Fern Lea is registered with the Care Quality Commission (CQC) to provide care and accommodation for 18 older people, some of whom may be living with dementia.

It is situated in a public park and has good access to local facilities and amenities. It also has good access to public transport routes to the city centre.

The service was last inspected in June 2015 and found to be compliant with the regulations looked at. Following this inspection the service remains good.

People were cared for by staff who understood their needs and who had received training in how to keep them safe from harm. Staff were able to recognise the different types of abuse they may come across and how to report this to the proper authorities. The provider had systems in place which ensured staff were recruited safely and people who used the service were not exposed to staff who had been barred from caring. The provider made sure there were enough staff on duty both day and night to make sure people’s needs were met. The service was clean and free from malodours and the staff used personal protective equipment, like gloves and aprons, to lessen the risk of cross infection. People’s bed rooms were clean and tidy and they contained furniture and other personal items which people had brought with them when they had moved into the service. Procedures were in place for staff to follow in the event of an emergency.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The provider made sure staff had received training which helped to meet the needs of the people who used the service; however we have advised that the topics for training could be more varied. People who used the service could have a choice of food at every meal time and snack and drinks were provided. The staff closely monitored people’s food and drink intake and consulted with health care professionals if any problems arose, for example, difficulty with swallowing or a loss in apatite. People’s weight was monitored, any changes were noted and action taken when needed. People were provided with a range of activities both inside and outside of the service. The staff supported people to access health care professionals when needed and accompanied people on appointments to the hospital or their GP.

People who used the service had good relationships with the staff. Interaction was friendly and there was a lot of laughter around the service. People or their representatives were involved with the formulation of care plans. Staff understood the importance of respecting people’s dignity, privacy and choices and could describe to us how they would maintain this.

Care plans described the person and their life experiences; they also documented what was important to the person. People or their representative had been involved with formulating their care plan and these reflected people’s choices when it came to the support they wanted and how they wanted this delivered by the staff. The provider had a complaints procedure which could be accessed by the people who used the service or anyone else who an interest in their wellbeing. All complaints were investigated and the outcome shared with the complainant. Any changes made as a result of a complaint were shared with the staff and action taken to make sure the issues didn’t happen again.

The provider was accessible and people who used the service, their relatives and staff all found them supportive and approachable. Systems were in place to ensure the service was well run and audits were undertaken to make sure the processes, policies and procedures which were in place were effective and safe. The provider sought the views of the people who used the service, their relatives and the staff about how the service was run and produced a report of any findings; they also had an action plan for improvements to the se

Fern Lea is registered with the Care Quality Commission [CQC] to provide care and accommodation for 18 older people who may be living with dementia.

It is large converted Victorian building and accommodation is provided over three floors. The upper floors are accessed by stairs or stair lifts, there is no passenger lift. Communal areas on the ground floor comprise of a lounge and a dining room. The garden has been adapted with raised flower beds and seating areas.

It is situated in a park and has good access to local facilities and amenities. It also has good access to public transport routes to the city centre.

This inspection took place on 29 June 2015 and was unannounced. The service was last inspected in April 2014 and was found to be compliant with the regulations inspected at that time.

The registered provider is also the registered manager. A registered manager is a person who has registered with the CQC 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.

Staff understood the importance of reporting abuse if they witnessed it and how to keep people who used the service safe from harm. They had received training in how to recognise abuse and how make sure this was reported to the proper authorities.

Staff had been recruited safely and were provided in enough numbers to meet the needs of the people who used the service. This ensured, as far as practicable, people needs were met and they we not exposed to staff who had been barred from working with vulnerable adults.

People who used the service were provided with a wholesome and nutritious diet which was of their choosing. People’s weight and food consumption was monitored and staff involved health care professionals when needed. Staff had received training which enabled them to meet the needs of the people who used the service; they also received support to gain further qualifications and experience. This meant people were cared for by staff who had the skills and who received support to meet their needs. People’s human rights were respected and upheld by staff who had received training in the principles of the Mental Capacity Act 2005. People were supported to access their GPs and district nurses supported the staff to ensure people’s health needs were met.

Staff understood people’s needs and were kind and caring. People had good relationships with the staff and they had been involved with the formulation of their care plans and reviews. Where people needed support to agree their care this had been arranged and family members had been involved or advocates.

People received care which was person centred and staff understood and respected people’s choice and wishes and respected people’s dignity. The service provided a range of activities for people to participate in, which included activities within the service and in the local community. People were supported to pursue individual hobbies and interests and staff took the time to engage those people who were living with dementia in meaningful activities.

There was a complaint procedure in place for people to use if they felt the need to express dissatisfaction with the service provided. The registered provider investigated any concerns to the satisfaction of the complainant. All complaints were recorded and the outcome shared with the complainant, any action taken as result of a complaint was recorded and any lessons learnt were shared with the staff.

People who used the service were involved with the running of the service. The registered provider sought people’s views and opinions; they also sought the views of others who had an interest in the person’s wellbeing. The registered provider had a range of audits and checks which ensured, as far as practicable, people lived in a safe well run service. The management style of the registered provider was open and inclusive, people who used the service and staff could approach them and felt comfortable doing so. Staff meetings were held so the registered provider could share information with the staff.

The registered provider analysed all incidents and accidents to see if there were any trends or patterns and put action plans in place to address any shortfalls identified. The registered provider informed the CQC of any notifiable incidents so we had up to date information on which to assess the ongoing quality of the service provided.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes. People told us they were happy with the care provided at the service. Comments included, “The staff are marvellous you can’t fault them,” “All the staff are caring and kind” and “If I want anything I just have to ask.”

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Is the service responsive?

The manager regularly asked people who used the service for their opinions about how the service was run. These were analysed and any shortfalls rectified. The service also had a complaints procedure which people could access. People can therefore be assured that complaints are investigated and action is taken as necessary.

Staff followed instructions from visiting health care professionals for example GPs and district nurses. This ensured people received the care and attention they required to meet their needs.

Is the service safe?

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

The registered manager sets the staff rotas, they took people’s care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people’s needs were met.

Is the service effective?

People’s health and care needs were assessed with them and they were involved in writing their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service well led?

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the home and quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

We found that people were consulted about their care and treatment one person told us “The staff are brilliant, can’t think what else they can do for us.”

We saw that information was available for staff to follow to ensure people received care which met their needs. There was also information about how to keep people safe. People told us “There is always someone I can call if I need anything”, “The staff are really kind and caring they help me a lot” and “You just can’t fault the staff they are really very good.”

We saw people were cared for in a well maintained and clean environment; people told us “I have my own wardrobe in my room and some pictures which belong to me.”

We found there were enough staff on duty to meet people’s needs, one person told us “If there is an emergency or I need someone I can always pull the cord and someone sees me really quickly.”

We found that people were consulted about how the home was run.

People who used the service told us they were free to come and go as they pleased. One person told us “You can go to bed when you want and get up when you want, it’s lovely.” Another person told us they go out on a regular basis.

People also told us they thought the care staff very kind and caring. One person said “The staff are wonderful they just can’t do enough for you.”

People said they would see the manager if they had any concerns or complaints and they felt the concerns would be taken seriously and acted upon.