CQC report explained · a nursing home
What the CQC found at Fernbank Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed with clear guidance for staff. They also found enough staff, suitable recruitment checks, safe medicines management and infection control procedures.
- Effective?
- Good
- People were supported to eat and drink well, access healthcare and maintain their health. Inspectors also found improvements in consent arrangements, staff training and support.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used in calculating the overall rating.
- Well-led?
- Good
- Inspectors found that management checks, audits and an improvement plan were in place. Relatives and staff described communication with management as positive.
What inspectors found, May 2022
Fernbank Nursing Home is rated Good; inspectors found safe, effective and well-managed care, with improvements since the previous inspection.
This was an unannounced focused inspection on 18 March 2022. Inspectors spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found suitable risk assessments, enough staff, safe medicines management, infection control measures and appropriate staff training. People were supported with food, drink, healthcare and decisions about their care.
The home had previously been rated Requires Improvement and had breached three regulations. Inspectors found that improvements had been made and that the home was no longer in breach. This inspection did not assess Caring or Responsive, so those ratings were carried forward from the previous inspection.
Clear risk management
Risks such as falls, choking, diabetes and COVID-19 had been assessed. Staff had guidance on how to reduce those risks.
“Risks associated with people's health and care needs had been clearly identified and assessed, with specific guidance to care staff available on how to manage and minimise risk.” from the report
Enough suitable staff
Inspectors saw enough staff to meet people's needs safely. Recruitment checks included criminal record, identity and previous employment checks.
“Throughout the inspection we observed there to be sufficient staff available to meet people's needs safely.” from the report
Safe medicines
Medicines were given as prescribed and records were complete. Staff received training and regular checks of their competence.
“Records relating to medicine administration were complete.” from the report
Choice at mealtimes
People were offered different food and drink choices. Pictorial menus helped people choose what they wanted.
“People were offered choice and also shown pictorial menus to help them make a choice of what they wanted to eat.” from the report
Improved management
The home had introduced audits, safety checks and a service improvement plan. This addressed earlier concerns about management oversight.
“Since the last inspection, the required systems and processes had been implemented to maintain quality and safety.” from the report
No formal satisfaction surveys
minorThe home had not carried out satisfaction surveys with people, relatives or other stakeholders because of COVID-19 pressures. The report says relatives were still contacted regularly, but families may want to ask how feedback is now collected.
“The registered manager explained that due to the pressures of COVID-19 they had not been able to carry out satisfaction surveys with people, relatives or other involved stakeholders.” from the report
Redecoration was still in progress
minorThe home had a planned programme to redecorate all areas. Families may wish to ask what work remains and whether it affects residents.
“All areas of the home were being redecorated as per a planned schedule of works” from the report
- 01What minor issues were identified during the inspection, and have all of them now been completed?
- 02How do you currently collect and act on feedback from residents and relatives, now that formal satisfaction surveys were not carried out?
- 03What redecoration work remains, and how will it affect residents during the work?
- 04How often are each person's risks and care plans reviewed, especially for falls, choking and medical conditions?
- 05How are medicines audits and staff competency checks carried out and followed up?
This was an unannounced focused inspection of Safe, Effective and Well-led only; the Caring and Responsive ratings were carried forward from the previous inspection. This explanation was written from the published report of 6 May 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2021
Fernbank Nursing Home was rated Requires Improvement; inspectors found kind care but serious weaknesses in risk management, records, consent and oversight.
This was a focused inspection carried out over four visits in January and February 2021. Inspectors spoke with people, relatives, staff and the manager, observed care, and checked care, medicine, recruitment, health and safety records.
People were generally seen to receive appropriate care. Relatives said staff were kind, caring and approachable. Medicines were given safely, staff knew people well, and infection control arrangements were judged satisfactory.
However, risk assessments were often generic, hard to read or missing clear instructions. Some furniture and parts of the building were in poor repair. People did not always get a choice of meals, oral care was not always provided, and consent and best-interest decisions were not properly recorded.
The home was rated Requires Improvement for Safe, Effective and Well-led. Caring and Responsive were not inspected during this focused visit, so their previous ratings were used in the overall rating. The overall rating fell from Good at the previous inspection.
Kind staff
People were observed to receive appropriate care and relatives were positive about staff. Staff were seen to know people well and interact with them positively.
“During the inspection we observed that the registered manager and all care staff knew people well and engaged and interacted with them positively with care and kindness.” from the report
Medicines
Medicines were stored securely and records showed they were given as prescribed. Staff had training and competency checks.
“People received their medicines safely and as prescribed. Policies in place supported this.” from the report
Healthcare support
People were referred to healthcare professionals when needed. Records showed visits, outcomes and follow-up actions.
“People were supported to access health care and were referred to healthcare services where required.” from the report
Infection control
Inspectors were assured about infection prevention, protective equipment, testing and arrangements for managing outbreaks.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staffing levels
There were enough staff available during the inspection to support people's safety.
“Throughout the inspection we saw that there were enough staff available ensuring people's safety.” from the report
Risk records were unclear
seriousRisk assessments and care plans were sometimes generic, illegible or missing clear instructions. This meant staff might not have been able to provide safe, consistent support.
“Care plans were handwritten, however, the handwriting was illegible. This meant that staff would not be able to read, understand and deliver safe care as required.” from the report
Unsafe or damaged environment
seriousInspectors found exposed radiators, a missing window restrictor and furniture, fittings and flooring in poor repair. Some urgent problems were fixed after the inspection, but wider repairs had been delayed.
“A number of light bulbs in the lounge were not working, some chests of drawers, wardrobes, bathroom cabinets, kitchen cupboards and flooring were old, in a general state of disrepair, chipped and rusty.” from the report
Food choices and oral care
needs fixingPeople were not always offered a choice of meals, and the home could not show how people had helped choose weekly meals. Oral care equipment in many rooms appeared unused.
“People were not always offered a choice of what they ate.” from the report
Consent and best-interest decisions
seriousThe home did not consistently record consent or document best-interest decisions for restrictive equipment, self-neglect risks and covert medicines.
“Care plans did not record people's consent to receiving care and support.” from the report
Weak management checks
seriousAudits did not identify the problems found by inspectors. Recruitment checks were also incomplete, including missing employment history and unexplored gaps.
“The registered manager and provider did not have effective systems and processes in place to monitor and oversee the quality of care people received.” from the report
- 01What has been repaired since the inspection, including the radiators, window restrictor, furniture, fittings, flooring and lighting?
- 02How do you now make sure risk assessments are individual, complete and easy for staff to read?
- 03How are residents offered and reminded of meal choices, including cultural or religious food preferences?
- 04How do you check that oral care is actually being provided rather than only recorded?
- 05How are consent and best-interest decisions now recorded for bed rails, wheelchair straps, self-neglect risks and covert medicines?
This was a focused inspection of Safe, Effective and Well-led, including infection control; Caring and Responsive were not inspected and their previous ratings were used. This explanation was written from the published report of 24 March 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Fernbank Nursing Home
5 rated inspections over 5 years: the service has improved, from Requires improvement to Good.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- March 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- June 2017Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- February 2017Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 14 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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