Fairfield

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The management team told us the registered manager completed assessments for people and pre assessments for people prior to moving into the home. A relative told us before their family member moved to Fairfield, staff visited them in their home to complete an assessment of need. This meant they would make sure they could meet the person’s needs. Any new assessments were completed, and the providers care plan system was updated so staff had the information they required. People's needs were reassessed as they changed. One relative told us an assessment was completed before their relative moved in, they said, “It’s been such a relief. I am so happy with the care they get.” People’s assessments included their medical history, what physical assistance and well-being support they wanted and if other people had legal authority to make decisions on their behalf. Care plans once completed, were reviewed. People’s information helped support any personal evacuation plans and important information needed for other health professional settings.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s nutritional needs were assessed and met. Staff ensured people had enough to eat and drink. People were positive about the food and told us where staff support was needed this was given. Comments included: “The food is good, we have choices” and “If I was thirsty, they would get me a drink at any time.”

Some people ate their own meals, drinks and snacks independently, or with support from staff where required. Staff gave us examples showing how they escalated any concerns they had to other health and social care professionals, for example related to catheter care and people who required modified diets. However, records for other health care professionals were not always captured to ensure people continued to receive the treatment they required.

Staff used nationally recognised tools appropriately to assess and monitor people’s needs. For example, the Malnutrition Universal Screening Tool (MUST) was used to identify people from risk of malnutrition.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff felt there was effective communication and coordination between their own staff team which included thorough handovers and supporting one another. Comments included: “It’s about being there for one another - I don’t class them as work colleagues we call this the Fairfield family, and we are, we work together.” “Important information is shared through handover’s such as encouraging further fluids for people.”

Staff said health professionals were good at sharing information and advice. Comments included: “The district nurses are lovely, really informative” and shared “They [District Nurses] will notify us or the office of any changes in medication such as a person’s insulin and I record it on the system.”

The registered manager told us the GP carried out a weekly visit at the home. The registered manager described the relationship with the GP as positive, saying, “If we have any concerns, we call them [GP] they will give us advice to inform if it can wait until the next visit or if needed, they [GP] will come out. The registered manager explained 1 person had 2 falls within a day they had called the GP for assistance, whilst the GP was unable to attend the paramedic for the GP practice came out and prescribed antibiotics. This meant the person had not been delayed from seeking medication to support their medical condition.

One professional said, “The care home seek to access healthcare appropriately- both keeping things for routine review at weekly ward round, and also urgent issues that cannot wait- either by contacting ourselves, 111 or 999 where appropriate.”

Another professional shared with us they were involved in important decisions relating to people’s care and said, “Key decisions about the care of my patient at Fairfield involve the home, our service, and the patient.”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to access healthcare professionals to help maintain their physical and mental welfare. A typical comment included: “The GP comes in and I can also see the optician and dentist.”

The provider had 2 lifestyle coordinators who planned and organised recreational and therapeutic activities for individuals or groups to enhance their wellbeing and promote social connections. These had been tailored to people’s personal interests and abilities. One relative shared, “They sometimes take the residents who are able to talk and have conversations to have lunch together. They have a good time.” Staff gave us examples showing how they worked flexibly with people, relatives and community groups to ensure they met people’s social needs. People were supported to maintain links into the community which was important to them for example staff assisted relatives to support people to continue to attend faith groups. One staff member said, “It’s important to [Person] to maintain relationships and things they did before they came to the home.”

Some people were supported by staff to go out with family this meant people were still able to maintain important relationships and be able to do things which they enjoyed.

A healthcare professional said, “Staff know their residents well, and as a result, respond appropriately to changing care needs. They seek to promote wellbeing and health of residents in an appropriate manner.”

For people who required pressure relieving equipment we found the equipment had been maintained and set to people’s individual requirements. This is important for preventing and treating wound care or for people who have limited mobility.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Where people required monitoring of their food and fluids this had not always been completed. We could not be confident; people’s needs were routinely monitored. We found people’s health conditions when managed with certain prescribed medicines, was not always done safely. Whilst we cannot say people were harmed, the lack of proactive management to identify and investigate record discrepancies was not always identified in a timely way. We found an example of a person who had a catheter which was managed by a district nurse team. Whilst we were satisfied the person received the care they required from staff and external health professionals, this was not always recorded. This could impact on other health professionals not having up to date information of a person’s care.

The provider respected people’s rights when delivering care and treatment, however the documentation in relation to capacity assessments and best interest decisions needed to be improved.

People’s capacity to make their own decisions had been considered. However, capacity assessments had limited information about how people had been supported to understand the decision to be made.

A decision had been made which was in the person’s best interests. Whilst this had involved people who knew the person well. There was a lack of information of why the decision had been made in the persons best interest and these did not always include the views of the families involved. The provider had made appropriate referrals where people were potentially being deprived of their liberties. On our second day of inspection, the registered manager told us they were reviewing their mental capacity assessments and best interest decisions.

However, people told us they were free to make their own decisions. Staff demonstrated a good understanding of respecting people’s wishes and decisions this included when a person lacked mental capacity. One staff member said, “If they [People] say no, I will leave them to it and check them again. I would respect their wishes or try another carer a different face sometimes helps. I would wait until they feel ready if they want a shower in the afternoon, that’s fine.”