Fairfield Nursing Home

Updated 14 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out b two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fairfield Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. [Care home name] is a care home [with/without] nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been appointed but had not yet taken up post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with four people living in the home, four relatives, five members of staff, the deputy manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included six people’s care records and multiple medication records. We looked at five files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 14 February 2023

About the service

Fairfield Nursing Home is a residential care home providing personal and nursing care to up to 30 people. The home is a detached property set in its own grounds in a quiet residential area. The service provides support to people in need of nursing support, respite care, end of life care and general assistance with everyday living for people with dementia. At the time of our inspection there were 25 people using the service.

People’s experience of using this service and what we found

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.

Medicines were not managed safely and the monitoring information for people living in the home was not always completed fully. Risks in relation to people's care had not been properly assessed.

People’s dietary needs were identified, however there was no adequate system in place to ensure catering staff had accurate information about people’s dietary needs or risks.

The systems in place to monitor the quality and safety of the service were not always used effectively to identify and mitigate risks including allegations of abuse.

Information regarding some agency staff not always available and the information provided to agency staff for the safe care of people was not always up to date.

There were a range of audits completed by the provider and manager, however they were not always effective in identifying and bringing about improvements.

Permanent staff were recruited appropriately and they received training and support for their role. There were enough staff on duty on the day of inspection to meet people's needs.

Equipment had been serviced and maintained and accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence. The environment seemed clean and welcoming however it had been recognised by the provider that refurbishment was needed.

Complaints were managed appropriately, and referrals were made to other professionals when people living in the home were in need.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 01 November 2017.)

Why we inspected

The inspection was prompted in part due to concerns received about the use of medicines, recruitment, and governance of the service. A decision was made for us to inspect and examine those risks.

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.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairfield Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

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 will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the need for consent, fit and proper persons, medicines management, risk management and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.