3 November 2022
During a routine inspection
Fernways is registered to provide personal care and support to people living in specialist ‘extra care’ housing in London Borough of Redbridge. Not everyone who lived in the housing received personal care from the service. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. People using the service lived in their own flats within a gated community where there were 52 properties. The service was providing personal care to 17 people at the time of the inspection.
People’s experience of using this service and what we found
The provider had missed calls to people using the service, this related to staff absence and system failure. Medicines management required improvement; there were no protocols for medicines which were administered as and when required (often referred to as PRN medicines) and there were often gaps found in medicine administration records and no record of follow up with prescribing health professionals or GPs as to what to do if medicines were missed. Lessons were not always learned when things went wrong, incidents and accidents were not regularly discussed with staff.
Improvements were required in respect of governance systems at the service. We found a lack of systematic follow up or record of response to issues noted in staff communications. Similarly, records of communications with health professionals were not always recorded. There was no record of what occurred in staff handovers, and staff meetings did not contain rolling agenda items such as safeguarding or incidents and accidents.
We have made recommendation about recording people’s end of life wishes.
There were systems in place to safeguard people from abuse. Risks to people were assessed and monitored. Infection prevention measures were in place.
Staff were supported through induction, training and supervision. The service worked alongside other agencies to provide effective care. People were supported with their health needs. People’s needs were assessed so the service knew whether they could meet them or not. People were supported with their dietary needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s equality and needs were recorded so staff could support people in culturally sensitive way. The service had received compliments about the care they provided. People and relatives were supported to express their views on the service. People were supported respectfully and their independence promoted.
People received personalised care; their care needs were recorded in their care plans. People’s communication needs were met. People were supported with activities. The provider was responsive to complaints and concerns raised.
The provider had some quality assurance measures in place. While some aspects of their quality assurance systems did not work well, such as medicines audit follow up and incident and accident reporting, other aspects helped to improve the service, such as spot checks.
. People and relatives, we spoke with were generally positive about the service and staff working there. Staff knew their roles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The previous rating for this service was good (published 08 December 2017).
Why we inspected
The inspection was prompted in part due to concerns received about people’s care calls being missed. A decision was made for us to inspect and examine those risks.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and recommendations
We have identified breaches in relation to safe care and treatment good governance at this inspection. We have also made a recommendation about recording people’s end of life wishes.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.