Fernhill House

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. The provider was not always working in accordance with The Mental Capacity Act 2005 and there was no evidence of the provider following best interest decision processes where medicines were administered covertly.

Some care plans and risk assessments were overdue on the first day of the inspection. A visit by the local authority prior to our inspection had resulted in a suggestion to improve wound care plans, however, limited evidence of improvement was available during our inspection.

Governance and quality assurance at the service were not always effective. The provider's systems and processes such as regular audits of the service had failed to identify issues found during this inspection.

People were safeguarded from the risk of harm or abuse. Staff were recruited safely. People were supported by a sufficient number of staff. When people required additional support from external services, they were promptly referred by staff who were skilled in recognising when people's needs change.

People, their relatives and staff spoke highly of the management team. They felt the service had an open culture, where the registered manager was available to support them and encouraged feedback, both positive and negative.