- Care home
Fairland House
Report from 10 January 2024 assessment
Contents
On this page
- Overview
- Person-centred Care
- Care provision, Integration and continuity
- Providing Information
- Listening to and involving people
- Equity in access
- Equity in experiences and outcomes
- Planning for the future
Responsive
Experience over time for people using this service has been poor and the provider has not always employed the right number of staff or had effective management and oversight in place. This has meant various experiences and change over of staff. Speaking to one person they said there has been poor communication over changes within the service and they have had poor experiences such as a poor mealtime experiences which have improved dramatically since a new chef has been employed and a more robust management team put in place. Relatives also describe a rocky road with their concerns not being listened to or dealt with effectively, meaning they were having to raise issues more than once. We had renewed confidence in the current management team and the changes they were implementing, with a focus on person centred care through improved staffing ratios, more effective person-centred planning and integrated working. They also agreed training and supporting staff to improve their professional practice was high on their agenda, but they were getting to know staff and observing their practices to identify gaps in staff knowledge.
This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Person-centred Care
During our site visit we noted that routines were flexible and there were no set times for breakfast. Staff supported people at their own pace but were still assisting people up to lunch time. Lunch was well organized. Activities were provided but could be enhanced if the activities coordinator had more support. The activity schedule was not robust, listing only one activity a day and nothing at the evening or weekends, although the activities coordinator said about creating down time and putting a film on in the evening. It was pleasing to see televisions in communal areas were off and people were listening to music and chatting. After lunch more people came downstairs. Care plans identified peoples individual needs but further steps could be taken to help people have more autonomy and control over their lives such as being given the opportunity to take their own medicines, or creams and make informed decisions about what they were taking. Being encouraged to take part in daily life and have a say and influence over their care.
People had experienced inconsistent care over time which had impacted on their view of the service. We spoke to people and relatives who had concerns about safety and basic care. However, things did appear to be improving and we observed staff speaking to people kindly. Audits helped to identify concerns with the service, but it was not clear how people and relatives were able to influence change within the service or affect their care. For example, there was no resident of the day and meetings were poorly established. There was no longer a key worker system which might ensure people had a point of contact.
The manager had relevant experience and was mindful of what needed to change. The electronic care planning records they said were working well but the manager was reminded that records must be accurate and concise and people and their relatives when holding power of attorney should be given access to records if requested. The manager said they would reestablish the key worker system and resident of the day or something similar. There were daily handovers and heads of department meetings to focus on risk. The manager and deputy were visible around the service and one staff member had said they had learnt more in the last few weeks than the whole time they had been employed due to the hands-on approach of the new management team. Observations of lunch during our site visit was really positive, and we saw there had been some dining room audits which hadn’t been good, but lessons had been learnt and practices improved to enhance people’s experiences. The manager also agreed to review why people were in their rooms and if this was their choice or more to do with staffing and not being aware of what activities were taking place.
Care provision, Integration and continuity
We did not look at Care provision, Integration and continuity during this assessment. The score for this quality statement is based on the previous rating for Responsive.
Providing Information
We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.
Listening to and involving people
During this site visit there were processes in place to gain peoples feedback and family members told us they were able to raise concerns although they had not found the service to be particularly responsive. The provider did not have regular mechanism to capture peoples feedback and act on concerns. Complaints were recorded and actions were taken but there was limited learning to ensure the quality of care improved. One relative told us of the concerns they had about the care and said things had improved but only after raising concerns three times. We make it easy for people to share feedback and ideas or raise complaints about their care, treatment, and support. We involve them in decisions about their care and tell them what’s changed as a result.
Equity in access
We did not look at Equity in access during this assessment. The score for this quality statement is based on the previous rating for Responsive.
Equity in experiences and outcomes
People had good access to health care as there was regular input to a GP practice and concerns or changes in need were identified by the staff in the home. Improvements to care records would help to enhance people’s experiences of care and flag up in a timely way any changes necessary to people’s support. Greater involvement and inclusion of people in all aspects of their care would greatly improve this service.
Planning for the future
We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.