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Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 September 2017

We carried out this announced inspection on 25 July 2017.

Fairview Farm can provide accommodation and personal care for 22 people who have a learning disability. There were 19 people living in the service at the time of our inspection.

The service was run by a charitable body who was the registered provider. Although there was a registered manager they were not working in the service at the time of our inspection visit. In their absence the service was being managed by the chairperson of the charitable body and the senior care team leader. 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. In this report when we speak about the charitable body (as represented by the chairperson) we refer to them as being, ‘the registered person’.

At our inspection on 30 August 2016 we found that improvements needed to be made to ensure that people who lived in the service fully benefited from it being safe, effective, responsive and well led.

In more detail, at our inspection on 30 August 2016 we found that in order to keep people safe the registered person needed to address shortfalls in the way people were supported to manage their personal spending money. Another of our concerns involved shortfalls in the provision that had been made to keep people safe in the event of an emergency. At the present inspection we found that these concerns had been addressed. We also found that a particular background check had not been updated to confirm that some care staff continued to be suitable people to be employed in the service. Although at the present inspection we found that this check had been completed we also noted that additional improvements needed to be made in the way new care staff were recruited. A further concern we highlighted involved the need to strengthen the way in which medicines were managed to ensure that people were reliably assisted to use them in the right way. At the present inspection we found although improvements had been made further developments were needed to ensure that the progress made could be sustained.

At our inspection on 30 August 2016 we also found that the registered person needed to ensure that care staff received all of the training, support and guidance they needed in order to make the service more effective. At the present inspection we found that care staff had been provided with training, guidance and support. We also noted that care staff had the knowledge and skills they needed to care for people in the right way.

At our inspection on 30 August 2016 we concluded that more needed to be done to provide people with a responsive service by more actively involving them in deciding what care they wanted to receive. We also highlighted the need for people to be offered more opportunities to enjoy participating in occupational and social activities. At the present inspection we found that both of these concerns had been addressed.

As a result of the shortfalls we noted on 30 August 2016 we identified that more robust arrangements needed to be put in place to manage the day to day running of the service. At the present inspection we found that although a number of quality checks had been completed further progress was needed to ensure that people consistently received all of the care they needed.

Our other findings at the present inspection were as follows. We found one breach of the Care Quality Commission (Registration) Regulations 2009. This was because the registered person had not told us about a number of significant events that had occurred in the service. You can see what action we have told the registered person to take at the end of the full version of this report.

Care staff knew how to respond to any concerns that might arise so that people were kept safe from abuse. People were supported to take reasonable risks and helped to avoid preventable accidents. There were enough care staff on duty.

People enjoyed their meals and they were helped to eat and drink enough. Care staff had ensured that people received all of the healthcare they needed.

People were helped to make decisions for themselves whenever possible. When people lacked mental capacity the registered person and the manager had ensured that decisions were taken in people’s best interests. The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered person had ensured that people only received lawful care.

Care staff were kind and people were treated with compassion and respect. People’s right to privacy was promoted and there were arrangements to help them to access independent lay advocacy services if necessary. Confidential information was kept private.

People had been supported to be as independent as possible and they had received all of the practical assistance they needed.

People and their relatives had not been fully involved in the development of the service. However, good team working was promoted and care staff said that the service was run in an open way so that they could speak out if they had any concerns.

Inspection areas

Safe

Requires improvement

Updated 6 September 2017

The service was not consistently safe.

Medicines had not consistently been safely managed.

Full background checks had not always been completed before new care staff were appointed.

Care staff knew how to keep people safe from the risk of abuse including financial mistreatment.

People were supported to take reasonable risks and helped to avoid preventable accidents.

There were enough care staff on duty.

Effective

Good

Updated 6 September 2017

The service was effective.

Care staff had received training and guidance and knew how to care for people in the right way.

People enjoyed their meals and were helped to eat and drink enough.

Care was provided in a way that ensured people’s legal rights were protected.

People had been assisted to receive all the healthcare attention they needed.

Caring

Good

Updated 6 September 2017

The service was caring.

Care staff were kind, respectful and compassionate.

People’s right to privacy was promoted.

There were arrangements to help people use independent lay advocacy services.

Confidential information was kept private.

Responsive

Good

Updated 6 September 2017

The service was responsive.

People had been consulted about the care they wanted to receive and had been given all of the assistance they needed.

Suitable provision was in place to promote equality and diversity.

People were supported to pursue their hobbies and interests.

There were arrangements in place to quickly and fairly resolve complaints.

Well-led

Requires improvement

Updated 6 September 2017

The service was not consistently well led.

The registered person had not told us about significant events that had occurred in the service.

People and their relatives had not been fully involved in the development of the service.

Quality checks had not always resulted in problems in the running of the service being quickly put right.

The registered manager was not overseeing the running of the service.

There was good team work and care staff had been encouraged to speak out if they had any concerns.