Ferncroft

Ferncroft is a residential care home providing personal care to up to 6 people. The service provides support to people who have learning disabilities and/or autistic people. At the time of our inspection there were 4 people using the service.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it. The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome.

Right Care:

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it. The service had enough appropriately skilled staff to meet people’s needs and keep them safe. People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing and enjoyment of life. Staff and people assessed risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks.

Right Culture:

People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of the management and staff. People received good quality care because trained staff and specialists could meet their needs and wishes. People and those important to them were involved in planning their care. Staff evaluated the quality of support provided to people. However, we found that some areas of the provider’s governance arrangements were not sufficient enough to ensure all areas of service delivery were in line with best practice guidance and adhered to legislative reporting requirements. Action was taken promptly after the site visit to address these concerns.

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 12 September 2019).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good.

We undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service remains good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ferncroft on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Ferncroft is a 'care home' providing personal care and accommodation to people living with moderate to complex learning disabilities. The service can support up to six people. The care home accommodated five male adults at the time of this inspection in one adapted building. All the people had been living in the home for more than two years and for some up to fifteen years.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and / or autism to live meaningful lives that include control, choice and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found:

Staff refresher training was not updated as required by the provider’s own policies. The frequency of supervision support for staff needed to be more regular. The team manager and the registered manager told us improvements were required and put in place a plan to implement this immediately.

People and their relatives told us they were safe and that staff were kind to them.

Staff had training to do with safeguarding adults that helped them keep up to date with best practice. Staff followed clear safeguarding procedures that helped to protect people from harm.

Risks to people, including those associated with their healthcare needs, were assessed and plans were in place to reduce them.

Whistleblowing procedures were in place and displayed on notice boards. Staff told us they were confident any concerns they reported would be dealt with appropriately.

Appropriate infection control procedures were in place and staff received training with food hygiene.

Staff rotas and staffing levels were appropriate to meet people's needs and safe recruitment practices were in place.

People’s medicines were stored, administered, recorded and audited appropriately. The provider had appropriate policies and procedures in place to support people safely with their medicines as prescribed.

Comprehensive needs assessments were carried out and there was sufficient detail and personalisation in the care plan to ensure the person's needs were met in a personalised way.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Records showed people were supported to have their health needs met, with access to health professionals as required.

Relatives of people told us their relationships with the staff team was good. They said people's privacy and dignity was respected. They also said they were able to express their views and preferences and staff responded appropriately.

There were systems in place to ensure concerns and complaints were responded to in an appropriate way.

Quality assurance processes were in place that monitored practice and procedure by staff, however some improvements in developing the quality assurance systems were needed and the provider was in agreement with this. The provider worked collaboratively with other agencies and organisations to meet people’s needs.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at the last inspection

At the last inspection the service was rated Good (9 February 2017published).

Why we inspected:

This was a planned inspection in line with our inspection schedule.

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.

There was a registered manager in post, and they were at the home at the time of our inspection. 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.

The home had a homely feel and reflected the interests and lives of the people who lived there.

Most of the people living at the home were unable to communicate verbally with us to provide feedback. In addition to speaking with people we used observation of interaction and engagement between people and staff in order to understand how comfortable and at ease people were. People were able to demonstrate their needs through various interactions with staff and enjoyed freedom of movement and activity in and around the home.

There were sufficient numbers of staff to meet the needs and preferences of the people that lived there. Staff understood their duty should they suspect abuse was taking place, including the agencies that needed to be notified, such as the local authority safeguarding team or the police. Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. Staff ensured that people were involved in these decisions by speaking with people and making sure care plans were personalised and easy to read.

People were offered choices, supported to feel involved and staff knew how to communicate effectively with each individual according to their needs. People were relaxed and comfortable in the company of staff. Staff supported people in a way which was kind, caring, and respectful.

People were supported to keep healthy and well. Staff supported people to attend appointments with GP’s and other healthcare professionals when they needed to. Medicines were stored safely, and people received their medicines as prescribed. People were involved in their food and drink choices and meals were prepared taking account of people’s health, cultural and religious needs.

Where people did not have the capacity to understand or consent to a decision the provider had followed the requirements of the Mental Capacity Act (2005). An appropriate assessment of people’s ability to make decisions for themselves had been completed. Where people’s liberty may have been restricted to keep them safe, the provider had followed the requirements of the Deprivation of Liberty Safeguards (DoLS) to ensure the person’s rights were protected.

The provider regularly sought people’s and staff’s views about how the care and support they received could be improved. There were systems in place to monitor the safety and quality of the service that people experienced.

We saw the people who used the service were well supported by the staff who treated everyone with respect and dignity. We also found staff were suitably trained and supported to effectively meet the needs and wishes of the people who lived at Ferncroft.

However, although people receiving services in the home were happy and well supported by staff; the provider may wish to note that some parts of the home's interior had not been adequately maintained. This meant the premises needed to be improved to ensure Ferncroft was a more comfortable and homely place for people to live.

The provider did have effective systems in place to routinely assess and monitor the quality of the service people who lived at Ferncroft received.