Fernleaf residential 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.

Fernleaf residential accommodates 21 people in one adapted building. At the time of our inspection there were 18 people living at the home.

There was a registered manager in post. 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. In this report when we speak about both the company and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on the service was rated, ‘Good’.

At the present inspection the service remained, ‘Good’. Arrangements were in place to carry out regular quality checks and had ensured that there was enough staff on duty. In addition, people told us that they received person-centred care.

There were systems, processes and practices to safeguard people from situations in which they may experience abuse including financial mistreatment. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. Medicines were managed safely. Background checks had been completed before new staff had been appointed.

Furthermore, there were arrangements to prevent and control infection and lessons had been learned when things had gone wrong.

Staff had been supported to deliver care in line with current best practice guidance. People were helped to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had access to healthcare services so that they received on-going healthcare support.

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

People were treated with kindness, respect and compassion and they were given emotional support when needed. They had also been supported to express their views and be actively involved in making decisions about their care as far as possible. People had access to lay advocates if necessary. In addition, confidential information was kept private.

Information was provided to people in an accessible manner. In addition, people had been supported to pursue their hobbies and interests. The registered manager recognised the importance of promoting equality and diversity. People’s concerns and complaints were listened and responded to in order to improve the quality of care. Arrangements had been made to support people at the end of their life.

There was a registered manager who promoted a positive culture in the service that was focused upon achieving good outcomes for people. They had also taken steps to enable the service to meet regulatory requirements. Staff had been helped to understand their responsibilities to develop good team work and to speak out if they had any concerns. People, their relatives and members of staff had been consulted about making improvements in the service. The provider had put in place arrangements that were designed to enable the service to learn, innovate and ensure its sustainability. There were arrangements for working in partnership with other agencies to support the development of joined-up care.

Further information is in the detailed findings below.

We carried out an unannounced inspection of the service on 21 January 2016. Fernleaf Residential Home is registered to accommodate up to twenty one people who require nursing or personal care. At the time of the inspection there were eighteen people using the service.

On the day of our inspection there was 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.

The risk to people’s safety was reduced because staff had attended safeguarding adults training, could identify the different types of abuse, and knew the procedure for reporting concerns. Accidents and incidents were investigated and used to reduce the risk to people’s safety. Regular assessments of the risks to people’s safety, the environment in which they lived and the equipment used to support them were carried out. People had personal emergency evacuation plans (PEEPs) in place.

People were supported by an appropriate number of staff. Appropriate checks of staff suitability to work at the service had been conducted prior to them commencing their role. People were supported by staff who understood the risks associated with medicines. People’s medicines were stored safely; however the temperature of the room in which they were stored did on occasions exceed recommended limits.

People were supported by staff who completed an induction prior to commencing their role and had the skills and training needed to support them effectively. Although there were a small number of areas where some staff required refresher training.

The registered manager ensured they had recorded how the principles of the Mental Capacity Act (2005) had been applied when decisions had been made for people. The appropriate processes had been followed when applications for Deprivation of Liberty Safeguards had been made.

People spoke highly of the food and were supported to follow a healthy and balanced diet. People’s day to day health needs were met by staff and external professionals. Referrals to relevant health services were made where needed.

Staff supported people in a kind and caring way. Staff understood people’s needs and listened to and acted upon their views. Staff responded quickly to people who had become distressed and communicated well with people living with dementia.

People told us they were provided with the information they needed that enabled them to contribute to decisions about their care. People were provided with information about how they could access independent advocates. People’s friends and relatives were able to visit whenever they wanted to.

People were involved with planning the care they wanted to receive from staff. People’s care records were written in a person centred way and staff knew people’s likes and dislikes and what interested them. People were encouraged to do the things that were important to them and they were supported to follow their hobbies and interests. People were provided with the information they needed if they wished to make a complaint.

The registered manager led the service well, understood their responsibilities and were well liked and respected by people, staff and relatives. People and staff felt the service was well managed. Staff understood what was expected of them and processes were in place to delegate further roles of responsibility to staff.

People were encouraged to provide feedback and this information was used to improve the service. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.