Fairfield Care Ltd

Fairfield Care provides is a domiciliary care service. The service operates a supported living service and outreach provision to both children and adults with complex care needs and learning difficulties. A supported living service enables people with a learning disability to live in their own home and the outreach provision is a service which supports people to access their local community with support from staff. At the time of the inspection 11 people were receiving support.

People’s experience of using this service:

Medication procedures had improved since the last inspection. All staff received medication administration training and competency levels were regularly reviewed. Staff had access to an up to date medications administration policy and understood the importance of complying with policy guidance.

We received positive feedback about the quality and safety of care people received. Relatives confirmed that Fairfield Care provided high-quality, person-centred care.

Care records contained the most up to date, relevant and consistent information in relation to people’s support needs and areas of risk that needed to be safely and effectively managed.

People were protected from the risk of harm and abuse. Staff received safeguarding training and knew how to report any concerns that presented. There was an up to date safeguarding and whistleblowing policy for staff to refer to.

Staffing levels and recruitment practices were safely managed. We received positive feedback about continuity of care people received from regular staff.

The registered provider ensured that all pre-employment checks were carried out and staff were suitable to work with vulnerable adults. Staff received a thorough induction and were supported with a variety of different training, learning and development opportunities.

The registered provider complied with the principles of the Mental Capacity Act, 2005. Staff understood and respected people’s right to make their own decisions and where possible, encouraged people to make decisions about the care they received.

A person-centred approach to care was evident. Care records contained detailed information about people’s likes, preferences and wishes; it was clear during the inspection that staff were familiar with the care that people required.

Relatives told us that staff provided kind, compassionate and dignified care. Staff developed positive relationships with people they supported; staff understood the importance of providing care that was tailored around people’s needs.

Staff supported people with activities that they enjoyed; people were actively engaged in hobbies and interests that were stimulating, exciting and fun.

The registered provider had a complaints process and policy in place; relatives knew how to raise a complaint and were confident that their concerns would be listened and responded to.

The quality and safety of the care was continuously monitored and assessed. The registered manager was committed to providing care that was safe, effective, compassionate and high-quality.

We received positive feedback from staff and relatives about the approach of management and their dedication to providing a high standard of care and support.

Staff told us that they received support on a daily basis and felt ‘valued’ as a member of the Fairfield Care team.

Rating at last inspection: At the last inspection service was rated ‘Good’ (report published May 2016). At this inspection we found that the registered provider continued to provide a good provision of care. The evidence we reviewed and feedback we received continued to support the rating of ‘good’; there was no evidence or information from our inspection or ongoing monitoring that demonstrated serious risks or concerns.

Why we inspected: This was a planned, announced inspection to confirm that the service remained 'good'.

Fairfield Care Limited is a domiciliary care service which provides supported living services and outreach provision to both children and adults with complex care needs and learning difficulties. A supported living service enables people with a learning disability to live in their own home instead of residential care or with their family. An outreach provision is a service which supports people to access their local community with support from staff. It is also a respite service for parent carers as they have a break from caring whilst their relative is out on an activity with staff.

The office of Fairfield Care Limited is situated within Fairfield Farm project which is based on a farm in South Manchester. The service also has access to a log cabin on the farm which is used by people supported by staff as well as for staff training and meetings. At the time of the inspection Fairfield Care was supporting twenty nine people within the local community.

There was a registered manager in post. 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.

Family members told us their relative received safe care, which was reliable and consistent. The service had sufficient staff to meet people’s needs, and people were given the time they needed to ensure their care needs were met. We saw that people were protected from avoidable harm.

During the inspection we checked to see how the service protected vulnerable people against abuse and if staff knew what to do if they suspected abuse. There was an up to date safeguarding vulnerable adult’s policy in place. Risks to people were assessed and risk management plans were in place. We found the staff we spoke with had a good understanding of the principles of safeguarding.

