Fern House is a large purpose-built complex which consists of an independent extra care housing scheme and a 30-bedded residential and respite unit. The complex is situated in the grounds of the old Bingley Hospital and overlooks Bingley Moor. On the day of our inspection there were 13 people living on the residential unit and 20 people receiving care and support in the extra care housing scheme.

The residential unit at Fern House 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 self-contained apartments at Fern House provide care [and support] to people living in specialist 'extra care' housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People's care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people's personal care and support service.

There was no registered manager in post at the time of inspection. However, the recently appointed manager was in the process of registering with the Commission [CQC]. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This inspection took place on 31 August and 12 September 2018 and was unannounced. This was the first inspection of the service since it registered with the Commission [CQC] in July 2017.

Policies and procedures ensured people were protected from the risk of abuse and avoidable harm. Staff told us they had received safeguarding training, and they were confident they knew how to recognise and report potential abuse.

Risks associated with personal care were well managed on the extra care housing scheme. However, on the residential unit risk assessments did not always provide staff with accurate and up to date information.

The service was meeting the requirements of the Deprivation of Liberty Safeguards (DoLS) and acting within the legal framework of the Mental Capacity Act 2005 (MCA). This helped to make sure people’s rights were protected.

Systems were in place to ensure people received their prescribed medicines safely. However, staff did not always follow correct procedures when administering medicines therefore we could not be certain they were being given/applied as prescribed.

There were enough staff available to meet people’s needs but staff were not always deployed effectively. In addition, safe staff recruitment and selection procedures were not always followed

Staff received appropriate training and told us the training provided was informative and relevant to their role. Staff were supported by the management team and received formal supervision where they could discuss their ongoing personal development needs.

Infection control policies and procedures were in place. However, staff on the residential unit did not always follow the correct procedures when managing clinical waste.

We saw arrangements were in place that made sure people's health needs were met. For example, people had access to the full range of NHS services. This included GPs, hospital consultants, community health nurses, opticians, chiropodists and dentists.

The care plans and supporting records and reports identified specific risks to people health and general well-being, such as falls, mobility, nutrition and skin integrity but on the residential unit they did not always provide accurate and up to date information.

Relatives told us they were made welcome and encouraged to visit the