10 and 11 September 2015
During a routine inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014.
This was an unannounced inspection. At our previous inspection on 28 November 2013, we found the provider was meeting the regulations we checked.
Fairmount Residential Care Home provides accommodation and personal care for up to 38 people and is situated in the London Borough of Bromley. There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. At the time of the inspection, the home was providing care and support to 35 people.
Whilst people and relatives were pleased with the standard of care provided at the home, we found that people needs had not always been assessed comprehensively and detailed care plans were not in place to describe how people’s needs should be met. They were therefore not being protected against the risks of unsafe care. This was a breach of legal requirement. You can see the action we told the provider to take at the back of the full version of this report.
The registered manager and some staff had been trained in the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Whilst staff carried out mental capacity assessment to check whether people could give consent to aspects of their care and treatment, the actual decisions being made was not always described and recorded to make clear what specific decisions needed to be made. We have made a recommendation for the provider to review the service’s practices around mental capacity assessments in line with the MCA and DoLS Codes of Practice.
The home had made appropriate DoLS referrals to the local authority in line with legal requirements. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.
There were arrangements to manage risks to people and where risks were identified, appropriate management plans were in place to mitigate risks. The provider ensured the premises and equipment were maintained to ensure the safety of people and others
There were enough staff to meet people’s needs and the provider made appropriate recruitment checks before staff started work to make sure only suitable staff were chosen to work at the home. Staff received training and were appropriately supported to fulfil their roles and responsibilities.
Medicines were managed safely to make sure people received their medicines as prescribed. They were supported to maintain good health and had access to health care support. The provider ensured a variety of meals was provided to people to meet their nutritional needs and choices. Where people needed support to eat and drink this was provided in a caring way.
People were treated in a kind and considerate way and were given opportunities to be involved in their care and make decisions. Staff had a good understanding on how to maintain people’s privacy and dignity.
There was a range of suitable activities available to people using the service to enjoy, and these activities were provided consistently by the activities coordinator. People were provided with information about the home and they were aware of the services and facilities available to them.
Where people or their relatives had concerns or were unhappy about the quality of the service there were processes in place to enable them to raise their concerns with the provider. These were taken seriously and addressed appropriately.
The home had a well-established staff team. People said the service was well managed and staff worked as a team. Staff said the registered manager was approachable and provided good leadership. They felt confident to raise concerns for example through the whistleblowing procedure and said their concerns would be addressed.
The provider had arrangements to receive feedback about the quality of the service from people and their relatives by conducting satisfaction surveys and through regular daily contact with them. Where areas for improvement were identified, the provider took action to make the necessary improvements.