Ferns Nursing Home is a care home for 39 older people. 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.

Ferns Nursing home provides nursing care with trained nurses available throughout the day and night. The home specialises in the care of older people. The majority of accommodation is on the ground floor with a small number of rooms on the first floor which can be accessed by a passenger lift. At the time of the inspection there were 36 people living at the home.

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.

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At this inspection we found the service remained Good.

Why the service is rated good

Since the last inspection a new manager and nominated individual had been appointed and registered with the Care Quality Commission.

The new registered manager had begun to implement changes and improvements to the home and the care people received. People and visitors felt the registered manager and staff were very approachable and keen to listen to their views and ideas.

People felt safe at the home and with the staff who supported them. There were systems in place to minimise risks to people and staff knew how to report concerns. The environment was regularly audited and well maintained which meant people lived in a pleasant and safe environment.

People received effective care and support because their health was monitored by trained nurses who made sure they received prompt treatment to meet their individual needs. All staff received training to ensure they were practising in accordance with up to date best practice guidance and legislation.

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.

People were cared for by staff who were kind and friendly. Comments about staff included, “They chat with me quite pleasantly, if I want anything, they will do it” and “They make me feel comfortable, if I want something in particular, they run around for it”

Staff were responsive to people’s wishes and adapted care and support to meet people’s changing needs. People felt able to follow their own routines. One person told us, “It’s quite relaxed. You can do what you want to.”

People had access to a range of social activities which were inclusive of everyone regardless of their culture, background or abilities. Where people choose not to join in their privacy and independence were respected.

Further information is in the detailed findings below

Ferns Nursing Home is a care home with provides personal and nursing care to up to 39 people. The home specialises in the care of older people. At the time of the inspection there were 34 people living at the home.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good

Why the service is rated Good.

People felt safe at the home and with the staff who supported them. One person told us, “It’s a comfort to know there is always someone here. That makes you feel safe.” The provider had appropriate systems to make sure staff were thoroughly checked before they began work and knew how to recognise and report any suspicions of abuse. People received their medicines safely from registered nurses.

People received food and drinks which met their dietary needs and took account of their preferences. One person told us, “Food is always very nice.” People’s healthcare needs were monitored and the home supported people to access healthcare professionals according to their individual needs. 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.

People were cared for by staff who were kind, caring and patient. People’s privacy and dignity was respected and personal care was provided in accordance with people’s wishes. People or their representatives were fully involved in decisions about their care and treatment including the care they would like to receive at the end of their lives.

Care and support was personalised to people’s individual needs and wishes. One person said, “They get used to how you like things done and they always oblige.” People had access to social and mental stimulation through group activities, trips out and one to one support. The provider had a complaints procedure which made sure all complaints were investigated and action was taken to address any identified shortfalls in the care provided.

People benefitted from a management team who were open and approachable and had systems in place to seek people’s views and ensure ongoing improvements to the service. The home was well maintained to ensure the safety and comfort of people. Staff morale was good which helped to create a happy and relaxed atmosphere for people to live in.

Further information is in the detailed findings below.

The service was meeting the needs of older people, most of whom needed nursing care due to long term physical conditions. The home had an open, friendly and lively atmosphere. We observed frequent, respectful interaction between people and staff and people speaking to each other in a friendly manner.

One person we spoke with told us ‘You get everything you need here, the staff are all very helpful and you can do things in your own time’.

One person told us they were very happy living in the home and that the staff 'they always tell you what's going on'. Another person told us that the staff always asked 'would you like to?' and respected their choices.

We saw that staff used signals and gestures for people unable to respond verbally and this appeared to reflect their knowledge of people and their relationships with them. We found a system of individual care planning in place which was regularly reviewed for each person.

The service worked well with other agencies to meet care standards. We found evidence that staff were trained to understand their role in safe use of medicines. We spoke with six staff members who expressed a highly positive commitment towards the people who used the service and to the home.

We observed an open culture of feedback from relatives and encouraged suggestions from staff about improvements. There were systems to identify and manage risks relating to the service and for monitoring and checking quality and safety in the home.

We spoke with seven people who lived in the home. They told us that staff provided the care and support they needed. Everyone spoke very highly of the home. People said staff were very patient and kind and they listened to them. One person said “they don’t tell you what to do, the staff, they always ask you”.

