CQC report explained · a nursing home
What the CQC found at Fernhill
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- Inspectors found good systems for identifying and managing risks, enough staff, safe recruitment and safe medicines arrangements. People said they felt safe and did not have to wait for support.
- Effective?
- Good
- Staff assessed people's needs and provided appropriate training, health support, food and drink. Inspectors found that people's outcomes were consistently good.
- Caring?
- Outstanding
- People were treated with exceptional kindness, dignity and respect. Staff built strong relationships and supported people to remain independent, involved and connected with others.
- Responsive?
- Outstanding
- Care was highly personalised and based on people's histories, preferences and wishes. The home offered a wide range of individual and group activities, including special experiences arranged around people's interests.
- Well-led?
- Outstanding
- Inspectors found exceptional leadership, an open culture and strong teamwork. People, relatives and staff were regularly involved in shaping the service, and audits and learning systems were well established.
What inspectors found, October 2019
Rated Outstanding; inspectors found exceptionally caring, responsive and well-led support, with safe and effective care rated Good.
This was an unannounced inspection on 19 and 20 August 2019. Inspectors spoke with people living in the home, relatives, staff and a health professional. They also reviewed care, medicine, recruitment and management records.
People were described as safe, respected and well cared for. Inspectors found enough staff, safe medicine systems, good staff training and suitable support with food, healthcare and decision-making.
The home was especially strong in caring for people as individuals, providing meaningful activities and involving families. Its overall Outstanding rating means inspectors judged the service to be exceptional overall, although Safe and Effective were rated Good.
Kind and respectful care
Staff treated people as individuals and made time for conversation and emotional support. Inspectors saw warm and caring interactions.
“People received exceptional care and support from a staff team who valued and celebrated individuality and diversity.” from the report
Personalised activities
Activities were based on people's interests, life histories and wishes. Staff arranged creative experiences, community links and activities for people who could not easily leave the home.
“There was an outstanding comprehensive programme of often unique and personalised activities arranged every day that was very much based on people's interests and preferences.” from the report
Dementia and family support
Specialist dementia nurses supported people, relatives and staff with practical, clinical and emotional advice. Families were involved in care planning and could visit without restriction.
“The company employed 'Admiral Nurses.' These are specialist dementia care nurses who gave expert practical, clinical and emotional support to people and their families facing the challenges of dementia.” from the report
Strong leadership
Inspectors found motivated leaders, good teamwork and an open culture. People, relatives and staff were encouraged to give feedback and suggest improvements.
“There was an extremely positive and open culture that ensured people were at the centre of everything the service did.” from the report
Some building work unfinished
minorMajor upgrading was still under way, including a planned roof garden and updates in some areas. Inspectors said this did not affect the home's operation or people's safety at the time.
“Some work was not yet completed including the design of a new roof garden and updating in several areas.” from the report
- 01Which parts of the building improvement work, including the roof garden, are now complete?
- 02How would you assess and adjust staffing if my relative's needs increased?
- 03How would you involve my relative and our family in care planning and regular reviews?
- 04What dementia support would be available from the specialist nurses?
- 05How would you tailor activities to my relative's interests, history and abilities?
This was an unannounced, planned inspection covering all five CQC questions and the overall quality and safety of care and the premises. This explanation was written from the published report of 31 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.
What inspectors found, February 2017
Rated Good; inspectors found safe, kind and responsive care, with some records and checks needing improvement.
The inspection was unannounced on 16 January 2017 and continued as an announced visit on 17 January. Inspectors spoke with people, relatives, staff and a therapist. They reviewed care files, medicines, recruitment, training, complaints and quality checks, and observed care, a meal and activities.
Inspectors found that people were safe and that there were enough staff to meet assessed needs. Medicines were managed safely. Staff understood safeguarding, people's risks and emergency arrangements. Staff were trained, supervised and supported people to access health care, eat and drink well.
People and relatives described caring staff who knew people's preferences and treated them with dignity. Care plans and risk assessments were regularly reviewed. People could take part in activities, access the community and give feedback. Complaints were recorded and there were no outstanding complaints.
The overall rating was Good, with Good ratings for Safe, Effective, Caring, Responsive and Well-led. This means inspectors found the home was meeting the relevant standards at the time of the inspection, although they identified some records and processes that needed attention.
Safe medicines
Inspectors found medicines securely stored, correctly recorded and given only by trained and qualified nurses.
“Medicines were managed safely, securely stored, correctly recorded and only administered by nurses that were trained and qualified to give medicines.” from the report
Kind and respectful care
Staff knew people well, supported their choices and treated them with dignity. Inspectors saw relaxed and positive interactions.
“Staff treated people in a dignified manner. Staff had a good understanding of people's likes, dislikes and interests.” from the report
Responsive support
The home reviewed changing needs and acted on health concerns, including arranging professional help and updating care plans.
“This meant that people's health, wellbeing and changing needs were constantly discussed and reviewed by staff which enabled them to respond promptly to changes.” from the report
Open management
The manager and clinical lead encouraged staff and relatives to give feedback. Audits and action plans were used to make improvements.
“Effective quality monitoring was in place and improvements acted upon within appropriate timeframes.” from the report
Recruitment record error
needs fixingOne staff file said a criminal records check had been satisfactory, but other information showed that it had not been requested. The provider changed its checking procedure immediately.
“on one person's file this form indicated that this check had been satisfactory completed- but other information contained in the staff file indicated that this check had not been requested.” from the report
Missing capacity records
needs fixingTwo people's files did not initially contain capacity assessments or best-interest decisions, despite inspectors being told the people lacked capacity. The home said these would be completed as a priority.
“When reviewing two people's files on day one we found that there were no capacity assessments completed or best interest decisions recorded.” from the report
Overdue nutritional reviews
minorEight chef visit records were overdue. Four people had died and the home said visits for the others would be arranged and the kitchen file updated.
“Further review of the file identified that eight people were overdue a visit.” from the report
Activity calendar accessibility
minorThe activity calendar was not pictorial. Inspectors raised this with managers, who said they would look at it.
“We noted that the activity calendar was not pictorial and discussed this with the registered manager and clinical lead who said that they will look at this.” from the report
Unfinished night review record
minorThe latest night review had not been typed up when inspectors checked it. The manager said it would be completed.
“We found that the record for the last visit had not been typed up.” from the report
- 01How do you now make sure every staff member has had the required criminal records checks before starting work?
- 02Have the missing capacity assessments and best-interest decisions been completed, and how are they kept under review?
- 03Have all overdue chef visits and nutritional reviews now been completed?
- 04How do you make the activity programme understandable and accessible for people living with dementia?
- 05Has the outstanding night review record been completed, and what do your night checks cover?
This was a planned inspection covering all five CQC questions, based on discussions, observations and reviews of care, medicines, recruitment, training, complaints and quality records. This explanation was written from the published report of 23 February 2017 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 Fernhill
2 rated inspections over 3 years: the service has improved, from Good to Outstanding.
- October 2019Outstandingcurrent ratingup from GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- February 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2016
Registered with the Care Quality Commission on 23 February 2016.
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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