Fernery House

Updated 2 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and an Expert by Experience made telephone calls to people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fernery House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fernery House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. There was a manager in post who was in the process of applying to become the registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed information we had received about the service. We used all this information to plan our inspection.

During the inspection

People were not able to give us detailed feedback about the care and support provided, we spent time observing people and staff interacting. We received feedback from 5 relatives. We reviewed a range of records. This included 3 people’s care records and medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed. We received feedback from one professional that visited the service.

Updated 2 February 2023

About the service

Fernery House is a residential care home providing personal care for up to 7 people with a learning disability and/or autistic people. At the time of the inspection 6 people were living at the home. The service is a residential property based in Burnham on Sea. Local shops, the beach and the town are within a close proximity to the home.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support

People had plans in place to guide staff on how to support them if they became anxious or upset. However, the plans were not always regularly reviewed or updated. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice. Some improvements were required to ensure people were supported to make decisions following best practice in decision-making. The service did not always give people care and support in a clean environment. Staff did not always support people with their medicines in a way that achieved the best possible health outcome.

Staff supported people to play an active role in maintaining their own health and wellbeing. The service gave people care and support in a safe and well-furnished environment that met their sensory and physical needs. People had a choice about their living environment and were able to personalise their rooms. The service supported people to have choice, control and independence. People were able to pursue their chosen interests.

Right Care

Improvements were required to ensure risks to people were fully assessed and mitigated. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse, not all staff were able to tell us where they would report abuse outside of the organisation. There were some shortfalls in staff training. The service had enough staff to meet people’s needs and keep them safe. People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff understood and responded to people’s individual needs.

Right Culture

The systems to monitor the quality of the service were not fully effective in ensuring shortfalls were actioned. Staff understood people well and were responsive to their needs. People’s quality of life was enhanced by the service’s culture of improvement and inclusivity. Staff valued and acted upon people’s views.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 17 October 2019).

Why we inspected

We received provider level concerns. During the inspection we identified concerns relating to the management of risk, medicines, infection control, the application of the Mental Capacity Act 2005, staff training and governance.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fernery House on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.