Background to this inspection
Updated
17 March 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. The inspection was planned to check whether the provider was 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 an unannounced inspection and took place on the 8 and 9 August 2016.
The inspection was carried out by one adult social care inspector and a Specialist Advisor in Mental Health. Prior to the inspection we reviewed information we held about the service, including notifications the Care Quality Commission (CQC) had received from the provider. Notifications are changes, events or incidents that the provider is legally obliged to send us without delay. We also reviewed the inspection report from the previous inspection and contacted the Local Authority (LA) and Healthwatch Oldham to ask if they had any concerns about the service, which they did not. We also reviewed information submitted to us by the provider in the ‘provider information return (PIR). This document asks the provider to give us some key information about the service, what the service does well, and any improvements they are planning to make.
During our inspection we spoke with 8 people who used the service, the management team, including the registered manager and 6 care staff.
We looked around the building, observed how staff cared for and supported people, reviewed records and looked at other information which helped us assess how people’s care needs were met. We observed a lunchtime meal and watched the administration of medicine to check that this was done safely. We observed a staff ‘handover meeting’ to see how information about people who use the service was discussed and shared.
As part of the inspection we reviewed the care records of 5 people living at the home. The records included their care plans and risk assessments. We looked at three staff files to check that the recruitment process had been carried out correctly. We also reviewed other information about the service, such as the training and supervision programme, quality assurance process, policies, complaints and compliments.
Updated
17 March 2017
This inspection took place on the 8 and 9 August, 2016. Our visit on the 8 August was unannounced.
We last inspected the home in August 2014. At that inspection we found that the service was meeting all the regulations we assessed.
Fern Bank is a private care home, which has been owned and managed by the same family for over thirty years. It is a large detached Victorian House, situated opposite a park, approximately one mile from Oldham town centre. Fern Bank is registered to provide care and support for up to 26 people who have mental health needs or physical disabilities related to the ageing process and supports people who are over 50 years of age. At the time of our inspection there were 25 people living at the home, two of whom had a diagnosis of a dementia type illness. Although Fern Bank is a care home, the service calls itself a ‘therapeutic community’. It's philosophy is based on the concept of ‘normalisation’. The statement of purpose describes “normalisation,” as being brought about through ‘’social interaction with trained staff and support from fellow people who use the service’’ and explains that the giving and receiving of positive feedback promotes self-esteem and improves people who use the service’ social and emotional well-being.
The home offers three types of accommodation: single rooms with en-suite facilities, shared rooms with en-suite facilities and reablement studio apartments with a bedroom, bathroom and kitchen.
When we visited the service a registered manager was in place. 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.
We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to Deprivation of Liberty Safeguards (DoLS).
You can see what action we asked the provider to take at the back of the full version of this report.
Two people who use the service who had a diagnosis of dementia did not have the required Deprivation of Liberty Safeguard in place (DoLS).
The service was in the process of updating and reformatting all risk assessments and care documentation.
Staff had a good understanding of safeguarding procedures, how to identify signs of abuse and what action they would take to protect vulnerable people in their care.
From our observations we saw that there were sufficient, appropriately trained staff available to support people in the home and recruitment checks had been carried out on all staff to ensure they were suitable to work in a care setting with vulnerable people.
Medicines were stored correctly and administered by staff who had received appropriate training and been assessed as competent to safely administer medication.
The building and furnishings were maintained and decorated to a high standard and environmental checks were up-to-date. The home was clean and free from unpleasant odours and systems were in place for the prevention and control of infection.
Staff had received an induction and had undertaken a variety of training to ensure they had the skills and knowledge required for their roles. Staff received regular supervision which ensured that the standard of their work was monitored.
People were supported to eat and drink sufficient amounts to meet their needs and were actively involved with planning the choice of food offered.
We observed that staff were kind and caring. Through talking with staff and people who use the service we found that people were treated as individuals and that staff really knew each person and responded to their needs in a caring manner. Staff offered encouragement and spoke in a positive way to people who use the service in order to help improve their self-esteem.
People were supported to maintain good health and where needed specialist healthcare professionals were involved with their care.
Activities were at the heart of the daily life of Fern Bank and a range of varied activities, suggested by people who use the service, was available.
People using the service, relatives and healthcare professionals were able to express their opinions about the service through regular surveys about the quality and standard of care provided. The home had a complaints procedure and people we spoke with knew how to make a complaint if they needed to.
Quality assurance processes such as audits were in place to ensure that the service delivered a high standard of care. However, they had not identified that DoLS were needed for two of the people who used the service.
Staff worked well together and there was a positive culture among staff. The management team was forward thinking and keen to promote Fern Bank as a happy and positive place in which people with mental health problems could live.