Ferndale Court Nursing Home

Updated 29 March 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

This inspection was carried out by three inspectors, a specialist nurse advisor and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Their area of expertise is dementia care.

Service and service type:

Ferndale Court is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The service accommodates up to 57 people in one purpose building. At the time of our visit there were 41 people using the service.

The service had a temporary manager who was not yet registered with the Care Quality Commission. They were in the process of making an application to register.

Notice of inspection:

The inspection was unannounced.

What we did:

Prior to the inspection, we reviewed the information we had received about the service since the last inspection. This included information from other agencies and statutory notifications sent to us by the manager about events that had occurred at the service. A notification is information about important events which the provider is required to tell us about by law. We used all this information to plan our inspection.

During the inspection, we spoke with 10 people who used the service and five relatives. Some people who used the service were not able to speak to us about their care experiences so we observed how the staff interacted with them in the communal areas of the home.

We also spoke with a number of staff including, four care staff, a nurse, nurse assistant, chef, maintenance person, well-being coordinator, two home managers and the regional manager.

We viewed the care records of six people. We looked at three staff files, which included pre-employment checks and training records. We looked at records relating to the management of the service. For example, staffing rotas, complaint records, accident reports, monthly audits and medicine administration records.

Updated 29 March 2019

About the service: Ferndale Court is a purpose-built care home for up to 57 people. The service provides nursing care for frail older people and people with dementia. There are three separate units. During inspection 41 people were being supported by the service.

People’s experience of using this service:

Since the previous inspection the registered provider has worked hard to address the issues identified and improve the quality of the care. A turnaround manager had been employed and along with the regional manager and quality team, had made significant improvements. These improvements were ongoing. The new leadership team were dedicated to making further improvements and we found they had promoted an open culture, continuous improvement and person-centred care.

Overall, people and relatives were complimentary and positive about the care and support they received. Staff described the management team as very supportive and approachable, telling us the service was now much more organised. Effective systems were now being followed to check on the quality and safety of the service and improvements were made when required. These improvements need to be consistent and sustained.

Risk assessments were carried out and action taken to reduce risks to people. However, we found examples where actions to manage risks had not been followed robustly and needed further improvement. We made a recommendation in relation to the use of sensor beams.

Improvements had been made to ensure safeguarding procedures were followed and people were protected from abuse or harm.

There were sufficient staff to meet the needs of people in a timely way. Overall, we found that medicines were managed safely.

Significant improvements had been made to the cleanliness of the building. The building and equipment were now safely maintained.

The management team had addressed concerns relating to the dining experience and people were positive about the food and drink available. Any nutritional risks were monitored and acted upon.

Some improvements had been made to ensure staff acted in accordance with the Mental Capacity Act 2005 (MCA). However further improvements were needed to ensure staff fully understood the MCA and appropriate assessments and best interest decisions were carried out where necessary.

Staff were now trained to carry out their roles effectively and received supervision from the management team. We received very positive feedback from relatives about the sensitive and responsive nature of the end of life care provided by the staff.

The management team had worked hard to coach staff and support them to ensure the care provided respected people’s privacy and dignity. People told us staff were kind and caring.

Improvements had been made to care plans, however we found further improvements were required to ensure they included all specific details and that all charts were fully completed.

Improvements had been made to ensure records relating to complaints were fully completed. People felt able to raise any concerns and knew how to make a complaint if necessary.

Quality assurance systems were in place and were being used more effectively to monitor key aspects of the service. However further improvements were needed to ensure staff always understood and followed guidance and changes were communicated effectively.

Audits and checks were completed on a regular basis by the management team and registered provider to identify areas of improvement. A detailed home improvement plan was being implemented.

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore this service is now out of Special Measures.

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

Rating at last inspection: Inadequate (Published 23 November 2018).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service had improved from inadequate to requires improvement overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.