This inspection was unannounced and took place on 31st January and 13th February 2017. This was done to enable us to speak with people who used the service. The Ferns is one of three small homes owned by the same provider.

At our last inspection on 29 October 2014 we found that The Ferns was not meeting the regulatory requirement to ensure that effective systems were in place to monitor and assess the quality of the home. We returned to the home on 15 October 2015 and found that improvements had been made and the regulatory requirement had been met.

The Ferns is registered to provide accommodation for up to 6 people who have a learning disability and mental health needs who require support with personal care. There were five people living at the home when we completed this inspection.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There were two registered managers for the home who share this role, one of whom was a registered provider.

People and staff said that they felt safe at The Ferns. Staff we spoke with knew what action to take if they were concerned about a person who used the service being at risk of harm or the practices of a colleague. They were confident that if they raised concerns with the providers they would be listened to and action would be taken to address the issue.

Recruitment and selection procedures were in place to help protect vulnerable people from staff who may be unsuitable to work with them. Staff knew people well, and there were enough staff on duty to meet people’s needs.

There were procedures in place to ensure people received the appropriate support to manage their medicines. People were cared for in a safe and clean environment.

We saw that the home was comfortable, homely, clean and tidy. Some areas of the home had recently been decorated and the provider was aware that the home appeared tired in parts of the hall and stairways.

People who used the service had the capacity to make decisions about what they did and the choices they made. The staff we spoke with had a good understanding of people’s risks and personal preferences so that they could support people safely and effectively.

People had been asked about what they wanted to eat and were involved in menu planning and shopping for food to help promote choice and independence.

Everyone who used the service had the capacity to make decisions about what they did and how they spent their time.

Staff received the training and support from the providers to help support people safely and effectively.

People had access to the healthcare professionals that they needed, and were supported to attend routine appointments to help maintain their wellbeing.

The relationships we saw between people who used the service and support workers were warm, frequent and friendly. The atmosphere was calm and relaxed.

People were involved in developing their own person centred care plan, which included their personal preferences and wishes.

People chose which individual activities they wanted to be involved in and were able to take part in group activities if they wanted to, both in the home and in the community.

Systems were in place to record and review complaints. People no longer attend residents meetings and this was at their request. We saw people were encouraged to express their views about the service and we saw that they did so freely and openly.

Staff members we spoke with said that the registered manager and the providers were very approachable and supportive and they enjoyed working at The Ferns.

At our last inspection visit on 29 October 2014 we found that The Ferns was not meeting the regulatory requirement to ensure that effective systems were in place to monitor and assess the quality of the home. This visit was undertaken to check that the provider had made improvements. We found that this was the case and the requirement had been met.

At our last inspection we were told by the local commissioning team and by the provider in their PIR that there were shortfalls in quality monitoring and assurance processes, though efforts were being made to make improvements. At this inspection we were informed by local commissioners that the home had achieved a Grade A from them at the last quality review undertaken by them and the action plan had been completed.

We saw that new systems had been put in place and an annual tracker sheet was being used to remind staff of what action they needed to take. We were told by the providers that staff had been involved in this process and they confirmed this to be the case. We also saw that the provider had made significant headway with the electronic computerised system that had been purchased since our last inspection visit. The computerised system had been set up in each of the providers three homes and included audit information and all the homes policies and procedures. Plans were in place to add person centred planning documents for people who used the service into the new system. This system could be monitored remotely by the providers.

This inspection was unannounced and took place on 31st January and 13th February 2017. This was done to enable us to speak with people who used the service. The Ferns is one of three small homes owned by the same provider.

At our last inspection on 29 October 2014 we found that The Ferns was not meeting the regulatory requirement to ensure that effective systems were in place to monitor and assess the quality of the home. We returned to the home on 15 October 2015 and found that improvements had been made and the regulatory requirement had been met.

The Ferns is registered to provide accommodation for up to 6 people who have a learning disability and mental health needs who require support with personal care. There were five people living at the home when we completed this inspection.

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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. There were two registered managers for the home who share this role, one of whom was a registered provider.

People and staff said that they felt safe at The Ferns. Staff we spoke with knew what action to take if they were concerned about a person who used the service being at risk of harm or the practices of a colleague. They were confident that if they raised concerns with the providers they would be listened to and action would be taken to address the issue.

