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Inspection carried out on 1 February 2018

During a routine inspection

The inspection took place on 1 February 2018 and was unannounced.

Fairfield House is a care home in Newcastle that provides accommodation and care for up to 11 people with support needs relating to their mental health. There were nine people using the service at the time of inspection.

At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

People who used the service felt safe and there were appropriate risk assessments and systems in place to ensure risks were reduced and lessons were learned from incidents. People’s needs, such as medicines, the premises and staffing levels and pre-employment histories were managed safely.

There was effective liaison with external primary and secondary healthcare professionals, with people achieving good health and wellbeing outcomes. Documentation was generally accessible and sufficiently detailed, with a range of appropriate training and staff support in place.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005. People are 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.

People who used the service received an excellent continuity of care from staff who knew their needs extremely well and had built mutually trusting relationships with them. Feedback from relatives and external professionals was exceptional in this regard. People who used the service had developed improved independence and confidence with the help of dedicated and compassionate staff. People’s emotional wellbeing was respected and supported by staff and a registered manager who consistently exceeded good standards of care and ensured people could thrive in a caring environment.

The atmosphere at the home was welcoming and calm. Staff interacted warmly with people who used the service and demonstrated an in depth understanding of peoples likes, dislikes and individualities. People received a continuity of care from a well-established staff team.

The service had built good community links, which afforded people who used the service a range of learning and social opportunities. There were plans to build on these in the future.

The registered manager and deputy manager lead the service well, combining hands-on day to day responsibilities and accountability with a commitment to pursuing continuous service improvement. Staff confirmed they were well supported and people who used the service interacted comfortably with staff at all levels, including management. The culture was in line with the provider’s literature, caring and with a focus on people achieving and maintaining independence.

Inspection carried out on 14 and 22 December 2015

During a routine inspection

We carried out an inspection of Fairfield House on 14 and 22 December 2015. The first day of the inspection was unannounced. We last inspected Fairfield House in April 2014 and found the service was meeting the relevant regulations in force at that time.

Fairfield House is a care home that provides accommodation and care for 11 people with support needs related to their mental health. Nursing care is not provided. At the time of the inspection there were nine people accommodated there.

The service had a registered manager in post, who became formally registered in November 2015. A registered manager is a person who has registered with the CQC 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.

People told us they felt safe and were well cared for. Staff knew about safeguarding vulnerable adults and protecting their human rights. Incidents and alerts were dealt with appropriately, which helped to keep people safe.

We observed staff act in a courteous, professional and safe manner when supporting people. At the time of our inspection, the levels of staff on duty were sufficient to safely meet people’s needs. New staff were subject to thorough recruitment checks, although one person hadn’t provided a full employment history. This was obtained after our inspection.

Medicines were managed safely for people and records completed correctly. People received their medicines at the times they needed them and in a consistently safe way.

As Fairfield House is registered as a care home, CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. We found appropriate policies and procedures were in place and the registered manager was familiar with the processes involved in the application for a DoLS. Arrangements were in place to assess people’s mental capacity and to identify if decisions needed to be taken on behalf of a person in their best interests. Staff obtained people’s consent before providing care.

Staff had completed safety and care related training relevant to their role and the needs of people using the service. Further training was planned. Staff were well supported by the manager.

Staff were aware of people’s nutritional needs and where needed supported people with meal planning and preparation. People’s health needs were identified and external professionals involved if necessary. This ensured people’s general medical needs were met promptly.

People accessed community based activities and occupation. We observed staff interacting positively with people. We saw staff treated people with respect and explained clearly how people’s privacy and dignity were maintained. Staff understood the needs of people and we saw care plans were person centred.

People using the service and staff spoke well of the registered manager and care provider and felt the service had good leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people receiving care.

Inspection carried out on 18 September 2014

During a routine inspection

We considered our inspection findings to answer questions we always ask;

• Is the service safe?

• Is the service effective?

• Is the service caring?

• Is the service responsive?

• Is the service well-led?

This is a summary of what we found-

Is the service safe?

