CQC report explained · a residential care home
What the CQC found at Fernica (Residential Care Home)
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found sufficient staffing, safe recruitment, effective safeguarding systems, medicines given as prescribed and suitable infection control measures. Some individual risks were not clearly identified, and some personal emergency evacuation plans needed review.
- Effective?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Caring?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This key question was not inspected during this visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- Management and oversight had improved, but risks were not always clear and improvements had not yet been fully embedded and sustained. Staffing appointments had also not always been successful in the long term.
What inspectors found, November 2023
Rated Good overall; inspectors found safe care, but management and oversight still required improvement.
This was an unannounced focused inspection. Inspectors visited on 26 and 28 September 2023. They spoke with people living at the home, relatives and staff, and checked care plans, medicines records, recruitment files and management records.
The home was rated Good for Safe. Inspectors found enough staff, safe recruitment checks, medicines given as prescribed, infection controls and safeguarding systems. People said they felt safe. However, some risks were not clearly set out, and some emergency evacuation plans needed updating.
The home was rated Requires Improvement for Well-led. Management and oversight had improved since the previous inspection, but the changes needed to become consistent and lasting. The overall rating became Good because the other areas were not inspected during this visit and their previous ratings were carried forward.
People felt safe
People told inspectors they felt safe during the day and at night.
“People told us they felt safe both day and night.” from the report
Medicines records
People received their medicines as prescribed. Records were complete and checked each month.
“Medicines administration records (MARs) were fully completed and audited each month.” from the report
Safe recruitment
The provider completed application and interview records, references and pre-employment checks for the staff files reviewed.
“Application and interview forms were completed in full, and the provider had sought references and completed pre-employment checks” from the report
People were consulted
There were residents' meetings and a recent survey. People could raise issues and suggest topics for discussion.
“People we spoke with told us they were consulted about the service.” from the report
Team morale
Staff said they worked as a team and that morale was good.
“Staff told us they worked as a team and that morale amongst staff members was good.” from the report
Risk information was not always clear
needs fixingSome risks were recorded within wider care plans rather than clearly identified separately. Inspectors recommended using a separate risk assessment tool and said they would check this next time.
“Risks posed to people had not always been identified or weren't always clear.” from the report
Evacuation plans needed updating
needs fixingSome personal emergency evacuation plans did not reflect people's changing needs. One person's changed mobility also led to a referral for an assessment of the risks from steep stairs.
“Some of these needed to be reviewed, considering people's changing needs.” from the report
Improvements not yet sustained
needs fixingManagement systems had improved, but inspectors said the changes needed to become fully embedded and lasting.
“Whilst improvements to the service were noted these needed to be fully embedded and sustained.” from the report
One DBS check was being renewed
minorA regular bank worker's DBS check dated from 2015. The deputy manager started the process of renewing it after inspectors raised this.
“A regular bank worker had last had a DBS in 2015.” from the report
- 01How are individual risks now recorded on a separate risk assessment tool, and how often are they reviewed?
- 02Have all personal emergency evacuation plans been reviewed to reflect people's changing needs?
- 03How are you maintaining a consistent staff team, and has the outstanding DBS renewal been completed?
- 04What is the current progress of the application for the additional registered manager role?
- 05What arrangements would be used if someone needed a controlled medicine in the future?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous inspection. This explanation was written from the published report of 30 November 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, January 2023
Fernica: Rated Requires Improvement and still in special measures; inspectors found good responsive care but serious staffing and management oversight problems.
This was a focused inspection on 22 November 2022. The inspector spoke with people, relatives, staff and managers, and checked care records, medicines files, staff recruitment records and management records.
The overall rating improved from Inadequate to Requires Improvement. Safe was rated Requires Improvement, Responsive was rated Good, and Well-led remained Inadequate. The home had improved infection control, recruitment checks, medicines records and support for people to go out and see visitors.
Important problems remained. Staffing was not sufficient, with the registered manager working very long hours and covering sickness. The registered manager also did not have enough oversight of the home. These issues had been found repeatedly since 2017, and the home remained in breach of regulations about staffing and governance.
Safer recruitment
The home had improved its recruitment process. Required checks were completed before new staff started.
“Staff were safely recruited, with all pre-employment checks completed before new staff started working at the service.” from the report
Medicines records
People received their medicines as prescribed. Medicines administration records were complete and checked each month.
“People received their medicines as prescribed. Medicines administration records (MARs) were fully completed and audited each month.” from the report
Choice and community access
People could go out when they wanted and receive visitors. Extra support had been arranged or requested for people who needed help to go out more.
“People told us they were able to go out when they wanted to, and people were able to visit them at the home.” from the report
People's views
People and relatives were positive about living at the home. Regular meetings gave people a chance to discuss the home and what they wanted to do.
“People were positive about living at Fernica. They said they could speak with the care staff or registered manager if they had any concerns.” from the report
Very long working hours
seriousStaffing remained insufficient. The registered manager worked excessive hours, did not have a full day off during the four-week period checked, and covered a long-term sickness absence.
“Over a 4-week period the registered manager worked between 76 and 83 hours per week and slept at the home 5 nights each week.” from the report
Weak management oversight
seriousThe registered manager did not fully understand the role and responsibilities. The deputy manager was doing most management work, and the same problem had continued across several inspections.
“The registered manager continued to not have adequate oversight of the service to ensure good governance and compliance with regulations.” from the report
Fire alarm service overdue
needs fixingThe fire alarm service had not been completed because a contractor cancelled an appointment and it was not rearranged at the time of inspection.
“However, the fire alarm service was overdue. The contractor had cancelled an appointment and it had not been re-arranged.” from the report
One medicines stock record
minorThe stock quantity for one person's as-required medicine was not carried forward between medicine cycles, so it could not be stock checked.
“This meant it was not possible to stock check this medicine.” from the report
- 01What is the current plan to reduce the registered manager's working hours and provide cover for sickness and vacancies?
- 02How will the registered manager personally oversee the home, rather than leaving most management work to the deputy manager?
- 03Has the overdue fire alarm service now been completed, and can you show us the service record?
- 04How will you make sure as-required medicines are recorded and stock checked correctly between medicine cycles?
- 05What improvements do you expect to make before the next inspection while the home is in special measures?
This was a focused inspection of Safe, Responsive and Well-led, with infection control also checked; the other key questions were not inspected and their previous ratings were used for the overall rating. This explanation was written from the published report of 18 January 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.
Every inspection of Fernica (Residential Care Home)
7 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- November 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fernica (Residential Care Home) →
- January 2023Requires improvementup from InadequateSafe: Requires improvementWell-led: Inadequate
Read what inspectors found at Fernica (Residential Care Home) →
- April 2022Inadequatedown from GoodSafe: InadequateResponsive: Requires improvementWell-led: Inadequate
- November 2018Goodup from InadequateSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2018Inadequatedown from Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- November 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Inadequate
- March 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- September 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 20 December 2010.
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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