Fernbank Court

Updated 22 January 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 3 and 11 December 2018. The inspection was announced. We gave the service 48 hours’ notice of the inspection visit because it is small and the manager is often out of the office supporting staff or providing care. We needed to be sure that they would be in. The first day of the inspection was carried out by an inspector 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. The second day of the inspection was completed by an inspector.

This inspection was partly prompted by an incident which had a serious impact on a person using the service and this indicated potential concerns about the management of risk in the service. While we did not look at the circumstances of the specific incident, which we are looking at outside of the inspection process, we scrutinised the provider’s risk management process.

Before our inspection we reviewed information we held about the service, which included information shared with the CQC and statutory notifications sent to us since our last inspection. The provider is legally required to send notifications about events, incidents or changes that occur and which affect their service or the people who use it.

We also considered the Provider Information Return. This is information we require providers send us at least once annually to give key information about the service, what the service does well and any improvements they plan to make. We sought feedback from the local authority and local Healthwatch England. Healthwatch is an independent consumer group who share the views and experiences of people using health and social care services in England. We used all this information to plan our inspection.

During the inspection we spoke with six people who used the service and five relatives of people who used the service. We spoke with six members of staff which included the registered manager, team leader, care services manager and care and support workers.

We reviewed two staff files, which contained information about training, supervisions and appraisals. Only one staff member had been recently recruited and we checked their documentation. We looked at documentation for three people who used the service, which included care plans, risk assessments and daily records. We reviewed the medicines management systems and a variety of documentation relating to the running of the service.

Updated 22 January 2019

This inspection took place on 3 and 11 December 2018 and was announced. This was the service's first rated inspection since it was registered in December 2017.

Fernbank Court provides domiciliary support to mainly older adults living in their own flats.

This service provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service.

Not everyone living at Fernbank Court receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection, 12 people received support with a regulated activity.

There was a registered manager. 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.

Risk assessments were not consistently in place for areas of identified risk and medical conditions. The risk assessments which were in place lacked information to guide staff about the potential risk and actions taken to address this. We have made a recommendation about risk assessments.

People told us they felt safe and received support from a consistent team of staff. Recruitment procedures were safe. Staff understood the potential signs of abuse and knew how to report their concerns. People received the support they required with their medicines. Staff received medicines training and their competency in this area was assessed. Staff understood their responsibility to record and report if an accident or incident occurred. The provider had recently introduced the monitoring of any trends with accidents and incidents which was being further developed.

Staff received training essential to their role and received ongoing support in the form of supervisions and annual appraisals. Staff told us they felt well supported in their role.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s consent was sought before providing people with support and written consent was obtained. People received support to maintain their diet and fluid intake, if required. Staff sought the input of medical professionals if a person deteriorated or required further professional input. This information was available within people’s care records for staff to follow.

People told us staff were kind and caring towards them. Staff promoted people’s dignity and independence through the way they supported them. People’s communication needs were assessed and staff understood effective ways to communicate with people to promote their decision making. Confidential information was securely stored.

Care plans were in place which were detailed and person-centred. Reviews of people’s care were completed to ensure this continued to meet people’s needs and preferences. The housing provider scheduled a programme of activities for people to engage with. A complaints policy was in place and people were aware of their right to complain. People and their relatives expressed their confidence that any issues raised would be addressed.

People told us the service was well-led. There was a registered manager in post who was supported by team leaders. The management team worked closely with the housing provider and shared relevant information. A variety of meetings were held to share important information and learning from recent events and to promote best practice. The registered manager and provider had a system of checks to monitor the quality and safety of the service. People’s views were sought in the running of the service.