The inspection of Ferndale Lodge took place on 24 April 2018 and was unannounced. The service was last inspected on 21 and 23 September 2015 and at that time was meeting the regulations.

Ferndale Lodge is registered to provide personal care for up to eight people with learning disabilities and other complex health needs. The home is a single storey, purpose built building with a secure garden. There are eight private bedrooms with en-suite facilities, a communal bathroom, kitchen/dining room, lounge and sensory room. On the day of inspection there were eight people living at the home.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

At our last inspection the service was rated Good overall and Outstanding in effective. 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 on going 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.

Sufficient numbers of staff were deployed in order to provide safe care and treatment. Staff understood how to keep people safe and knew how to raise concerns. Risks had been assessed and recorded. People were protected from harm without restricting freedom.

Medicines were managed and stored safely. People were supported to have access to healthcare services.

Staff received appropriate induction and training to ensure they had the knowledge and skills to provide effective care. Staff received annual appraisals. Two members of staff had missed their scheduled supervision dates and these had not been rebooked.

Recruitment processes were in place. An employment reference had not been appropriately reviewed.

Food and drink was tailored to people’s individual needs. Staff supported people appropriately to maintain their hydration and nutritional needs where required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Positive relationships between staff and people who lived at Ferndale Lodge were evident. People's independence was promoted well by staff who understood how to maximise their independence.

There was clear evidence of person-centred care. People were involved in activities based upon their established routines and preferences. Care records contained very detailed information on how to support people.

Staff had clear direction and were sure about their roles and responsibilities. Systems and processes for ensuring the quality of the service were securely and effectively in place.

The service was led by an enthusiastic registered manager who was visible in the service and communication was open, honest and transparent.

Further information is in the detailed findings below.

On the day of our visit Ferndale Lodge had eight people living at the home but only seven were in residence. The manager explained the eighth person was temporarily being accommodated at an assessment centre in order to review their medications.

At the time of our inspection the provider did not have a registered manager in post. During the inspection we spoke with the home manager and the operations (area) manager. The home manager explained that they were new in post at the beginning of September 2013 and were applying to become the registered manager for the service.

Due to the complex needs of the people living at the home we were only able to speak with one person to ask for their views. We also spoke with a support worker, a senior support worker and the aroma therapist who visited the home every Thursday. Following our visit we spoke with the relatives of two people living at the home about their experience of the service provided by Ferndale Lodge.

During our visit we looked round the home we saw it was clean, tidy and well-maintained. We observed care being given to people in the lounge and dining kitchen. We also observed tea being served in the dining kitchen and lounge. People living at the home appeared relaxed and happy in their surroundings. We observed positive interactions between people and staff; people smiled and laughed a lot. We saw people were well-dressed and well cared-for. People were encouraged to make choices.

We looked at two people’s care files we saw their individual needs were assessed thoroughly and care and support was developed from an assessment of their needs.

People and relatives we spoke with told us they received good care the home. One relative told us, “I can’t praise them enough. It’s home from home for him there” and another relative said, “It’s a nice atmosphere at the home – she is really happy; I can tell from how she interacts with the staff.” The person living at the home told us “The staff are nice and I’ve got a great bedroom.” The aromatherapist visiting the home on the day of our visit said, "The residents here are so well looked-after; it feels like it's a family."

When we spoke with the support workers they told us they felt confident the service provided was good. They said they had enough staff to meet people’s needs and a good team who were always willing to help out. Staff received appropriate training for their role and told us they felt well-supported by the new manager. The support worker told us “We’re a team and we work together to make sure the residents are happy. The managers are the best I have ever worked with, and I’ve worked in a fair few places.”

On the day of the inspection there were seven people living at Ferndale Lodge.

People who lived there had complex physical and learning disabilities and as we were not familiar with everyone’s way of communicating to gain their views, we spent some time sitting with people, reading records, observing care practices and speaking with staff and relatives to find out what it might be like living at the home.

We spoke with three relatives of people living at the home and they spoke highly of the manager and care staff. One person's relative told us, “Ferndale Lodge is the next best thing to home.” Another relative said, “It feels like a proper home and not an institution.”

People who live at Ferndale Lodge have complex physical and learning disabilities. communicate verbally. We were unable to talk to people who live at the service about their experiences because we weren’t familiar with the way they communicate individually.

Staff at the service were able to explain how people communicated there. We observed positive interaction between staff and the people that live at Ferndale Lodge and we saw that staff understood how people were communicating their needs, wishes and choices.

We spoke to the relatives of a person who lives at ferndale Lodge. they were very complimentary about the manager, staff and the care and support their relative receives. they said that they trust staff and feel staff know and understand their relative very well.

This inspection took place on 21 and 23 September 2015 and was unannounced on both days. We previously inspected the service on 14 November 2013. The service was not in breach of health and social care regulations at that time.

Ferndale Lodge is registered to provide personal care for up to eight people with learning disabilities and other complex health needs. The home is a single storey, purpose-built building with a secure garden. There are private bedrooms with en suite facilities, a sensory/cinema room and there is a communal bathroom, lounge and kitchen/diner.

The service 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.

People indicated they felt safe living at Ferndale Lodge and visiting professionals also said they felt people were safe and well cared for. Staff had a thorough understanding of safeguarding procedures and staff knew what to do if they thought anyone was at risk of harm or abuse. Risks to people were thoroughly assessed and regularly reviewed and best practice guidance was followed in relation to keeping people safe.

We found that staff were recruited safely and they received regular training and supervision to ensure they were effective in their roles. There were enough staff to meet people’s needs and additional staff were deployed when required.

Medication was managed well and staff who were responsible for administering medication had been trained to do so in a safe way.

The home had achieved awards for good practice, for example in relation to healthy food and people received excellent care as a result of this. Staff and people had received training specific to diet and nutrition and people were encouraged to maintain a healthy lifestyle and healthy diet. People participated in a range of personalised activities, depending on their own interests.

People received care and support that was very effective and well coordinated. Staff and the registered manager went ‘above and beyond’ to ensure that people were supported effectively.

People’s lives were positively enriched by the environment, layout and design and the facilities within the home.

Staff had developed excellent communication skills and used creative ways to positively communicate with people.

Staff were caring in their approach and there was a positive atmosphere in the home. Feedback from people and their families showed they felt staff were very caring. People’s dignity and privacy were respected.

People’s views were sought and they were encouraged to be involved in the running of the home and were empowered to be as independent as possible. Staff knew what was important to people and people received care that was individual to them, according to their needs and wishes.

People we spoke with felt the home was well led. We found there to be an open and transparent culture. Staff felt supported in their roles. Regular checks and audits took place to try to continually improve the home.