Archived: Ferndene Care Home

Updated 11 December 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.

This inspection took place on 17 October 2018 and was unannounced.

The inspection was carried out by two inspectors, a specialist advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The specialist advisor was a registered nurse.

We examined information we held about the service. This included notifications of incidents that the registered persons had sent us since our last inspection. These are events that happened in the service that the registered persons are required to tell us about.

The provider had completed a Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report

During the inspection we spoke with 24 people who lived at the service, nine relatives,4 members of care staff, two nurses, the area manager and the registered manager. We also looked at six care records in detail and records that related to how the service was managed including staffing, training and quality assurance.

Updated 11 December 2018

This inspection took place on 17 October 2018 and was unannounced. Ferndene is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. It provides accommodation for older people and those with mental health conditions or dementia. The home can accommodate up to 48 people in one adapted building. The home is divided into two units one upstairs and another on ground floor level. At the time of our inspection there were 41people living in the home.

At the time of our inspection there was a registered manager in post. 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.

The service had previously been rated as ‘requires improvement’ in 2015 and 2017. At this inspection the service was rated as ‘requires improvement’. This was the third consecutive time the service was rated as ‘requires improvement’. The service had made some improvements but had not fully addressed the issues raised at previous inspections. At this inspection we found breaches of regulation 18 and regulation 17. There was insufficient numbers of suitably skilled staff. Due to the failure of the provider to address issues previously identified at inspection there was a breach of regulation 17.

The provider had ensured that there was usually a sufficient number of staff on duty however some staff did not have the experience required to carry out their duties. People told us that they received person-centred care. Sufficient background checks had been completed before new staff had been appointed according to the provider’s policy. A system was in place to carry out suitable quality checks and appropriate checks had been regularly carried out, however action plans were not always in place to address issues identified.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Most risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. The environment was clean. Staff did not adhere to arrangements to prevent and control infections.

Guidance was in place to ensure people received their medicines when required. Processes were in place to manage medicines. Where people required their medicines via a specialist method to administer food arrangements had not been in place to ensure the method of administration did not affect the efficacy of the medicine. We have made a recommendation about the management of some medicines.

Where people were unable to make decisions, arrangements were in place to ensure decisions were made in people's best interests. Best interests decisions were specific to the decisions which were needed to be made.

Care was not always delivered in line with current best practice guidance. There were ongoing issues with regard to staff not consistently treating people with dignity and respect. Arrangements were in place to ensure staff received training to provide care appropriately and effectively. People were helped to eat and drink enough to maintain a balanced diet. People had access to healthcare services so that they received on-going healthcare support.

People were supported to have choice and control of their lives. Staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice.

People were usually treated with kindness and compassion and they were given emotional support when needed. They had also been supported to express their views and be involved in making decisions about their care as far as possible. People had access to lay advocates if necessary. Confidential information was kept private.

Information was provided to people in an accessible manner. People had been supported to access a range of activities. People were supported to access local community facilities. The registered manager recognised the importance of promoting equality and diversity. People’s concerns and complaints were listened and responded to improve the quality of care. Arrangements were in place to support people at the end of their life.

The registered manager encouraged a positive culture in the home. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. People, their relatives and members of staff had been consulted about making improvements in the service. There were arrangements for working in partnership with other agencies to support the development of joined-up care.

Further information is in the detailed findings below.