This was the first inspection of Fernhill Court since the new provider took over the running of the service on 28 June 2017. The inspection took place on 17 and 19 December 2018 and was announced.

Fernhill court provides personal care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support services.

Not everyone using Fernhill Court receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; such as help related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing a service for 20 older people with a variety of care needs, including people living with physical frailty or memory loss due to the progression of age.

A registered manager was not in post at the time of our 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. A new manager had started with the service and will be applying to register with the commission. We refer to them as the ‘manager’ throughout the report.

People’s Medication Administration Records (MARs) were not always recorded appropriately and not all staff had been assessed as competent to administer medicines. There were no guidelines in place to support staff with the administration of ‘when required’ (PRN) medicines.

People felt staffing levels were not always consistent but felt it had improved recently. Relevant recruitment checks were conducted before staff started working at the service to make sure staff were of good character and had the necessary skills. However, there were unexplained gaps in staff employment histories.

Most people we spoke with felt staff had the skills and qualities and skills to deliver effective care. However, staff did not feel supported. Records showed one to one supervisions had fallen behind and training was not always in place to support staff.

People did not always feel listened to and felt that complaints were not dealt with effectively. People felt the service was not well led and raised concerns with us. The provider did not complete required documentation when requested.

Care plans showed some records needed to be updated and we could not see if records had been reviewed with people to ensure they were delivering person centred care.

People using the service and their relatives told us they felt safe. Staff understood and followed guidance to enable them to recognise and address any safeguarding concerns about people.

People were treated with kindness and compassion. Staff were able to identify and discuss the importance of maintaining people’s respect and privacy at all times.

People were supported with their nutritional needs when required. Heath professional were contacted were involved with peoples care when required.

During our inspection we found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.