Fairlight Manor

Fairlight Manor is a care home providing personal care to up to 19 people. The service provides support to older people, people living with dementia and other mental health conditions. At the time of our inspection there were 16 people using the service. Fairlight Manor accommodates people across two floors, each of which has separate adapted facilities.

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

Some people were not always kept safe. There were hazards with the environment that were not mitigated. There were stair gates in other areas of the service, however the first floor had a stair gate missing at the top of a staircase. This meant people’s safety was compromised living on that floor were at risk of falling should they have attempted to use the stairs if they were unsupervised or if they were not able to use the lift. This was addressed on the day of inspection.

Risk assessments were not always robust. Staff were not provided with full guidance with how to support people with different health needs and how to respond if health needs changed.

Quality assurance systems were in place to monitor the service people received. However, they had not identified the shortfalls we found at this inspection with regards to risk assessments for people and the environment.

The registered manager did not notify the CQC of incidents in a timely fashion in accordance with their regulatory responsibilities.

Staff understood how to protect people from poor practice and abuse. People told us they felt safe at Fairlight Manor. We observed people to be relaxed in the company of staff. Staff had training on how to recognise and report abuse.

People and their relatives told us they were happy with staffing levels. Staff were recruited safely and were suitable skilled and trained to support people.

Relatives told us they were confident in the care provided to people. People were supported to have choice and control of their day to day lives. Records showed that if people needed other healthcare needs, these were arranged using external healthcare professionals.

Staff supported people in the least restrictive way and in their best interests. Staff, people and relatives were supported to engage with the service. People and relatives told us the management team were approachable and accessible. Staff told us they felt well supported, empowered to develop and that Fairlight had a positive culture to work within.

Rating at last inspection

The last rating for this service was good (published 14 December 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 Fairlight Manor on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation risk assessments, safety and management, and governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

We found the following examples of good practice.

There had been an outbreak of COVID-19 at the home and people had previously been supported to isolate in their bedroom. At the time of our inspection, the home had finished its isolation period and was no longer closed to visitors.

The registered manager told us that during the outbreak some people were unable to understand the need for self-isolation due to living with dementia. A designated space in a communal area was allocated to these people in order to support safe movement around the home without restricting people.

The registered manager had designated the ‘celebration room’, an annexe in the garden for people to receive visitors. Inside the room, chairs had been arranged with tape on the floor marking a two metre distance. Visits to the home were pre-booked. Visitors had their temperatures taken on arrival and were asked to wear face masks during the visit.

The provider had been making renovations around the home before and during the pandemic. These changes to the environment focused on improving infection control around the home. For example, people’s bedrooms had hard flooring and blinds that could be easily wiped clean.

Staff were wearing personal protective equipment (PPE) in line with government guidance. PPE was stored in each person’s bedroom and there were pedal bins in people’s rooms to dispose of PPE safely.

The home is a converted older building, bedrooms are on three floors, and there was a lift to enable people to access all parts of the home and a secure garden to the rear of the building. The registered manager is part owner of the home. The registered manager was not present during the

inspection, we were able to speak with them on the telephone during the inspection and after to discuss our findings and to clarify a few areas.

At the last inspection in July 2015, the service was rated Good. We found no breaches of the regulations. However we did make a recommendation to the provider to provide suitable training for staff to ensure they can meet the needs of people diagnosed with Parkinson’s disease. The provider had taken action and training had been delivered.

At this inspection we found the service remained Good.

Why the service is rated Good:

People, visitors and staff gave us positive feedback about the management team. They were happy to approach them if they had a concern and were confident actions would be taken if required. The registered manager and staff promoted person centred care and a family like atmosphere at the service where people were treated equally with any diverse requirements accepted and met.

There were sufficient numbers of suitable staff to keep people safe and meet their needs. The registered manager often stayed at the service to observe staff levels and staff practice.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (2005) (MCA). Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. They had made appropriate applications to the local authority DoLS team for people they had assessed as needing to be deprived of their liberty.

People were supported by staff who had the required recruitment checks in place and were trained and had the skills and knowledge to meet their needs. Staff had received training in understanding Parkinson’s. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns.

People were supported to maintain a balanced diet. People were asked about their preferred meal choice and were seen enjoying their lunchtime meal.

People received their prescribed medicines on time and in a safe way. Staff treated people with dignity and respect in a caring and compassionate way.

People were supported to undertake activities. There was a program of activities for staff to use as a prompt. People were seen enjoying the activities during our visit. Staff said where people were not able to take part in the group activities they sat with them on a one to one basis.

Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. Care plans were person centred and people where able, and their families had been involved in their development. People where able were involved in making decisions and planning their own care on a day to day basis. People were referred promptly to health care services when required and received on-going healthcare support.

The premises were well managed to keep people safe. There were individual emergency plans in place to protect people in the event of a fire or emergency.

The provider had a robust quality monitoring system at the service. The provider actively sought the views of people, their relatives and staff through staff and residents meetings, surveys and questionnaires to continuously improve the service. There was a complaints procedure in place. There had been no complaints since our last inspection.

Further information is in the detailed findings below.

We observed the care provided and looked at supporting documentation. We spoke to three members of staff, the manager, a relative of someone who used the service and a visiting health professional. We talked briefly with five people who used the service.

Records showed that people's care needs had been assessed, planned, reviewed and delivered in line with their individual care plan. People's medication was managed safely and they had access to healthcare support.

Staff were well trained, recruitment procedures were robust and staffing levels were sufficient for the needs of those who used the service. People who used the service said that staff provided them with all the support and assistance that they needed and wanted.

There were systems in place to identify, assess and manage risks to people who used the service.