Fernbrook House is registered to provide care and accommodation with nursing care for up to 30 older people who may have care needs associated with dementia. At time of the inspection there were 26 people living in the service.

The home had a registered manager in place. 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.

Since October 2016, Fernbrook House now has a new provider and at this inspection we found the new management team had made several improvements.

Staff delivered support effectively and care was provided in a way that promoted people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people’s individual needs to be met adequately. Trained staff dispensed medications and monitored people’s health satisfactorily.

Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. Person centred social activities took place within the service.

Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits carried out by the manager and provider, which identified any improvements needed and actions were taken. A complaints procedure was in place and had been implemented appropriately by the management team.

Fernbrook House is registered to provide care and accommodation with nursing care for up to 30 older people who may have care needs associated with dementia. At time of the inspection there were 26 people living in the service.

The home had a registered manager in place. 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.

Since October 2016, Fernbrook House now has a new provider and at this inspection we found the new management team had made several improvements.

Staff delivered support effectively and care was provided in a way that promoted people’s independence and wellbeing, whilst people’s safety was ensured. Staff were recruited and employed upon completion of appropriate checks as part of a robust recruitment process. Sufficient numbers of staff enabled people’s individual needs to be met adequately. Trained staff dispensed medications and monitored people’s health satisfactorily.

Staff understood their responsibilities and how to keep people safe. People’s rights were also protected because management and staff understood the legal framework of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

The manager and staff ensured access to healthcare services were readily available to people and worked with a range of health professionals, such as social workers, community mental health nurses and GPs to implement care and support plans.

Staff were respectful and compassionate towards people ensuring privacy and dignity was valued. People were supported in a person centred way by staff who understood their roles in relation to encouraging independence whilst mitigating potential risks. People were supported to identify their own interests and pursue them with the assistance of staff. Person centred social activities took place within the service.

Systems were in place to make sure that people’s views were gathered. These included regular meetings, direct interactions with people and questionnaires being distributed to people, relatives and healthcare professionals. The service was assisted to run effectively by the use of quality monitoring audits carried out by the manager and provider, which identified any improvements needed and actions were taken. A complaints procedure was in place and had been implemented appropriately by the management team.

At the time of our inspection there were 28 people living in Fernbrook House. We spoke with and spent time with people who used the service. We spoke with three members of staff, the manager, the general manager, the provider of the service and the friends/relatives of three people who used the service. We looked at four people's care plans and records. Other records viewed included staff recruitment and training records, health and safety checks and quality monitoring information.

We considered our inspection findings to answer five key questions; is the service safe, effective, caring, responsive and well-led? This is a summary of what we found;

Is the service safe?

When we arrived at the service a member of staff checked our identity and we were asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

Staff had received a range of training to ensure that they worked in ways that were safe. Training included fire safety, first aid, the safeguarding of vulnerable adults from abuse (SOVA) and the Mental Capacity Act (MCA) 2005. This assured people who used the service that staff had the knowledge to know how to care for them safely and protect them from harm.

During our inspection we assessed how the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) were being implemented. Mental capacity assessments had been completed for people correctly to maintain the safety and rights of people who used the service.

People told us they were content living in the service and that they would speak with the staff if they had concerns.

We found that people lived in a safe environment which was kept maintained. We saw records which showed that the health and safety in the service was regularly checked. This included regular fire safety checks which meant that people were protected in the event of a fire.

When people needed to use equipment such as hoists, specialist beds and mattresses we found that these were kept clean and well maintained to ensure people's safety.

Is the service effective?

People told us that they were very happy with the service and that it met their needs. People made comments such as, "I am quite content here," and, "The staff are good." People who were unable to verbally express their views were relaxed, interacted well with staff and were being well supported. Feedback from relatives showed that they were happy with the care and support offered at Fernbrook House. One person told us, "It is always so warm and welcoming."

People's care was supported through assessments, care plans and risk assessments being in place. This ensured that staff understood people's needs and could care for them safely, effectively and consistently.

Staff who worked in the service were recruited safely and checked to ensure that they were suitable to work with vulnerable people. New staff undertook an induction programme so that they got to know about the service, expected levels of practice and the needs of the people living in Fernbrook House.

Is the service caring?

We saw and heard good interactions between the staff and people who used the service. Staff were respectful, caring, encouraging and supportive towards people.