Recruitment and selection procedures were in place to help protect vulnerable people from staff who may be unsuitable to work with them. Staff knew people well, and there were enough staff on duty to meet people’s needs.

There were procedures in place to ensure people received the appropriate support to manage their medicines. People were cared for in a safe and clean environment.

We saw that the home was comfortable, homely, clean and tidy. Some areas of the home had recently been decorated and the provider was aware that the home appeared tired in parts of the hall and stairways.

People who used the service had the capacity to make decisions about what they did and the choices they made. The staff we spoke with had a good understanding of people’s risks and personal preferences so that they could support people safely and effectively.

People had been asked about what they wanted to eat and were involved in menu planning and shopping for food to help promote choice and independence.

Everyone who used the service had the capacity to make decisions about what they did and how they spent their time.

Staff received the training and support from the providers to help support people safely and effectively.

People had access to the healthcare professionals that they needed, and were supported to attend routine appointments to help maintain their wellbeing.

The relationships we saw between people who used the service and support workers were warm, frequent and friendly. The atmosphere was calm and relaxed.

People were involved in developing their own person centred care plan, which included their personal preferences and wishes.

People chose which individual activities they wanted to be involved in and were able to take part in group activities if they wanted to, both in the home and in the community.

Systems were in place to record and review complaints. People no longer attend residents meetings and this was at their request. We saw people were encouraged to express their views about the service and we saw that they did so freely and openly.

Staff members we spoke with said that the registered manager and the providers were very approachable and supportive and they enjoyed working at The Ferns.

The Ferns is an ordinary house situated on a main road that goes into the town centre. There are good transport links into Bury and Manchester. There is a large park opposite and local shops and public houses nearby.

There were six people living at the home at the time of our visit. Three people were at home and three people were out either visiting family, attending a doctor’s appointment or at a local outreach or day centre. Two people were watching television in the lounge. One person said that they were enjoying their retirement from work and liked to watch a movie on television in the afternoon.

People told us that they liked the food provided at the home. The support worker said that if a person did not like what was on the menu then an alternative meal would be provided.

People living at the home told us that support workers helped them to clean their bedrooms and changed their bedding every week. To help maintain their independence people who were able also took responsibility for other household tasks such as washing and drying the pots and bringing in the milk and putting out the bins.

We saw that there were frequent and friendly interactions between people and the support worker. The atmosphere was relaxed and friendly.

Before our visit we contacted the local commissioning and safeguarding teams. They informed us that they had no concerns about the service.

One person we spoke to talked about all the homes they had stayed at previously. They said “I have been in a lot of homes. I love it here, it is the best.”

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

People we spoke with told us that they liked and got on well with the staff. We saw people living at the home speaking openly and freely giving their opinions to staff during our visit.

People we spoke with told us that they could speak to the manager or a staff member if they had any problems or concerns. They said that they were confident that they would be taken seriously and they would do their best to sort the problem out. Some people also said that they could speak to a relative and they would help them.

Prior to our visit we contacted the local safeguarding and commissioning teams about the service. They informed us that they had no concerns about The Ferns.

We visited the home on 11 January 2012 at 12.30pm. When we arrived three people living at the home were in the dining room finishing their lunch. One staff member was on duty and they were busy with household tasks. They all made us feel very welcome. One person who lived at the home was out at the outreach centre that they attended on a daily basis and another person was on holiday with their family.

We spoke with two of the people living at the home. Both people had lived at the home for a long time. They said that they had no concerns or worries about living at the home. The third person had limited communication but they appeared happy, they smiled at us and were enjoying a cup of tea.

We talked with the staff member who told us that they had worked at the home for over one year. They told us that they were well supported by both registered managers who were described as "always approachable." They said that the managers were available on call at all times and rang regularly to check that they were alright and asked if they had any concerns. They confirmed that they had not experienced any issues that they could not manage and they really enjoyed working at the house.

The organisation has three care homes covered by two registered managers, one of whom is the provider. They both came to the home to talk with us about The Ferns and also give updates on the other two homes. They raised no concerns or issues about The Ferns.

We also asked the local adult care commissioning and safeguarding teams whether they had any concerns about The Ferns. They confirmed that at this time they had not.