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Fairfield House Residential Care Home Good

Inspection Summary


Overall summary & rating

Good

Updated 6 March 2018

This inspection took place on 19 January 2018 and was unannounced. The inspection continued on 22 January 2018 and was announced.

Fairfield House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The care home accommodates up to 36 people across two floors. The service is located in Lyme Regis and is a large detached building with rooms arranged over two floors and a central ground floor lounge and dining area. There is both lift and stairlift access to the first floor. People are able to access secure outside space at the home. There were 28 people living at the home at the time of our inspection.

At our last comprehensive inspection on 27 September and 4 October 2016 we found that people’s care and treatment was not always appropriate or met their needs. Care and treatment was not always designed with a view to meeting people’s individual needs. The registered persons were not acting in accordance with the Mental Capacity Act (2005) to ensure care and treatment of people was provided with consent. People’s nutritional and hydration needs were not always met to ensure food and hydration was adequate, dietary supplements were not consistently given and people were not always provided with the support required to keep them hydrated. Systems were not always in place to ensure concerns were picked up and met through the quality assurance process.

We found four breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to take steps to improve and ensure that they were compliant. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question(s) Effective and Well led to at least good. At this inspection we found that improvements had been made.

The service did not have a registered manager in post at the time of inspection. However the manager had applied to CQC and since our inspection they confirmed that they had successfully registered. 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.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of the risks that people faced and understood their role in managing these to ensure people received safe care. Risks around behaviours that could challenge were planned to be recorded in people’s care plans where appropriate.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

People received their medicines as prescribed and staff worked with healthcare professionals to ensure that people received joined up, consistent care. Where written guidance around medicines prescribed ‘as required’ was needed, the manager confirmed that this would be put into place.

People were supported from the spread of infection by staff who understood their role in infection control and used appropriate Personal Protective Equipment (PPE).

People were supported to make choices about all areas of their support and staff understood the principles of mental capacity. Where decisions were needed in people’s best interests, these were in place.

People were supported to have enough to eat and drink and there were systems in place to ensure that any concerns around wei

Inspection areas

Safe

Good

Updated 6 March 2018

The service was safe

Risks people faced were understood and managed by staff but risks around behaviours which could challenge needed to be included in people’s care plans.

People received their medicines as prescribed.

People were supported by staff who had been recruited with safe

pre-employment checks.

Sufficient numbers of staff were deployed to meet people’s needs.

People were protected from the risks of abuse by staff who understood the potential signs and were confident to report.

People were protected from the spread of infection by staff who understood the principles of infection control.

Lessons were learnt and improvements were made when things went wrong

Effective

Good

Updated 6 March 2018

The service was effective.

People were asked to consent to their support and assessments of capacity and decisions were made in people’s best interests where needed.

Staff received training and supervision to give them the skills they needed to carry out their roles.

The service worked with other healthcare services to deliver effective care.

People’s needs and choices were assessed and effective systems were in place to deliver good care and treatment.

People were supported in an environment which was adapted to meet their needs with personalised rooms and accessible outside space.

People were supported to eat and drink enough and concerns about weight or fluid intake were effectively managed.

Caring

Good

Updated 6 March 2018

The service was caring.

People were supported by staff who were compassionate and kind in their approach.

Staff knew how people liked to be supported and offered them appropriate choices.

Visitors felt welcomed at the service and visited whenever they chose.

People and their relatives were listened to and felt involved in making decisions about their care.

People were supported by staff that respected and promoted their independence, privacy and dignity.

Responsive

Good

Updated 6 March 2018

The service was responsive.

Feedback about social opportunities and activities was not consistently positive but there were plans in place to improve opportunities for people

People had individual care records which were person centred and gave details about people’s history, what was important to them and identified support they required from staff

People and relatives knew how to raise any concerns and told us that they would feel confident to raise issues if they needed to.

People received person centred, compassionate end of life care.

Well-led

Good

Updated 6 March 2018

The service was well led.

People, relatives and staff spoke positively about the management of the home and the improvements in the service since our last inspection.

Staff felt supported and were confident and clear about their roles and responsibilities within the service.

Quality assurance measures provided oversight and enabled the service to identify good practice and areas for further development.

Feedback was used to highlight areas of good practice or where development was needed. Information was used to plan actions and make improvements.