About the service Fern Leaf Carehome (26 Purleigh Avenue) is a care home registered to accommodate and support up to six people with physical disabilities, learning disabilities and/or autistic people. At the time of the inspection, six people were living at the home. The service is a two-floor building. Each floor has separate adapted facilities.
People’s experience of using this service
We expect health and social care providers to guarantee people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, Right care, Right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right support:
- The provider had not ensured the premises was safe because windows were not fitted with restrictors. This put people at potential risk of serious injury. The provider did not have adequate systems to discuss people’s wishes should they require end of life support. We have made a recommendation about end of life care. People were supported to make decisions on how their current care and support was delivered to them. They were supported to integrate into the local community and be as independent as possible.
Right care:
- Care was personalised and staff ensured people's dignity, privacy and human rights were respected.
Right culture:
- The values and attitudes of staff and managers in the home encouraged people to be as independent as possible and feel they could go about their daily lives. However, quality assurance systems to monitor the quality and safety of the service had not identified some of the shortfalls we found.
People were supported to have maximum choice and control of their lives. Staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. However, improvement was needed with paperwork because records to show people had consented to certain aspects of their care and support were not always completed.
People told us they felt safe in the home. Systems were in place to protect people from the risk of abuse. Risks to people’s health were assessed so staff could support them safely. Medicines were stored and managed safely by trained staff. Recruitment procedures ensured staff who were suitable were recruited to work with people. There were suitable numbers of staff present, at all times. Systems were in place to prevent and minimise the spread of infections. Lessons were learned following accidents and incidents in the home.
Staff were trained to carry out their roles and received an induction upon their employment. Staff felt supported in their roles.
People were encouraged to maintain a balanced diet and their nutritional needs were monitored. People attended health appointments with professionals to ensure they remained in good health.
People and staff had developed positive relationships with one another. Care plans were personalised to ensure people received care that met their needs and preferences. People participated in activities and were supported to avoid social isolation. Systems were in place to manage complaints. People’s communication needs were met. Feedback was sought from people to help make continuous improvements to the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 30 April 2020 and this is the first inspection. The last rating for the service under the previous provider was Good, (report published on 15 October 2018).
Why we inspected
This was a planned inspection because the service had not been inspected since registering under a new provider.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014 in relation to premises and equipment and good governance.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.