We carried out an inspection of Fernbank Residential Home on 9 January 2017. The inspection was unannounced and conducted by an adult social care inspector. We last inspected Fernbank Residential Home in February 2014 and found the service was meeting the relevant regulations in force at that time.

Fernbank Residential Home provides accommodation, nursing and personal care for up to 32 people, including people living with dementia. There were 24 people accommodated there on the day of our inspection.

The service had a registered manager in post. 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.

People were safe. The registered manager and staff team were all knowledgeable about safeguarding issues and protected people from harm. Where concerns had been raised previously, the registered manager worked with the local authority safeguarding team and made changes where these were needed. The staff team knew how to raise and report concerns if they witnessed, suspected or were told about any bad practice or abuse. All staff had received training in safeguarding adults. Medicines were administered to people safely.

Risks relating to people's care were assessed and reviewed each month. Staff were familiar with risks associated with people's care and records showed that control measures that had been put in place to minimise risks to people where appropriate.

The accommodation provided was to a good standard, with a variety of pleasantly decorated and well furnished lounges and seating areas. The building was safe and well maintained. The property was in the process of being extended and as such had additional signage to improve safety and highlight potential hazards. Other risks associated with the building and working practices were assessed and steps taken to reduce the likelihood of harm occurring. The home was clean throughout.

Any risks to people's health and welfare were assessed. The care plans included instructions on how to reduce or eliminate the chances of injury. Where people needed to be assisted to move, their moving and handling needs were assessed and a moving and handling plan was written.

Staffing numbers on each shift were calculated to ensure each person's care and support needs could be met. Staff were provided with regular training and were supported by their colleagues and the registered manager to do their jobs.

The registered manager and the staff team were aware of the principles of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. People were asked to give consent to care, support and treatment. Where people lacked the capacity to do this, staff worked within best interest decision making procedures.

People enjoyed their food and were provide with a varied and balanced diet. People's health needs were met and they had access to external professionals as required.

Staff were kind and caring and understood people's needs. People were involved in decisions about their care. People's privacy and dignity was respected.

People using the service and staff spoke well of the registered manager and they felt the service had good leadership. Good communication was evident between staff working different shifts. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care and oversight from external managers.

People's needs were assessed and care and treatment was planned and delivered according to people's individual care plans. We saw people were given appropriate information to help them with their choice of home; this was also available to relatives when they had to make a choice on behalf of their family member.

People who used the service told us they liked living in the home. "Staff are kind and caring and always help me when I call them". "I have a lovely room and they keep it so clean". People were given control to make lifestyle choices and we saw evidence that care was directed around the needs and choices of the people living in the home.

The home was clean and hygienic and staff were aware of their responsibilities regarding infection control. The staff we spoke with told us they liked working in the home. They said they had received the training and supervision necessary to undertake their roles.

We saw staff offered care and support to people who used the service in a sensitive, caring and professional manner. We looked at the provider's quality assurance systems and found a range of monitoring processes in place to monitor the quality of the service provided.

We spoke with three people who lived at Fernbank. People told us that they were treated with respect and were involved with their care. One person said they were "More than satisfied" and "I'd be quite happy to stay here the rest of my life." Another person said, "It's really lovely . . . staff are really nice."

We found that people were protected from the risk of abuse and unsafe care. People told us they felt safe living at Fernbank. Staff members had received appropriate safeguarding training and were knowledgeable about these procedures. Background checks were done on members of staff to ensure they were of good character.

We spoke with two members of staff who told us they received appropriate training and support in their roles. We saw that staff had received yearly refresher training in key areas of health and caring for people. Staff also received regular supervisions, appraisals and had support from their managers and colleagues. Staff expressed high job satisfaction and one member of staff commented, "I love it."

We spoke with five people who live at Fernbank Residential Home. People told us that they received a high quality of care and were happy living at the home. People told us that the staff were kind and respectful. One person said of the staff, “I think they’re very caring, very pleasant to talk to.” Another person said the quality of care was “excellent.”

We spoke to four people during the visit. Each person commented that they like living at the home. One person commented, “I’m very satisfied. I couldn’t wish for better.”

People said they were able to make choices in how they spent their time, where they ate their meals and what they ate. This included times for getting up and going to bed as well as a choice of breakfast meals. People said they were asked in advance what they would like to eat for each meal

People said they were satisfied with the care and support they received. Comment was made that the care was “good” and “very good.” Another person said he/she was looked after well.

People said when they used the call point to ask for assistance staff always responded promptly.

Each person said they felt safe at the home. One person said, “I feel safe knowing that staff are just the other side of the bedroom door.”

People described the staff as very kind, pleasant and helpful.

The home was said to provide sufficient numbers of staff to meet people’s needs although one person said he/she wished there were more staff on duty on some days.

People told us the home provided a range of activities including entertainment and talks. Two people commented that they were aware that activities were being provided on the afternoon of the inspection visit. One person commented that he/she can choose whether or not to join in with the activities. Another person said he/she attends a club outside the home one afternoon a week.