Risk assessments were in place. All risks to people living in the home, their relatives and staff were regularly assessed and appropriate steps taken to minimise such risks. People were supported and encouraged to maintain their independence and this was balanced with the risk to the person. Audits were carried out which helped the provider learn from accidents and incidents and the necessary action was taken to keep people safe. Information was available to show that the service worked with other agencies to help ensure people's mental health needs were met and to prevent admissions to hospital wherever possible.

Staffing levels were in place to ensure all the needs of the people who lived at the service were met to ensure their safety. A member of the management team was available on call in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We were told the necessary applications had been submitted and one person was subject to Deprivation of Liberty orders. We saw proper policies and procedures were in place.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met.

We observed and spoke with people who said they had the opportunity for activities and outings if they wanted. One person told us they were looking forward to attending another music concert. Some people belonged to a walking group. We were told some people carried out voluntary work. We saw people were supported to maintain personal relationships with their friends and relatives.

Staff had received regular training to meet the needs of the people who used the service.

Is the service caring?

People told us they were supported by kind staff, who showed patience and gave encouragement when supporting them. People commented how helpful and friendly staff were. Some people we spoke with commented how pleased they were with the care provided by staff at the service. One person commented; "I'm quite happy here." Another person said; "I am well looked after."

Is the service responsive?

People’s needs had been carefully assessed before they moved into the service. People told us they had been asked for their views and these had been recorded. Records confirmed people’s needs had been recorded and care and support had been provided in accordance with their wishes.

Is the service well-led?

The home had a registered manager in post. We saw the ethos of the service was for people to be involved in decision making in their daily lives and future living arrangements. People we spoke with talked well of the support provided by staff. They said they were kept informed and involved in the running of the service. Staff told us they were clear about their roles and responsibilities. They said they felt supported by the manager and advice and support was available from the management team. We saw a system was in place to ensure management were supported in their role. An external quality assurance system was in place to audit the services provided.

Inspection carried out on 29 October 2013

During an inspection to make sure that the improvements required had been made

The provider had undertaken an audit of people's care records to ensure information was accurate and up-to-date. We found outcome plans had been reviewed in line with agreed timescales.

Inspection carried out on 18 June 2013

During a routine inspection

We found people had their needs assessed and this information was used to develop a range of personalised outcome plans. Staff told us people were encouraged to be involved in the assessment of their needs and developing their care plans.

We found the home was well maintained and clean. We saw the provider has systems in place to undertake regular checks to ensure the building was safe for people to live in.

Staff told us they felt there were enough staff to meet people's needs. People who used the service said they had no complaints about staffing. One person commented, "Staff help us with things when we ask them." We found the provider had systems in place to monitor staffing levels.

People who used the service said they had opportunities to express their views about the service they received. We found the provider had recently developed a system of quality audits which included gathering the views of people who used the service.

We found that care records were sometimes difficult to follow and understand. In particular we were unable to establish whether care records contained the most up to date information. We found that care plan evaluations were not always up to date.

Inspection carried out on 29 October 2012

During a routine inspection

People told us that they were involved in their care and were asked to sign their assessments and care plans to show that they had agreed to the content. We found that people were encouraged to voice their opinions and were enabled to make informed choices about their care and safety.

People told us how they maintained and developed their lifeskills and were being supported to move onto more independent accommodation. People commented "I am in control and make choices" and "staff try and help when they can." We found that people's needs were assessed and care was planned and delivered in line with their individual care plans.

We found that medicines were handled appropriately and that some people managed their own medication to promote their independence. We found that staff had a good understanding of the medication procedure and all staff had completed safe handling of medicines training.

People told us they were happy with the care that staff provided and said "staff are quite good", "staff are good at their job", and "staff are very good and sort them out".

People were aware of the complaints system and knew how to complain. We found that information about how to complain was made available and that people could be assisted to make a complaint if necessary.

Inspection carried out on 8 November 2011

During a routine inspection

People living in the home told us that staff treated them with respect and listened to what they said. They told us that they made their own decisions as to how they spend their day and could come and go as they chose. No one we spoke to could identify any improvements they felt the service should make.

People living in the home told us they received good care and that staff involved them in deciding how their care should be given.

A care professional with a client in the home said, in the most recent quality survey, “Fairfield sets a very high standard for service delivery. I commend Fairfield House as an exemplary model of service provision in residential adult mental health”.