We spoke with three relatives who were visiting people who lived in the home. They had been involved in choosing this home for their relative. One told us “we couldn’t have found a better nursing home. We looked at a few different ones. I’ve no doubt that we picked the best place for mum”.

Regular activities and events were arranged, as were occasional trips out of the home. The weekly activity programme was given to each person so they could choose what they wanted to take part in. Activities included flexercise (a chair based gentle exercise programme), quizzes, sing along, cinema club, card games, craft sessions and garden activities.

People who lived in the home told us they felt very well cared for and that staff were available when they needed them. People said staff helped them to do the things they needed help with. Comments from people included “the staff understand what help I need. I’m very happy here”, “I’ve no complaints. I’m very happy here” and “I’m so happy here. All the staff are very kind”. People told us staff arranged for them to see their GP or other health care staff if they needed to.

People told us they liked the food served in the home. Meals were discussed regularly and were always on the agenda for residents’ meetings. Some people chose to eat in their own rooms; others ate in the main dining area. One relative said “I come in every day and have a nice meal with my husband. The food is very nice here. It’s really nice to come in and spend time with him”.

People we spoke with said they thought the home was a safe place for them to live. One person said “it is a safe place for me. I have never had any complaints since moving here”. One person told us they chose to move to this home because they did not feel safe in their own home after they had a fall. They told us “I couldn’t go home so I moved here. I do feel very safe here”.

Visitors we spoke with said the home was a safe place for their relatives. One told us “I have never had any worries about safety. They always make sure mum is safe. The manager runs a very tight ship here and they wouldn’t let anything go”.

People who lived in the home spoke very highly of the staff team. Many people told us that staff “went out of their way” to ensure they were well cared for. They said staff were available when they needed them and they understood the care and support they needed. One person said “all the staff are lovely and have been very kind”.

Visitors we spoke with said there were enough staff to meet people’s needs. There were always a variety of staff working, including qualified nurses. One relative said “the staffing levels seem pretty consistent. They are a lovely group of staff”.

People who lived in the home and their visitors told us they were asked to give their views on the home and that they were listened to. They told us about the resident’s meetings and the relatives’ meetings. They said they felt able to raise any issues with any of the staff.

One relative told us “I visit every day. I’ve no complaints whatsoever. There are meetings but you can talk to the staff when you are here. You don’t have to wait for the meetings. They are always interested in what you have to say”.

This inspection was unannounced and took place on 28 and 29 April 2015.

Ferns Nursing Home is registered to provide nursing care and accommodation to up to 39 people. The home specialises in the care of older people.

There is 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.

People described the registered manager as open and approachable. People felt able to raise concerns with them and were confident any complaints or concerns would be responded to. There were regular meetings for people who lived at the home to enable them to keep up to date with changes and share their views.

There was a staffing structure which provided clear lines of accountability and responsibility. In addition to the registered manager there was a deputy and a team of registered nurses and senior carers. This ensured people always had access to experienced senior staff.

People told us they felt safe at the home and with the staff who supported them. People said staff were kind and sensitive when assisting them. One person said “I rely on the staff for everything. They are always kind and I always feel very safe with them.”

There was sufficient staff to meet people’s needs in a relaxed and unhurried manner. People received care promptly if they requested assistance. The registered manager kept staffing levels under review and made changes to ensure people’s needs were met.

People’s clinical needs were monitored and met by a team of registered nurses. Registered nurses had opportunities to undertake training which kept their skills and knowledge up to date. One person said “You can always talk with the nurse if you’re feeling a bit ropey. They’re very helpful.” In addition to healthcare support from registered nurses people were referred to other professionals according to their individual needs.

All staff had access to on-going training to make sure they had up to date knowledge to enable them to safely and effectively support people. People had confidence in the staff who worked at the home.

People had their nutritional needs assessed and food was provided in accordance with people’s needs and preferences. Without exception people were very complimentary about the food served. Comments included; “Food is very good,” “Food couldn’t be better and there’s always a choice” and “All meals are excellent. Always plenty to eat.”

People said they were supported by kind and caring staff. Comments included; “Staff are kind and gentle when they help” and “Staff are always polite and cheerful.”

People received care that was responsive to their needs and personalised to their wishes and preferences. People told us they were able to make choices about all aspects of their daily lives. The staff responded to changes in people’s needs and care plans were up dated to make sure they reflected people’s current needs and preferences.

People were able to take part in a range of group and one to one activities according to their interests. One person told us “One of the good things about here is there’s always something to occupy you.”