Family members of people who used the outreach service confirmed staff arrived on time and took their relative out accessing the local community for the length of time allocated. People also confirmed that visits were rarely missed and a manager was always available. There had been no formal complaints received over the last twelve months.

Staff had the skills, training and support they needed to deliver effective care. All of the staff we spoke with told us they were well supported by each other and the management team.

The service worked to the principles of the Mental Capacity Act 2005, which meant that care staff supported people to make their own choices about their care. They used alternative methods of communication where appropriate. Before any care and support was provided, they obtained consent from the person who used the service where appropriate. We were able to verify this by speaking with family members of people who used the service, checking people’s files, our observations and speaking to staff.

The provider had recruitment processes in place which included the completion of pre-employment checks prior to a new member of staff working at the service. This helped to ensure that staff members employed to support people were deemed suitable and fit to do so. However we saw that the interview process needed reviewing to establish criteria against which people were appointed to ensure formal and objective recruitment so it was clear on what basis staff were appointed to their role.

We saw evidence of a comprehensive induction pack, with appropriate training provided for roles and responsibilities, along with competency testing. Staff also signed to confirm they had read policies and procedures and that they were aware of the provider's requirements in respect of data protection and confidentiality.

All care staff were given a manual which included policies and procedures. These were discussed with the staff member as part of the induction process. Staff received supervision and appraisal from the care management team. These processes gave staff an opportunity to discuss their performance and identify any further training they required.

People were supported with a range of services which enabled them to continue to live in their own homes safely. Family members of people who used the service told us they had been involved in the assessment and planning of the care and support provided and that the service responded to changes in people’s needs.

The care records contained good information about the support people required and were written in a way that recognised people’s needs. This meant that the person was put at the centre of what was being described. The records we saw were complete and up to date.

All the care staff who dealt with people’s medicines had received medicine management training, been assessed as competent and were clear about their role in managing medicines safely. We discussed with the registered manager that the procedure for administering, disposal of refused food containing covert medicines and follow up action regarding the impact on the service user of medication not taken was reviewed in line with current guidelines.

We found from looking at people’s care records that the service liaised with health and social care professionals involved in people’s care if their health or support needs changed. The service worked alongside other professionals and agencies in order to meet people’s care requirements where required.

Family members of service users told us that they were listened to by the service. The registered manager told us that if the service received a new referral it would not be accepted unless there were enough staff available to meet the person’s care needs.

People told us the service was well managed and they felt they could approach the registered manager and provider with any concern and they would be listened to. Care staff told us they enjoyed working for the service, they received good training and felt supported.

Robust systems were in place to monitor the quality of the service provided to help ensure people received safe, effective, care and support. The registered manager and senior care staff had effective audit and quality assurance processes and procedures in place. Any actions required to improve the overall standard and quality of care were raised at the regular staff meetings and in formal supervisions.

There was an up to date accident/incident policy and procedure in place. Records of accidents and incidents were recorded appropriately within people’s care files. However we saw monitoring and analysis of incidents and accidents needed improving as different sections of the records were kept in different files. We discussed with the registered manager and service development manager that accident and incident management, reporting and recording was reviewed to ensure that all lessons learnt through analysis is identified and incorporated into daily practice. There was an up to date ‘business continuity plan’ in place which covered areas such as loss of access to the office, loss of utility supplies, loss of staff, office damage, loss of telephone/IT systems and adverse weather the action to be taken in each event.

There were detailed systems in place to record what care had been provided during each visit. Care plans contained a daily diary sheet which was completed by staff at each visit. Staff working with people on the outreach service completed a visit summary sheet after each visit which included parent/carer feedback.

Staff told us they felt they were able to put their views across to the management, and felt they were listened to. The staff we spoke with told us they enjoyed working at the service and said they felt valued.

The service undertook audits to monitor the quality of service delivery. We saw a number of audits in place such as spot checks, training, and supervisions with care staff to verify their competence in providing safe and good quality care.

Feedback received from other professionals with current or previous involvement with the provider was positive.