activity programme of people who use the service. One relative we spoke with told us 'There are always staff available to supervise people.'
The service had a complaints policy that ensured complaints were investigated and resolved appropriately. Relatives of people who use the service told us they were satisfied concerns were dealt with satisfactorily.
We saw information appropriate to the needs of people living in the home was provided in easy to read format. We observed staff using communication books to ensure people were able to communicate their wishes. We found personal risk assessments were undertaken to ensure people remained safe. One relative told us 'overall the care is fantastic.'
Staff told us of the safeguarding training they received, and explained the safeguarding procedure to us. We observed appropriate actions were taken as directed by care plans, implementing changes required following a safeguarding incident.
One member of staff told us 'the home is brilliant to work in.' Staff told us they felt well supported through training opportunities, supervisions and appraisals.
We saw evidence the provider undertook regular unannounced checks on the home, and staff acted on feedback provided to improve the service.