Fernleigh Court Care and Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

The service was not always well-led. We found a breach of regulations in relation to how well the service was governed and managed. Internal audits and other quality control measures were either not completed or were not effective in identifying where improvements were needed at the service. As a result of this some people living at the service had not experienced good outcomes. Whilst improvements were now underway, these happened as a reaction to people having these poorer outcomes and findings from external agencies, rather than due to the providers quality audits in place at the service. More time would be needed to ensure the necessary improvements are made and sustained. The registered manager and senior management team had reacted to the findings from external agencies and the poor experiences some people had recently experienced. As a result improvements to systems and processes were underway and had started to resolve many issues at the service. People were positive about the changes at the service and were now having good experiences. Staff had also noted improvements and were happy working at the service. Multiple audits and service improvement plans were in place to help make and sustain improvements at the service.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There had not always been a shared and positive culture at the service. This had resulted in people having fewer positive experiences of care such as not being supported with personal care as discussed throughout this report. The senior management team had reacted to these issues over the last three months and had now started on building a more positive direction at the service. However, this was only as a direct result of the poor experiences people had been identified by other professionals. The registered manager told us they had been working directly on shift with the staff team and had not always prioritised making sure the culture at the service was positive. Relative spoke with us about how they felt there was not a shared direction or culture at the service before the senior management team took actions. One relative said, ‘‘It was very clear things were not right for [family member] but it took a long time for things to be done to make things better.’’ Another relative told us, ‘‘I felt for the staff team a couple of months ago. More and more people using the service and staff were expected to just keep going as they were. It felt very chaotic.’’ Since the senior management team had started taking action, there was a more positive culture at the service. They had a clear vision for how to support people and shared this with the staff team in group meetings and individual supervisions. They were closely monitoring how people were being supported to help make sure they were having good experiences. Staff told us they had noticed significant improvements as a result of this. One person said, ‘‘It is lovely here. Like one big family. I love it.’’ A relative told us, ‘‘I am really impressed as a whole with the service, both the management and the staff team. They really love what they do and are always looking out for [family member’s] best interests.’’

Before the senior management team became heavily involved at the service over the last three months the management team did not have a full overview of how people were being supported. The registered manager was not being supported to be fully capable in their job role. As a result, people had not always had good outcomes at the service as discussed throughout this report. One relative said, ‘‘It used to be quite difficult to get hold of [registered manager] as they were always busy doing other things. This made it hard to get our points across.’’ The senior management team and provider did not have a consistent or effective presence at the service before they had reacted to issues at the service and started to make improvements. Since the senior management team and provider had been more involved at the service, they had started to resolve a lot of issues that had led to poor experiences for people. They and the registered manager had started auditing aspects of the service to help ensure people were being supported in line with their needs. The registered manager was compassionate and listened to people and the staff team. People and the staff team were positive about the kind and caring nature of the registered manager. One person said, ‘‘[Registered manager] is fantastic. They take the time to walk around and come and see us, so they know we are okay.’’ A relative told us, ‘‘I know the registered manager and they are very helpful, approachable and supportive. I would say the service is well managed.’’

Processes were in place to support people to speak up. However, it was unclear how people who did not attend larger meetings were being supported to feed back about the service. Some relatives told us communication between them and the staff team could be improved. Their comments included, ‘‘I am not always told when [family member] has an appointment or if there has been any changes to their support needs.’’ and, ‘‘I have had issues in the past where I don’t hear from the service unless I make effort to get in touch with them.’’ The senior management team were taking action to support people to speak up in different ways and to meet with people individually if they chose to do so. Staff told us they felt comfortable speaking up and raising concerns. There was a detailed complaints policy in place and complaints were dealt with promptly and in detail. One person said, ‘‘If I had a problem I could speak with [staff] or the [registered manager].’’ A relative said, ‘‘I have no need to raise any concerns but know how to and wouldn’t hesitate to do so.’’

Staff felt well supported by the registered manager and the management team. They told us they had noted significant improvements to the service recently. The management team met with staff regularly and discussed how they could support them, for example by offering them working hours to help support them. Staff were invited to discuss the service in meetings and supervisions. The providers recruitment process was fair and equitable.

Audits were either not being completed or were not effective in identifying where improvements at the service could be made. This had led to some poor experiences of care for people as discussed throughout this report. People’s care plans were not always effectively audited to make sure they were detailed and gave good guidance to staff about how best to support people. People’s daily records were not being consistently completed however audits were not in place to review these records so improvements could be made. The senior management team had reacted and started to take actions to put effective governance systems in place. However, this was as a result of findings from external professionals, rather than as a result of internal audits and governance processes. The senior management team had started to put audits and checks in place to monitor the quality of the service. Thes had been effective in making and driving up immediate improvements at the service. Care plans were now being reviewed and updated as were people’s daily records. The provider had completed analysis to see why people had poor experiences and put actions in place to help ensure this did not happen again. The senior management team were supporting the registered manager to upskill themselves and become more confident in their job role. One person said, ‘‘[Management] must know what they are doing. Things are really good here and are going really well.’’ A relative told us, ‘‘I think [registered manager] is dedicated and wants what is best for the service. Things have got much better recently.’’ The senior management team showed us evidence systems were now in place to sustain the improvements they had started to make.

Staff had not supported people to get support off of health professionals in a timely manner before the senior management team started supporting at the service. This had led to poor outcomes for people. One health professional explained, ‘‘It was quite difficult to work with the service as people started living there and we were not told they needed our support. As a result, we could have given better support if we had known sooner.’’ Some relatives told us the staff team did not always communicate and work well together. One relative said, ‘‘The problem is I think some of the staff have good ideas and support [family member] well but don’t tell the other staff members. It sometimes feels like staff don’t really speak with each other.’’ The senior management team had taken actions and worked to improve relationships with health professionals over the last three months. One health professional told us, ‘‘I can see the management team are really keen to improve. We have had good experiences working with them and as a result people have had the care they need.’’ The staff team were supported to have regular meetings to help make sure they were working together consistently. They told us they had noted significant improvements at the service recently. The senior management team had linked and worked well with partners such as the local authority to start make and sustain improvements. One person said, ‘‘The staff will always get hold of someone to help me if I need support. I think they work well together.’’ A relative told us, ‘‘I have confidence staff know the signs to show that [family member] needs more support.’’

There has been some safeguarding concerns and issues relating to people not receiving their essential support needs such as personal and oral care at the service. These issues have been references and discussed throughout this report. Whilst the senior management team had reacted to these issues and started to take action to improve the service, this was as a reaction to them occurring and from findings from external professionals. Systems in place at the service had not been effective in preventing people from having poor experiences or taking action to improve things. There had not been any effective plans in place to improve the service before the senior management team started working intensively at the service. People had not been supported to start living at the service safely which had made it more difficult to make and sustain improvements. People’s care plans and daily records were not being effectively reviewed to see where improvements could be made. Since the senior management team started supporting the service, significant improvements had been made. Audits were now effective and there were improvement plans in place to help improve the service. Actions had been completed to help people have better experiences of the service. The senior management team updated us regularly throughout the assessment process which helps assure us improvements would be made and sustained. They evidenced to us that systems would be able to sustain the improvements they had started to implement. One person said, ‘‘There has been a definite change to things here and things feel really good at the moment. The staff all have a smile on their face.’’ A relative told us, ‘‘There have been some issues at the service, and I know this, but I also know a lot of effort is being made to improve. Staff have made sure they prioritise how [family member] is first and foremost. I have faith things will keep getting better.’’