CQC report explained · a residential care home
What the CQC found at Fernery House
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, February 2023
Fernery House was rated Requires Improvement; inspectors found kind care and enough staff, but concerns about risks, medicines, consent, training and management checks.
The inspection was unannounced and took place on 15 and 16 November 2022. One inspector visited the home, an expert by experience spoke to relatives, and inspectors reviewed care records, medicines records, staff files and management records.
The home supported six people with learning disabilities and/or autism. Staff knew people well, treated them kindly and there were enough staff to meet people's needs. People were supported with healthcare, meals, personal choices and activities.
Inspectors found important shortfalls. Risk assessments and care plans were not always reviewed, medicines records had gaps, some areas were not clean, and staff training was not always up to date. Mental Capacity Act procedures were not always followed.
The overall rating changed from Good at the previous inspection to Requires Improvement. Safe, Effective and Well-led were all rated Requires Improvement. The inspection did not give new ratings for Caring or Responsive.
Kind and respectful care
People received compassionate care. Staff knew people well and protected their privacy and dignity.
“People received kind and compassionate care. Staff protected and respected people's privacy and dignity.” from the report
Enough staff
Inspectors found enough staff to meet people's needs. Relatives and staff also said staffing was sufficient.
“There were enough staff available to meet people's needs. People had individual hours commissioned, rotas were arranged flexibly to meet people's needs.” from the report
Choice and independence
People could personalise their rooms, choose their living environment and pursue their interests.
“People had a choice about their living environment and were able to personalise their rooms.” from the report
Support with health
People were supported to attend healthcare appointments and staff worked with health professionals to improve people's health.
“Staff were working closely with local primary care and specialist learning disability teams to monitor and improve people's health and access to health services.” from the report
Positive culture
Relatives and staff described a helpful, passionate and happy team. People were supported to achieve their chosen outcomes.
“There was a person centred and positive culture in the service, people were supported to achieve their chosen outcomes.” from the report
Risk assessments were out of date
seriousSome risks were not fully assessed or reduced. Risk assessments had not always been updated after incidents or reviewed regularly.
“Some of the risk assessments had not been reviewed and updated for over two years.” from the report
Medicines records were incomplete
seriousGaps in medicines administration records meant inspectors could not always tell whether medicines had been given as prescribed. Guidance for medicines given when needed was also missing.
“However, gaps on people's MARs meant it was not possible to tell if medicines had been given as prescribed.” from the report
Consent procedures were not always followed
seriousMental capacity assessments and best interest decisions were missing or not regularly reviewed for some restrictions, including food and snacks.
“People's rights were not fully protected because the correct procedures were not always followed where people lacked the capacity to make specific decisions.” from the report
Staff training gaps
seriousSome staff needed training or refresher training in areas including safeguarding, dysphagia, oral health, autism, mental health, the Mental Capacity Act and DoLS.
“Staff did not always receive training to meet the needs of the people they supported.” from the report
Cleaning and infection control
seriousSome areas were not clean. Cleaning records had gaps, storage for cleaning equipment was unsuitable, and staff did not always wear masks correctly.
“Some areas of the home were not clean. Night cleaning records showed gaps in cleaning and there were not suitable storage arrangements for mop heads and buckets.” from the report
Management checks had not fixed problems
needs fixingQuality checks had not ensured that care plans, risk assessments, consent records and staff training were kept up to date. An action plan still had outstanding actions.
“The systems were not fully effective in ensuring shortfalls were identified and addressed in a timely way.” from the report
- 01Which risk assessments were updated after this inspection, and how often are they now reviewed?
- 02How do you check that every medicine has been given and recorded correctly, including medicines prescribed when needed?
- 03Which residents have had their mental capacity assessments and best interest decisions reviewed for food, snacks or other restrictions?
- 04Have all staff completed the missing and refresher training, including safeguarding, dysphagia, oral health, autism, mental health, the Mental Capacity Act and DoLS?
- 05What cleaning and infection control changes have been made, and how do managers check that they are being followed?
This was an unannounced focused inspection prompted by provider-level concerns and covering Safe, Effective and Well-led; the Caring and Responsive ratings were not newly assessed and the overall rating used the new findings with the previous ratings for questions not inspected. This explanation was written from the published report of 2 February 2023 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, October 2019
Rated Good; inspectors found safe, kind and personalised care, with some care records still being updated.
This was an unannounced planned inspection on 10 and 12 September 2019. One inspector observed care, spoke with staff and relatives, and reviewed care, medicines, recruitment and management records.
The home was rated Good overall and in all five areas. Inspectors found enough staff, safe medicines practice, good infection control and action taken after incidents.
People were supported to make choices, stay independent and take part in meals, activities and community life. Staff were described as warm and respectful, and relatives were positive about the care.
Some details in care plans were not up to date. The home had identified this and was updating and transferring records to an electronic system. The previous overall rating was also Good.
Safe staffing and medicines
Inspectors found enough staff and safe recruitment checks. Medicines were stored, given and disposed of safely, with action taken when errors were found.
“There were sufficient numbers of staff, safely recruited.” from the report
Kind and respectful care
Staff knew people well and supported them in a warm and respectful way. Inspectors saw people appearing comfortable and relaxed with staff.
“People were treated with kindness, respect and compassion.” from the report
Personalised communication
Staff adapted communication to each person, using pictures, videos and accessible information where needed. Care was adjusted to suit how people communicated and engaged.
“Staff knew people well and responded to their individual communication needs.” from the report
Activities and community life
People had opportunities to enjoy activities, attend events, visit the community and take longer trips. The home supported relationships and interests that were important to people.
“Everybody had the opportunity to engage in activities they enjoyed.” from the report
Care records needed updating
needs fixingSome details in care plans were not up to date. The manager had identified this, and records were being updated and moved to an electronic system.
“People had comprehensive care plans, however, some details were not up to date.” from the report
End of life planning was still developing
minorThe home was developing end of life plans with people and families. No one was approaching the end of their life at the time, so this was not an immediate issue identified for a resident.
“The deputy manager told us they were currently developing end of life plans with people and their families” from the report
- 01How far has the transfer of care records to the electronic system progressed, and how do you check that no important details are missed?
- 02How will you assess and record my relative's communication needs and preferred ways of making choices?
- 03How will my relative be involved in planning meals, activities, healthcare and their daily routine?
- 04What staffing levels will be in place, and how often will agency staff be used?
- 05How will you develop and review an end of life plan with my relative and our family if it becomes needed?
This was an unannounced planned inspection of the care home, covering the premises and care provided, with all five key questions rated Good. This explanation was written from the published report of 18 October 2019 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 Fernery House
3 rated inspections over 6 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2019Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- September 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Registered with the Care Quality Commission on 14 February 2014.
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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76 live-in carers within about two hours of Somerset
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Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
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