The Care Quality Commission
  • Care Home
  • Care home

Archived: Fernhill

Overall: Requires improvement read more about inspection ratings

122 Ringwood Road, Longham, Ferndown, Dorset, BH22 9AW (01202) 651800

Provided and run by:
Colten Care Limited

Important: The provider of this service changed. See new profile

All Inspections

4, 5 and 6 November 2014

During a routine inspection

This inspection took place on 4, 5 and 6 November 2014 and was unannounced. Fernhill provides accommodation and nursing and personal care for up to 58 older people, specialising in care for people with dementia. There were 56 people living there when we visited. This provider is required to recruit a registered manager for this type of service. 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 and associated Regulations about how the service is run.

People were not safe living in the home because not all concerns about abusive practice had been reported to the local authority. The senior management team and the registered manager were not aware of the outcome of an internal investigation into these concerns.

There were not enough staff to meet people’s needs. The majority of staff told us more staff were needed to meet people’s needs. We observed that there were not enough staff to meet people’s needs.

People received their medicines when they required them and medicines were stored safely.

Recruitment checks had been completed before staff worked unsupervised at the home.

People, who did not have mental capacity to make specific decisions for themselves, had their legal rights protected. Best interest decisions involved people’s representatives and health care professionals in accordance with the principles of the Mental Capacity Act 2005. The home complied with the conditions of Deprivation of Liberty Safeguards (DoLS) where they had been authorised. These safeguards aim to protect people living in care homes and hospitals from being inappropriately deprived of their liberty.

The service was not always caring. We observed some staff interactions that were not respectful and two health care professionals told us that some staff were not always respectful towards people.

People’s representatives told us that staff were caring and contacted them if there were any concerns. People were supported by staff to meet their social and welfare needs. People were supported to take part in activities in the home, go out on trips and at times supported on a one to one basis with their social needs.

Staff were not always trained to meet people’s needs. The majority of staff had not received training to support people whose behaviour challenged. Staff had completed training in other areas to meet people’s needs and received support in meetings and in shift handovers.

The service was not well led. Audits of care provided did not always identify actions that were required to ensure people’s needs were responded to. There was however an improvement plan in place to improve how audits were carried out.

People gave us mixed feedback about the registered manager. Some staff told us they were “supportive” whilst other staff told us the registered manager was not approachable or fair.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 which corresponds to regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These were in relation to safeguarding people, care and welfare of people who use services, supporting people to eat and drink; and not monitoring the quality of the service effectively. You can see what action we told the provider to take at the back of the full version of this report.

14 November 2013

During a routine inspection

During our visit we were able to speak with people, review records and made observations.

We saw that people had and individual plan of care that included their needs and personal preferences and detailed people's physical and emotional healthcare requirements.

In order to meet individual needs, staff worked with a variety of healthcare professionals including an advisor from the social care team. We were shown that advocates and specialist consultants were used where appropriate. We were able to speak with a visiting professional who told us: "the staff really do everything they can to make sure people's rights are protected and they are treated with dignity and respect".

People were protected from the risk of abuse or harm by there being safeguarding policies and procedures in place and by staff knowing how and when to use them.

We saw there was a caring and experienced staff team who were well supported and trained to carry out their duties safely and effectively. One member of staff told us: " I absolutely love it here, I wouldn't want to work anywhere else".

People were positive about the manager and the staff team and said they were kind and supportive.

Service quality audits were carried out at regular intervals to ensure the home was kept under review. Records showed us that families and professionals invloved in people's care were consulted. Outcomes from the last audits were positive.

18 October 2012

During an inspection looking at part of the service

We saw that people's capacity to make decisions was assessed in relation to the specific decision they needed to make, as required by the Mental Capacity Act 2005. For example, one person was assessed as having capacity to consent to having their photograph taken for identification purposes, but lacking capacity to consent to having bed rails to prevent them falling.

Three people were subject to deprivation of liberty safeguards (DOLS) authorisations. We found that all documents relating to this process were present at the front of people's care records.

We saw that sharing of equipment was reduced as far as possible within the home. Each person, who required, had an identified hoist sling and slide sheet for their sole use. Staff explained that when these were soiled they were laundered and returned to the person's room.

We looked at the staff files of five care workers who had been recently employed and found that appropriate checks had been carried out. However, a full employment history was not present for three of the five staff files we looked at.

The provider maintained accurate records relating to people who used the service and informed the Commission of notifiable incidents.

In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a Registered Manager on our register at the time.

17 July 2012

During an inspection in response to concerns

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We observed care being delivered to people, spoke with staff and looked at records relating to care delivery.

We saw that people were treated with consideration and their privacy and dignity was respected and people's preferences were documented in their care records. Staff were aware of people's care needs and delivered care in the manner described in people's plan's of care.

There was a risk that decisions may have been made about people's care and treatment by people who did not have the legal authority to do so. Decisions regarding resuscitation were not always appropriately recorded.

The environment was clean and hygienic although shared hoist slings were not always cleaned effectively between use. The provider had a number of policies relating to the prevention of infection and staff were aware of basic precautions.

The provider did not always notify the local authority of safeguarding incidents and CQC was not always notified of reportable incidents as is required. Records were kept securely and retained for an appropriate period of time.

22 August 2011

During a routine inspection

During our visit we were able to observe people's experience of daily life throughout the home. We shared a meal time with four people at a dining table, which allowed for conversation. We spoke with visitors to four people during the day. Afterwards we spoke by telephone with two people that regularly visit their relatives in the home.

We found that people chose how much time they spent in their rooms or in communal rooms or the patio and garden. A person's regular visitor told us staff were always readily available to provide transfers into and out of a wheelchair by hoist when the person wished to go out, and when they returned.

People's relatives told us the home conducted thorough assessments of people's needs before offering a place in the home. People felt fully included in assessments, and in ongoing consideration of people's needs and how the home could best meet them. A regular visitor had seen that the home was able to continue their relative's favoured routines, for example around rising and bed times, and meal times. They considered staff showed appreciation of the past lives and interests of people with dementia. All the visitors we spoke to were pleased by the attitudes and respect that staff showed towards people living in the home.

One person's visitor said the home provided 'much more than nursing care, the social care is very good'. We saw support by activities and care staff to people on their own or in pairs, as well a group singing session in a lounge, and groups of people going out on minibus trips. A person living in the home showed us that they had taken on a role of delivering daily newspapers to others in the home.

A person who visited their relative in the home told us they had reduced the frequency of their visits because they felt they could trust the home with the safety of their relative. Some people's relatives told us that when they had raised specific care issues, their observations or suggestions had been responded to by nursing staff, and agreed actions had been implemented.