Fairfield

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.
A member of staff told us where a person had an accident or incident this was recorded on their electronic system; they gave us examples of the level of detail required when completing the form. Updates such as further monitoring was shared through staff handovers. The staff member said this meant they were able to monitor how the person was and where needed, people were referred to other healthcare professionals for further advice and support.
The management team investigated accidents and incidents and took actions such as reviewing equipment in place and identifying themes and trends to reduce the risk of reoccurrence. The management team told us they reviewed learning as an organisation and from a previous incident, they recognised further development in reviewing falls documentation was needed and implemented staff workshops. The management team shared with us, following the workshops they held, the recording of accidents and incidents had improved within the home.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The duty manager confirmed people had a ‘hospital passport’. This contained important information so if a person required external medical treatment, a summary of their communication, health, mobility and medical needs could be shared. The duty manager was confident these were up to date and said if required, these could be printed. Where people had made a decision not to receive any medical intervention in the event of a cardiac event, this was known and could be shared when needed. From reviewing examples of people’s hospital passports, we found 1 example where some additional but important information was required, such as the person required a diet to manage their diabetes.

A staff member told us, where a person was discharged from hospital, further checks were completed to ensure the safety of the person. One staff member said, “When [People] are discharged from hospital we do a body map, check any changes in medication and weigh them” and told us “Any changes to the [Person] are shared from our care coordinator’s.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living at Fairfield. Comments included: “There is always someone about that makes me feel safe” and “I feel the security of staff being here.” One relative told us, [Person] is 100% safe.” Staff told us they were confident to escalate any concerns about people’s health and wellbeing and poor practice. No staff we spoke with had seen any poor practice. One staff member said, “I would report any issues to senior staff, once I made sure the person was safe.” Staff also understood which other external organisations had responsibilities for promoting people’s safety, should this be required.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks to people’s care were managed. Relatives described working in partnership with staff so any new or emerging risks were shared with them so any potential risks would be reduced.

Some people had behaviours that were communicated through their emotions and distress. Positive support behaviour plans (PBS) were in place to guide staff to positively distract people if and when they were anxious, these were tailored to people’s individual needs.

Staff had a good understanding of the risks people experienced, and explained how they tailored the support they offered, to reduce risks when people were distressed.

A staff member told us, “I definitely feel the combination of training and the care plan instructions gives me enough information to safely move people.” People’s care plans and risk assessments reflected their individual risks. For example, if one or two staff members were required to safely support people.

One healthcare professional said, “I have recently been very impressed with how accommodating and responsive the team at Fairfield’s were when faced with risks and behaviours that I do not believe are typical for their service. I feel they worked collaboratively with our service and made appropriate short-term changes to the way they worked to support a resident through a period of mental health crisis. They were focussed on the safety and needs of their resident through this time.”

Staff said care plans informed them about people’s risks however we found where people needed some risk management, such as modified diets and fluids, daily fluid and nutrition records needed better recording to accurately reflect how those risks were managed safely.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home environment contained references to different themes in areas of the home. Themes included sport and motoring. One area of the home reflected the local important history of the area. This included references to ribbon making, brick production and poppy parade which was celebrated by veterans. These themed areas can help people navigate and move throughout their home by association with those themes. The provider’s environmental risk assessments considered a range of risks and detailed how these risks could be controlled. Environmental checks were completed regularly that included gas, electricity and fire safety. We found some fire doors for bedrooms closed too fast, presenting a possible risk to people of entrapment or risk of falling. We told the registered manager who arranged for this to be rectified. The home was undergoing a refurbishment programme during our visit. Plans to add additional café facilities and upgrade the existing environment, to include specialised lighting to support people with cognitive impairment was underway.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us they received staff support when they wanted. One person said, “There is enough staff to meet my needs.” Another person said, “I think that the staff are trained to meet my needs.” A relative was complimentary about the knowledge and skills of the staff providing care. They told us staff were friendly, approachable and knowledgeable. One relative said, “I can see in [Person’s] face they are happy.” Another relative told us, “There is enough staff here, there is always someone about.”

The registered manager told us the staff team worked well together, with good communication and regular handovers that gave staff the right information to care for people. The registered manager used a staff dependency tool to ensure they always had enough staff on duty to meet people’s needs. The registered manager said they allocated staff based on those calculations which were completed from people’s assessed needs. Systems were in place to check the suitability of staff before they commenced employment. Staff were supported through an induction process and on-going supervisions, training and competency checks. The provider did not use agency staff but had their own mobile bank team who supported across all the provider’s homes.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

We saw positive practices to minimise cross infection. Handwashing signage was displayed in communal toilet/bathroom areas and all bins were foot operated, meaning less risk of cross contamination. Normal and clinical bins were emptied regularly. Personal protective equipment (PPE) stations were available on trollies and were stocked. Staff were seen to use the appropriate PPE at the required times. A housekeeper on each floor made sure the home was clean. A housekeeper told us they undertook a deeper clean every two weeks, or when a person had an infection, cleaning regimes were increased. Housekeeping staff had products to ensure people’s bedrooms and touch points were regularly cleaned. A relative told us their family members room was always clean, tidy and well presented.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Some people received their medicines via a transdermal patch which was applied on the body. A transdermal patch application chart showed where the medicines patch had been applied however, medicine patches were not always applied in accordance with the manufacturer’s instructions. This is important to prevent skin irritation and that the medicine is absorbed safely from repeated use on the same area.

When required (PRN) protocols were in place however, from those we reviewed, they did not always include clear guidance on how to assess the effectiveness of the medicine or the next steps to take based on the person’s outcomes. This lack of detail had potential to increase the risk of inconsistent care and made it difficult for staff to make informed decisions. On our second day of inspection, the registered manager told us medication management had been discussed in their team meetings and the issues identified were being reviewed. There was no missed medications and people we spoke to raised no concerns around their medicines, comments included: “They give me medication if I am in pain.” “I do have medication, and they do not forget to give it to me.”