Archived: Fairview House Residential Home

There was not a registered manager in post. The manager from Fairview Court Care Home was in the process of applying to be the registered manager and will be supported by a newly appointed deputy manager. 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.

Improvements were required with the management of some medicines to ensure they were administered to people safely. The arrangements in place for the re-ordering of some people’s medicines were disorganised and raised the risk of a medication error being made. Medicine administration charts were not always completed correctly.

All staff received safeguarding adults training and were knowledgeable about safeguarding issues. They knew what to do if there were concerns about a person’s welfare and who to report their concerns too. The manager had previously worked well with the local authority safeguarding team when concerns were raised. Safe recruitment procedures were followed to ensure only suitable staff were employed. The appropriate steps were in place to protect people from being harmed.

A set of risk assessments were completed for each person and where risks were identified a care plan was written to reduce or eliminate that risk. Some people had other risk assessments and management plans in place where specific needs were identified. The premises were well maintained and regular maintenance checks were completed.

The number of staff on duty was based upon the care and support needs of the people at any given time. Staff felt that the staffing numbers were sufficient and this meant they had enough time to meet people’s needs. People were safe because the staffing levels were sufficient.

Staff completed a programme of the provider’s mandatory training to ensure they had the necessary skills and knowledge to care for people correctly. New staff completed an induction training programme and there was a programme of refresher training for the remaining of the staff. Care staff were encouraged to complete nationally recognised qualifications in health and social care.

People were encouraged to make their own choices and decisions and to maintain their independence for as long as possible. An assessment of each person capacity to make decisions was made and people were always asked to consent before receiving care. We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards.

People were provided with food and drink they liked and met their own particular requirements. People were encouraged to eat well and where required were provided with fortified food and drinks. There were measures in place to reduce or eliminate the risk of malnutrition or dehydration. Arrangements were made for people to see their GP and other healthcare professionals when they needed to.

People had good relationships with the staff who looked after them. Each person had a keyworker who would link with the person’s family or friends. People were given the opportunity to take part in a range of different meaningful activities. There were group activities and external entertainers visited the service on a regular basis.

Assessment and care planning arrangements ensured people were provided with care and support that met their needs. Daily records were maintained which evidenced the support delivered to each person. Staff always received a handover report at the start of their shift which made aware of any changes in people’s needs.

The staff team was led by an experienced manager and a newly appointed deputy. Staff were provided with good leadership and the manager was visible and available within the service. Regular staff meetings were to be re-introduced to keep the staff up to date with changes and developments in the service.

The registered provider had a regular programme of audits in place which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

When we arrived at the service the staff we met ensured we had our identification and signed in the visitor's book. This meant that actions were taken to ensure that people who used the service were protected from people who did not have the right to access their home.

People told us they felt safe living in the service. One person told us 'I feel safe here no worries at all'.

We saw that the staff were provided with training in safeguarding vulnerable adults from abuse, Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). This meant that staff were provided with the information that they needed to ensure that people were protected.

We saw records which showed that the health and safety of the service was regularly checked. This included regular fire safety checks; this meant that people were protected in the event of a fire.

Is the service effective?

People told us they felt they were provided and received a service that met their needs. One person said, "I get everything I need." Another person said, "They help me to the way I want." Another person said, "I am very happy here."

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated. This meant that staff had up to date information about how people's needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, respectful and professional manner. For example we saw one staff member spoke discreetly to a person who needed help with their personal care. People told us that the staff treated them with respect. One person said, "'they are all lovely, very caring." Another person said, "They are all very kind and respectful".

We also spoke with a people's relatives who told us that they felt that their relatives were well looked after. One person said, "I have no problems at all with the home. We are always pleased to see how our relative is well looked after'.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. One person told us 'we have activities three days a week. We also have external entertainments during the week. We also have shopping trips and I make sure that I go'. Another person told us 'staff respect my choices and my wish to remain as independent as possible'.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised complaints appropriate action had been taken to address them.

We saw that where staff identified concerns about people's wellbeing, they sought support and guidance from healthcare professionals. This included seeking support and guidance from health care professionals, included a doctor and district nurse.

Is the service well-led?

People told us they were happy with how the service was run. One person told us 'the manager is very approachable and will always stop and listen to what I've got to say'.

The service worked well with other agencies and services to make sure people received their care in a joined up way. For example we saw that care plans included contact details of preferred professionals such as optician, dentist, chiropodist and general practitioner.

The service had a quality assurance system and records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

People were cared for in a clean, hygienic environment and we found high standards of cleaning. People were protected from the risk of infection because there were effective systems in place to reduce the risk and spread of any infection in the home.

We received positive comments from people about the staff who looked after them. We found that there were effective recruitment and selection processes in place. Appropriate checks had been undertaken before staff began to work in the home. Staffing levels were appropriate and met people's needs.

People told us they were regularly asked for their views about life at Fairview House. The provider had a range of measures in place to ensure that the quality of service was maintained, but they needed to make sure that the records were reflective of the checks that had been undertaken and were available for inspection. People told us they felt able to raise any concerns or complaints they may have.

Visitors we spoke with said that the staff always kept them informed of what was happening and reported any changes in their relative's health or welfare. They told us they were informed of GP visits.

People we spoke with when we visited Fairview House told us that the meals were good and that they had enough to eat and drink. They told us they felt safe and that the staff who looked after them were kind, friendly and were good at their jobs. People were asked for their views about living in the home and they were listened too.