CQC report explained · a residential care home
What the CQC found at Fernlea
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2022
Rated Requires Improvement; inspectors found gaps in staff training, care records, infection control and quality checks.
This was an unannounced focused inspection on 11 August 2022. Inspectors looked at Safe, Effective and Well-led because concerns had been raised about staff training, health conditions, mental capacity and restrictions. They spoke with people, relatives and staff, observed care and checked care, medicines, recruitment, building safety and management records.
People generally felt safe and staff knew how to report abuse. Medicines were mostly managed safely, and people were supported with food, healthcare, choices and visits from relatives. However, some risk information and medicine instructions were out of date or not detailed enough for new staff.
Staff had not received all the training needed for the people living in the home, including training about autism, learning disabilities and continence care. The home also needed more meaningful activities, better decoration and hygiene, and stronger quality checks. The overall rating fell from Good at the previous inspection to Requires Improvement.
Choice and consent
Staff supported people to make everyday choices and respected consent. People were involved in decisions about their care and room improvements.
“Staff empowered people to make their own decisions about their care and support.” from the report
Food and health support
People were supported to eat and drink enough and to use healthcare services. Inspectors saw people being supported with their meal choices and care needs.
“Staff provided people with choices. For example, we observed the cook speaking with all people about their meal preferences.” from the report
Supportive culture
Staff described a positive atmosphere and felt able to raise concerns with management. People and relatives also said management was approachable.
“There was a positive culture among staff and staff supported people to make their own choices.” from the report
Care and risk information
seriousSome care plans and risk assessments did not contain the latest information or enough detail. This could make it harder for new or unfamiliar staff to respond safely.
“some information was out of date and more detail was required to explain risks and show staff how to safely respond.” from the report
Staff training
seriousStaff had not received specific training for continence care, autism and learning disabilities that was suitable for their roles. Inspectors found this was a breach of the staffing regulation.
“Staff had not received specific training to support people in the service with their continence care” from the report
Quality checks
seriousManagement systems did not reliably identify and address risks. Medicines audits, care records and follow-up of delayed equipment and assessments needed to be stronger.
“The above concerns show quality assurance systems had not been fully effective at ensuring the quality and safety of the service was monitored and improved.” from the report
Activities
needs fixingSome people and relatives said there were not enough meaningful activities. The home was exploring alternatives after activities affected by the COVID-19 pandemic had not restarted.
“Relatives told us they felt people needed to be able to be involved in more activities.” from the report
Environment and infection control
needs fixingThe décor was tired and outdated, and damage to furnishings and flooring affected confidence in hygiene arrangements. Refurbishment was in progress, but the infection prevention and control policy was not up to date.
“We were not assured that the provider was promoting safety through the layout and hygiene practices of the premises.” from the report
- 01What specific training have all staff now completed on autism, learning disabilities and continence care?
- 02How have you updated care plans, risk assessments and 'as and when' medicine instructions so that new staff can use them safely?
- 03What has been done to improve medicines audits and other quality checks since the inspection?
- 04What regular meaningful activities are now available, and how are people involved in choosing them?
- 05What progress has been made with refurbishment, damaged furnishings, flooring and the infection control policy?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected, and the report says the other ratings were carried over from the previous inspection. This explanation was written from the published report of 21 October 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 2022
Fernlea was inspected but not rated; inspectors found good infection-control practice, but some checks and cleaning records needed improvement.
This was an announced, targeted inspection on 8 February 2022. It looked mainly at infection prevention and control, visiting arrangements, and whether COVID-19 staffing pressures affected care.
The home was clean and tidy. People and staff were tested regularly, staff vaccination checks were completed, and infection-control training had been provided. The home used personal protective equipment safely and supported people to keep in touch with relatives.
Inspectors found that vaccination checks for visiting professionals had not been completed. Records of regular cleaning of frequently touched surfaces were also missing, and some worn surfaces would be difficult to clean hygienically. Immediate action was taken after inspectors raised these points.
The home was inspected but not rated. This was not a full assessment of all five areas of care.
COVID-19 checks
People and staff were tested regularly. Staff vaccination status was checked unless they were exempt.
“People and staff were involved in being tested regularly for COVID-19 and the registered manager had checked staff had received the vaccination, unless exempt.” from the report
Infection-control training
Some people had taken part in food hygiene training, and staff had received infection-prevention and control training.
“Some people had previously partaken in food hygiene training and the registered manager had plans to offer COVID-19 training to people who wanted it.” from the report
Support for family contact
People were supported to stay in contact with relatives through visits and phone calls.
“People were supported to maintain contact with loved ones, which included visits from relatives into the home or outside of the home and contact via phone calls.” from the report
Checks on visiting professionals
needs fixingThe home had not checked the vaccination status of visiting professionals. The manager took immediate action to add this to the entry process after inspectors raised it.
“However, the provider had failed to check visiting professional's vaccination status.” from the report
Cleaning records and worn surfaces
needs fixingRecords were missing for regular cleaning of frequently touched surfaces. Some surfaces were worn and would be difficult to keep hygienically clean.
“Records were not in place for regular touch point cleaning.” from the report
- 01How do you now check the COVID-19 vaccination status of visiting professionals?
- 02What records do you keep to show that frequently touched surfaces are cleaned regularly?
- 03What action has been taken about the worn surfaces that inspectors said would be difficult to clean hygienically?
- 04How do you check that infection-control improvements remain effective?
- 05How will you support visits and phone contact with relatives if infection risks change?
This was a targeted inspection of infection prevention and control, visiting arrangements and COVID-19 staffing pressures; the service was inspected but not rated and the report did not assess the other care areas. This explanation was written from the published report of 3 March 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.
Every inspection of Fernlea
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2022Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- March 2022Inspected but not ratedSafe: Inspected but not rated
- September 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- July 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2017Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- February 2016Requires improvementstayed Requires improvementSafe: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- April 2011
Registered with the Care Quality Commission on 11 April 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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