We saw that feedback from relatives about the service included comments such as, “The most important aspect is that the staff really care and take time to talk to residents on a one to one basis," and, "The staff are all very caring."

Is the service responsive?

We saw that staff consulted with people and offered them choices in their daily lives. People's choices were taken into account and listened to.

Staff were responsive to people's changing wishes and needs about where they went and what they did and supported them well.

People's care records showed that where concerns about their wellbeing had been identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from other health care professionals.

Is the service well-led?

The service had a manager in post who was supported by the senior team of the organisation. The provider had systems in place such as quality surveys and audits to monitor and improve the service. This showed us that the service was being well led.

People we spoke with told us that they were happy, safe and well cared for at Fernbrook House. People told us, "They treat me very well here," and, "I have no complaints at all. I like it here, everyone is friendly."

We saw that care and treatment for each person was planned and reviewed with their involvement where possible. People were given choices in their day to day lives.

Staff were trained and supported to care for people properly and to keep them safe. Risks to the health, welfare and safety of people using the service were identified and managed.

The service was clean and there were systems in place for minimising the risks of the spread of infection.

Medicines were stored, administered and disposed of safely and people's medicines were regularly reviewed to ensure that they were appropriate and effective.

The service was well managed and there were effective systems in place for monitoring and improving the quality and safety of the service, taking into account the views and suggestions of people living there.

During our inspection in December 2012 we spoke a number of people living in Fernbrook House Nursing Home and three of their visiting relatives . People were generally satisfied with the care and support provided by the home’s staff and management. Where there were issues people said that they felt comfortable in raising these with the manager or provider. We saw that the service had received much positive feedback and thank you cards from people who had used it.

People living in the service were mostly content. One person told us, “I am quite happy here, the food is good, the staff are good and I can do as I wish.” One visiting relative said, “The staff are always welcoming, I feel like part of the furniture."

We found that the service needed to take action in some areas to improve the quality of care and service provided to people. People needed to have more opportunities for stimulation and activity. Care and staff practices needed to be better monitored to ensure people's health and welfare.

People praised the staff at the service and we found that staff had been trained to a satisfactory level. Staff did not however receive regular formal supervision or support to assist them in their ongoing development and maintaining standards.

The issues that we identified showed us that the overall quality monitoring of the service needed to be improved.

People told us that they were generally happy and comfortable living at Fernbrook House.

People told us that they were happy and comfortable living in Fernbrook Nursing Home. People thought the home had improved and that the care and support offered was good. People said that they enjoyed the food provided and were offered choice.

The inspection took place on the 14 and 15 December 2015.

Fernbrook house is registered to provide care and accommodation with nursing care for up to 30 older people who may have care needs associated with dementia. At time of the inspection there were 29 people living in the service.

The home had a registered manager in place. 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.

Concerns we found during our inspection were mainly confined to people who received care on the first floor of the service.

People’s needs were being met, however people’s comments varied on whether the service had sufficient numbers of staff to cover both floors at all times of the day and night. There were concerns about the deployment of staff specifically on the first floor in terms of supporting people with higher care needs.

Opportunities for people to engage in social activities were variable, particularly for people who were immobile and/or remained in bed so improvements were required. Most people to have sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met; however the dining experience was not always good for everyone.

There were systems in place to seek the views of people who used the service and their relatives on how the home can make improvements people and relatives did feel this was effective. Relatives and people who used the service knew how to make a complaint and were assured that all complaints would be dealt with and resolved in a timely manner. The service had a number of ways of gathering people’s views about the quality of the service which included holding meetings with people, staff and relatives.

Arrangements were in place to ensure that staff had been recruited safely and received opportunities for training, we found all staff to have received regular supervision however the manager had not received formal supervision since commencing employment to provide them with ongoing support and opportunity to identify any areas of their practice that might require improvement.

Staff knew the needs of the people they supported. We found that people were always treated with respect and dignity and people received good care.

The registered manager had a very good knowledge of the recent changes to the law regarding Deprivation of Liberty Safeguards (DOLS) and was also aware of how and when to make a referral if required. People were safeguarded from harm. Staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS).

The service had a number of quality monitoring processes in place to ensure the service maintained its standards however they did not appear to have been effective.