Archived: Ferrol Lodge Care Home

This inspection took place over two days. The first visit on 17 August 2016 was unannounced which meant the provider and staff did not know we were coming. Another visit was made on 18 August 2016 which was announced.

Ferrol Lodge is a care home providing accommodation for up to 23 people. There are 19 single rooms and two shared rooms (shared rooms are only used by two people if both express a wish to do so). There were 22 people living at the home at the time of this inspection. The home does not provide nursing care.

The home had a registered manager who had been in this role for many years. 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.

All the people, relatives and care professionals we spoke with felt the home was a safe and comfortable place to live. People described the service as “family-run” and “very safe”. A relative told us, “We don’t worry now my [family member] is living here because they’re wonderful to them. It’s peace of mind and we have no qualms at all.” Care professionals who regularly visited the told us they had “no concerns” about the safety or care of the service or the care of people during their visits.

Staff were clear about how to recognise and report any suspicions of abuse. Staff told us they were confident that any concerns would be listened to and investigated to make sure people were protected. The provider carried out checks to make sure only suitable staff were employed and used robust probationary appraisals to make sure they had the right attributes to continue working at the home. People were assisted with their medicines in the right way.

People told us they were very happy with the care and felt there were enough staff to assist them. A relative told us, “There’s enough staff and they always know where people are and how they’ve been. Staff work very hard but they take their time with people.”

Staff had the relevant training and support to care for people. The manager carried out regular competency checks to make sure staff had the right skills to provide the right support. Staff understood the Mental Capacity Act 2005 for people who lacked capacity to make certain decisions.

Relatives said the staff cared for people in an effective way and responded quickly to any changes in people’s well-being. People said the meals were “excellent” and that they were “well-fed and watered”. Staff encouraged people to eat and drink enough and they had choices about their meals.

People, relatives and visiting healthcare professionals told us the standard of care and compassion at this home was exceptional. People described the staff as “lovely”, “very nice” and “very friendly.” One person commented, “They are so very kind. They ask us all the time what we would like.” A relative told us, “My [family member] is happy and loved here.” Another relative said, “The way they treat people is so lovely. There are lots of hugs.”

Relatives described how staff “cherished” the people who lived there. A relative told us, “The care my [family member] has had here is second to none. They’ve nurtured my [family member] back from the brink with love. They’ve done wonders with them. This is my [family member’s] home and they love it here.”

People were treated with kindness, courtesy and dignity. A relative told us, “It’s very family-orientated. If we take my [family member] out for the day they are welcomed back home with such love.”

A health care professional told us, “It’s a lovely care home with very caring staff. All my colleagues say its lovely and we all love visiting here.”

People, relatives and care professionals told us the service was highly personalised and tailor-made to suit each person. A relative commented, "My [family member] is so happy here. They can do what they want when they want. If they want their meals at a different time to mealtimes staff are fine about that and do everything to suit them.”

Staff were very knowledgeable about people and treated them like their own family. People described how they were the decision-makers in the home. It was clear that their individual choices were used to decide how they spent their day.

People and relatives commented very positively on the activities and social events that were held at the home. One person told us “There’s plenty to do - we’re always doing something.” One person had said they would like to go on a barge, so the home had arranged for a group of them to do this in the near future.

Staff often arranged for local entertainers and children’s groups to come to the home. A relative commented, “They bring loads of entertainment in and put on such a lot for them. There’s always visitors and children and they all interact with the people who live here.”

People, relatives, staff and healthcare professional felt the home was well-managed. Staff said they enjoyed working at the home. They felt appreciated and supported by the management team and provider.

The registered manager, general manager and deputy manager were experienced and well qualified to manage this service.

The provider had a quality assurance system to continuously check the quality and safety of the service. People and relatives’ views were sought and acted upon. The provider and managers constantly strived to improve the quality of the service.

As part of this inspection we spoke with three people who used the service, the registered manager, deputy manager, the activities coordinator and the local authority. We also reviewed records relating to the management of the home which included, five care plans, daily care records and medication administration records.

Below is a summary of what we found. The summary describes what people using the service, the local authority and the staff told us, what we observed and the records we looked at. Please read the full report for the evidence supporting our summary.

When we last visited the home in April 2014 we found that two care plans had not been updated to reflect changes to people's care and support needs. This placed the two people at risk of not having their current need for care and support met in a safe way. A Market Relationship Officer from the local authority told us they had no current concerns about this service.

During this inspection we found that improvements had been made to the systems for assessment, care planning, monitoring and review of the care and support provided to people living in the home. This had resulted in a person centred approach by recognising and responding to the diverse needs of each person using this service. Detailed care records provided evidence of the positives outcomes experienced by people and this was confirmed in our conversations with three of the people accommodated.

