We carried out an unannounced inspection of Fern Lodge on the 12th November 2018.

Fern Lodge is a care home with nursing registered to accommodate seventeen people who are experiencing mental health issues. It is managed and operated by Partnerships in Care. Fern Lodge is a Victorian, three-storey semi-detached house near Chester City Centre. At the time of our visit; twelve people were living there.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People told us that they were happy with the service they received. They told us that the staff team were caring and supportive. They told us that they felt listened to and were fully involved in the support they received and had control of their daily lives.

Staff were aware of how to best protect vulnerable people. Systems were in place to report any concerns.

The premises were clean and hygienic.

Medication management was robust. Steps had been taken to enable people to be in control of managing their medication.

Staff were available at all times to provide advice to people who used the service.

Assessments were in place to identify the risks people faced. These were regularly evaluated.

Staff received the training and supervision they required to carry out their role. New staff received a structured induction to their role to ensure that they were able to carry out their responsibilities.

The registered provider operated within the principles of the Mental Capacity Act 2005.

The nutritional needs of people were met. Consideration was made to the dietary needs of people as well as lifestyle choices.

The design of the premises met the needs of people and the usage of facilities was being reviewed to ensure that they best served the people who used the service.

The health needs of people were met.

Staff interacted with people in a caring and helpful manner. The confidential information of people was protected.

Activities were available in line with the individual preferences of people. The registered provider was aware of the risks of social isolation that could be experienced by people.

Care plans were very person centred and contained all the information to successfully support people. People were involved in their care plans.

A robust complaints procedure was in place.

The registered manager was aware of the needs of people and adopted an inclusive approach to the running of the service.

The views of people were sought to influence the running of the service.

Audits were in place to enable an oversight of the quality of the service to be gained.

The registered provider met their legal responsibilities to notify CQC of any incidents and to be transparent in the displaying of their most recent inspection rating.

We carried out an unannounced inspection of Fern Lodge on 9 of February 2016

Fern Lodge is a Victorian, three-storey semi-detached house near Chester City Centre. The home provides care and support for adults who have difficulties with their mental health.

A manager was in place but they were not registered . We saw evidence that this person had started the registration process with CQC and that this was on-going. 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.

People who used the service told us that they were happy living at Fern Lodge, felt safe and considered that staff cared about them. This was reinforced by observation of the care practice provided to all people who were present during our visit. Staff explained to us what they would do to keep people safe and how they protected their rights. Staff had been provided with training and showed an understanding about safeguarding adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS).Staff practice was focussed completely on the needs of people and this was delivered in a friendly yet dignified manner.

People had full access to general medical services as well as more specialised support reflecting their needs when required.

There were opportunities for people to take part in group activities but they were also encouraged to develop personal interests and employment in the wider community and this was evident throughout the building and through individual discussions.

Staff protected people from the risks associated with poor nutrition and hydration as they encouraged people to eat and choose a balanced diet. People had their nutritional needs met. Records that we looked at were comprehensive and kept up to date. Support plans contained detailed information on each person and how their care and support was to be delivered. All care plans were being reviewed to enabled them to become more person centred. The information was regularly reviewed with the person who used the service and significant others. People were given the opportunity to be involved in the devising of their care plans but not all chose to do so.

People were supported by staff who were trained and regularly supervised. The service was run by a manager who was undergoing the registration process with us and a registered provider who were open and transparent in their practice. They were responsive to the views of staff and people alike and monitored the quality of care in an objective and transparent manner.