Background to this inspection
Updated
2 April 2020
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.
Inspection team
The inspection was undertaken by two inspectors.
Service and service type
Fernwood Court Care Home 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 a manager 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service, since the last inspection. We sought feedback from the local authorities who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us 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. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and two relatives about their experience of the care provided. We spoke with eleven members of staff including the registered manager, assistant manager, senior care workers, care workers, a laundry assistant and the chef. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the registered manager to validate evidence found. We looked at a variety of additional information including training data and quality assurance records.
Updated
2 April 2020
About the service
Fernwood Court Care Home is a residential care home providing personal care for up to 56 people aged 65 and over. People are accommodated in a purpose-built building, over four floors. The service was providing personal care to 52 people, at the time of this inspection.
People’s experience of using this service and what we found
The management of people’s medicines was not always safe. Prescribed topical creams were not always administered as prescribed. The reasons for administering as required medications, and the outcomes of doing so, was not always fully recorded.
People’s care plans and risk assessments did not always provide enough detail to ensure people had choice in how their support was given, or to enable staff to keep people safe, for example when people were experiencing distressed behaviour.
There were not always enough staff on duty at night, to safely meet people’s needs. Staff were safely recruited and trained to meet people’s needs. Staff were trained in infection control, and infection control procedures were in place.
People were offered nutritional meals and were supported to eat where this was needed. The cook had information about people’s medical conditions, medication and personal preferences and used this information to ensure people received suitable foods.
Staff did not always promote people’s dignity. Staff promoted people’s independence and respected their privacy and confidentiality.
People, relatives, staff and health care professionals all had opportunities to give their views about the service, via a system of ongoing mini surveys. However, not all people had access to feedback about the surveys that had taken place.
Accessible information standards were not fully met, for people where English was not their first language.
The provider had a complaints policy and procedure in place. Complaints were effectively dealt with.
People participated in meaningful community outings and took part in a range of activities provided in the home.
People did not always have opportunities to discuss their end of life care. End of life care plans were not always in place. This meant people’s support may not reflect their preferences.
Quality assurance systems and processes were ineffective and did not consistently identify areas for improvement.
People were not always supported to have maximum choice and control of their lives. This meant staff may not be supporting people in the least restrictive way possible or in their best interests.
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 (published 02 August 2017)
Why we inspected
This was a planned inspection based on the previous rating.
The overall rating for the service has changed from Good to Requires Improvement. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see all sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fernwood Court Care Home on our website at www.cqc.org.uk.
Enforcement
We have identified breaches in relation to safe care and treatment, person centred care, dignity and respect, staffing and good governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
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.