Archived: Fern House

Updated 31 October 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 comprehensive inspection took place on 3 and 4 October 2018. The first day of the inspection was unannounced. The inspection was carried out by one adult social care inspector.

In preparation for the inspection, we reviewed the information we held about the service including notifications the provider had sent to us and previous inspection reports. A notification is information about important events which the provider is required to send us by law. We contacted the local authority contract monitoring and safeguarding teams for their feedback. We reviewed the information we had and used it to decide which areas to focus on during the inspection.

Before the inspection, the provider submitted a Provider Information Return (PIR). This is information we ask providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We used this information to assist us with planning the inspection.

During the inspection, we used a number of different methods to help us understand the experiences of people who lived in the home. We spoke with the provider and with a representative from the proposed provider, the registered manager and one member of care staff. We also spoke with four people living in the home and with one visitor. We observed care and support in the communal areas during the visit.

We looked at a sample of records including two people's care plans and other associated documentation, induction records, staff rotas, training and supervision records, minutes from meetings, complaints and compliments records, medication records, maintenance certificates and development plans, policies and procedures and quality assurance audits. Following the inspection visit, we asked the registered manager to send us some additional information; this was complied with as requested.

Updated 31 October 2018

We carried out an inspection of Fern House on 3 and 4 October 2018. The first day was unannounced.

Fern House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Fern House provides accommodation and care and support for up to six people with a learning disability. The service does not provide nursing care. There were five people living in the home at the time of the inspection.

At the time of our inspection, we were informed the ownership of the home was changing from Mr Shaun Martin Brelsford & Mrs Amanda Jane Brelsford to Affinity Supporting People Limited. Appropriate applications had been forwarded to CQC for consideration. This meant new systems and records were being introduced at the time of our inspection.

Fern House is a large mid terraced house, situated in a quiet residential area close to Burnley town centre. There is an enclosed patio/garden area to the rear of the home. Street car parking is available.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

There was a registered manager in place. 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.

At the last inspection on 18 and 19 October 2017 our findings demonstrated there were three breaches of the regulations in respect of risk management processes, medicines management and lack of compliance with the Mental Capacity Act 2005. The service was rated Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do to improve the service to at least good and to identify the date when this would be achieved.

During this inspection, we found some improvements had been made to address the breaches in regulation. However, whilst we did not consider the provider to be in breach of the regulations, we found further development was needed in the management of age related risks, the environment and with the management of people’s medicines.

This is the second consecutive time the service has been rated Requires Improvement.

We were aware the proposed new provider was committed to an extensive programme of development which would improve people’s lives. This included changes to the environment, policies and procedures and to the records and systems. During this inspection, we found changes were in progress.

The management of people’s medicines had improved and shortfalls noted at the last inspection had been addressed. However, improvement was needed with regards to the ordering process to ensure people's medicines were always managed safely. The registered manager acted on this at the time of our inspection to prevent this from re-occurring. Staff administering medicines had received training and were deemed competent to do this safely. Policies and procedures had been revised and would guide staff with good practice.

People were happy living in the home and were happy with the facilities provided. They had personalised their bedrooms as they wished and we saw personal touches in the communal areas. However, we found the general cleanliness of the home could be improved and improvements were needed to the environment. We noted that a development plan was in place and extensive refurbishment was due to commence this month (October 2018). We asked the provider to keep us up to date with changes that impact on people’s lives.

Risks to people's safety had been identified, assessed and managed safely. Further consideration and improvements were needed with regards to identifying and managing age related risks. Relevant health and social care professionals had provided advice and support when people's needs changed.

Monitoring of the service had improved since our last inspection visit. However, we noted some matters that had been identified by the provider’s checks, particularly in relation to the environment, had not yet been actioned. The registered manager and the representative from the new provider were aware of where further improvements were needed; there was a plan in place to support this and shortfalls were being addressed by policies and procedures, changes to the environment and with the introduction of new records. There were effective systems to obtain the views of people, their visitors and staff. People felt their views and choices were listened to. They told us they had been fully consulted and involved regarding the recent changes.

The staff team was stable and there had been no new staff recruited; this meant we were unable to determine whether recruitment processes were safe. A safe and robust recruitment procedure was being introduced to ensure new staff were suitable to care for vulnerable people. Arrangements were in place to make sure staff were trained and competent and additional training, from the new provider, was underway.

People were happy with the conduct and availability of staff and they were happy with the care and support they received. They told us they felt safe in the home and that staff were caring and kind. Staff understood how to protect people from abuse. People told us they did not have any complaints and knew how to raise their concerns. People's privacy, individuality and dignity was respected.

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. Staff sought people’s consent, respected people's diversity and promoted people's right to be free from discrimination.

Each person had a care plan, describing their individual needs and choices, which provided guidance for staff on how to provide people with support. Care and support was kept under review and people were involved in decisions about their care. Relevant health and social care professionals provided advice and support when people's needs changed.

People were supported with a range of activities that met their needs and preferences and had opportunities to maintain and develop their skills both inside the house and in the local community. People enjoyed their meals and were involved in menu planning, food shopping and meal preparation.