We observed people engaging in activities that stimulated their personal interests and promoted healthy and active lifestyles.

This service was following guidance on mental capacity legislation in relation to decision making on behalf of people living in the home. Mental capacity assessments and best interest decisions had been appropriately recorded and staff understood their responsibilities under this legislation.

Is the service safe?

Is the service effective?

Is the service caring?

Is the service responsive?

Is the service well led?

This is a summary of what we found-

Is the service safe?

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Suitable policies and procedures were in place and staff had been trained to understand their responsibilities under the DoLS Codes of Practice. No applications had been made to deprive people living in the home of their liberty. Care plans and our observation of staff provided evidence of good practice in applying the least restrictive options to promote each person's autonomy.

Staff records contained most of the information required by the Health and Social Care Act. The deputy manager said she would ask staff to bring in the missing documents so copies could be made and saved in the personnel files.

We saw a system was in place to keep the home clean and hygienic and no unpleasant odours were detected during our visit.

Care plans generally provided evidence of good risk management. For example, information in care records provided evidence of staff taking prompt action to prevent people's health from deteriorating. However, two care records were missing important information about the care and support people were receiving, which potentially placed them at risk of not having their care needs met safely. A compliance action has been set in relation to this and the provider must tell us how they plan to improve.

Is the service effective?

People living in Ferrol Lodge had been consulted about the service they received and were encouraged to express their views and make suggestions for how it could be improved. We saw people join in the activity session during our visit. Each person who had participated told us they had enjoyed it. Two people commented, "That brought back a lot of happy memories" and "I'm very competitive and enjoyed that."

Staff had received the appropriate training to ensure they had the knowledge and skills to support people safely. It was clear from our observations and from speaking with staff that they had a good understanding of the needs of the people they cared for. People living in the home told us, "The staff are marvellous. I've lived other places and they're nowhere near as good as this", "The staff provide excellent care" and "The staff give me all the help I need. I couldn't get better anywhere else."

Is the service caring?

During the midday meal we observed interactions between care staff and the people they cared for. We saw care staff use good observational skills to provide person-centred and compassionate care. Staff addressed people by their preferred titles and spoke with them in a quiet and calming manner to preserve their privacy and dignity.

Eight people living in the home told us the care and support provided was very good. Their comments included, "The staff give me all the help I need. I couldn't get better anywhere else", "My son and daughter in law visit and they are always made welcome" and "I receive excellent care here and have no concerns whatsoever",

Is the service responsive?

People living in the home had their needs assessed and their care plans told us how staff would provide care, treatment and support to meet their needs. Care plans also contained each person's choices and preferences for how their needs should be met. Eight people spoke positively about the way the service was provided. They said they were listened to and consulted about the way the service was provided. One of the people we spoke with said, "We are listened to and taken seriously. I'm happy with the way things are here."

Is the service well-led?

The manager had improved quality assurance processes to ensure people living in the home received the care and support they needed.

The people we spoke with during our visit told us the home was managed well. One person said, "This is a very good and well run home. I don't think any improvements are needed. If something wasn't right I'd speak to the manager."

Since our last visit the provider had enabled 11 staff to undertake training in the Mental Capacity Act and Deprivation of Liberty Safeguards and people living in in the home were receiving person centred care and support. This meant that people were enabled and supported to make informed choices and decisions about the service they received.

During this visit we found that improvements had been made to the medication administration system. Unused medicines had been consistently returned to the pharmacy to ensure that excess stock was not held in the home. We also found that a safer system for administering 'as required' medicines had been developed in line with professional advice received from the home's supplying pharmacist. Three people accommodated in the home told us that their medicines had been given to them in a safe manner.

The provider had effective systems in place to respond to views and suggestions and improve the service provided to people using the service. A person living in the home said, "It's marvellous here. Nothing is too much trouble. If you need any help the staff are always willing."

The four care plans we looked at were accurate and up to date and care and support had been provided according to people's preferences. People told us that they were happy with the service they received. One person said, "I couldn't receive better care anywhere. The staff are very kind and caring."

People living in the home told us that they enjoyed the food. A person commented, "The food is always good. We get enough to eat and drink."

We found that medicines were being administered safely. However, improvements were needed for the disposal of surplus medicine and guidelines were needed for staff when administering 'as required' medicine.

Sufficient staff were provided to meet the needs of the people accommodated. Action was needed to ensure that all staff had the opportunity to attend training in mental capacity legislation.

Ferrol Lodge had an appropriate system in place to investigate and respond to complaints. People using the service and their representatives were confident that they would be listened to and that action would be taken to deal with any concerns they might have. One of the relatives we spoke with said, "I can talk to any of the staff and know that they would listen if I had a concern. The staff communicate well. My X is very happy here."