Ferncross Residential Home

Updated 26 January 2024

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 completed by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Ferncross Residential Home is a ‘care home’. People in care homes receive accommodation, and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Ferncross Residential Home is a care home without nursing care, CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post. The registered manager was also a director of the provider company. Throughout this report, we refer to this person as the registered manager.

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 authority, commissioners and professionals who work with the service. We also looked at information we had received and held on our system about the service, this included notifications sent to us by the provider and information passed to us by members of the public.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.

We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service. We spoke with 2 relatives about their experience. We spoke with members of staff including the registered manager, another director of the provider company, care workers and a member of the domestic staff. We also spoke with 1 external health and social care professional and received their feedback of the quality of the service.

We looked at a variety of records to gather information and assess the level of care and support provided to people. We reviewed in detail 4 care records. We looked at staff rotas, risk assessments, multiple medicine records and 4 recruitment files. We also considered a variety of records relating to the management and governance of the service, including policies and procedures.

We looked around the home in both communal and private areas to establish if it met the needs of people who lived there and if it was safe. We also observed people’s care and support.

Updated 26 January 2024

About the service

Ferncross Residential Home is a care home providing personal care and accommodation to older people. At the time of the inspection, 12 people were receiving regulated activity at the home. The service can support up to 14 people. The home is an adapted building with bedrooms based over 2 floors.

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

Aspects of staff recruitment were not effective at ensuring staff members were always suitable to work with vulnerable people. Some essential safety checks had not been made. There was inappropriate oversight of these processes by the provider. Further detail is in the 'safe' and 'well-led' sections of this report.

Medicines management was unsafe. The registered manager was unaware of the full details of which staff were administering medicines and some of the record keeping was poor.

Care planning and risk assessing needed input and review to ensure records were current and effective in providing essential guides to staff so that people were supported appropriately.

Although fire safety was a priority and the provider was working with the local fire service, other environmental safety issues needed addressing. These included concerns around gas safety, legionella checks and people's access to hot water.

Any checks the registered manager and management team were making, were not picking up on issues and had not identified the concerns seen at this inspection.

The registered manager was responsive to concerns we noted during the inspection and took action to make improvements and promote safety. This included taking action related to staff and arranging for a medicines audit to be conducted by external specialists.

People, their relatives and staff were confident in the management team at the home and praised how approachable they were. Staff said they were appropriately trained and supported. Records we saw supported this position.

Infection, prevention and control processes were appropriate, and we were assured about the provider's ability to reduce the transmission of infections.

Staff were competent about safeguarding processes and knew how to protect people from abuse. Relatives said their family members felt safe in the home and were trusting of staff and management.

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. Staff supported people to have access to healthcare professionals and specialist support.

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 23 May 2022).

At our last inspection we recommended that the registered manager acquainted themselves with legislative requirements as they related to health and social care. This had not been acted on and we established breaches of regulations.

Why we inspected

This inspection was prompted by a review of the information we held about this service and information received from partner organisations. As a result, we carried out a focused inspection to review the key questions of safe 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 has changed to inadequate. This is based on the findings at this inspection.

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

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

Enforcement

We have identified breaches of regulations in relation to unsafe employment processes, medicines management, environmental issues, care planning and risk assessing and the governance/oversight of the service.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority and other partner agencies to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect and will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.