Fairholme House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Good. At this assessment the rating has changed to Inadequate. This meant services were not planned or delivered in ways that met people’s needs.

The service was in breach of legal regulation in relation to lack of consistent person-centred care.

This service scored 36 (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 did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

There was limited guidance in place for staff to follow to support people who may experience distress. There was no information about how people’s diagnosis affected them, and there was no guidance in place around people’s preferences, or support required with their mobility. However, staff we spoke with knew people and their needs well.

People were not routinely included in the planning or reviewing of their care. People told us “I've not been asked to give feedback. I've not been asked my opinion” and “I have to go to bed at 7:15. I’m OK going to go to bed then; I go and watch TV in my room.”

We did not always find staff responding in a person-centred way. For example, we found staff interactions were based on the carrying out of care tasks as opposed to spending quality time engaging with people on an individual basis. Staff told us “Theres not always enough time to sit and speak with people.” People’s care and support was not always in line with their choices and preferences. During a lunchtime observation, people were not asked where they would like to sit. Staff placed bibs onto people and meals were put down in front of people with no interaction

There was a bathing rota in place, indicating people were only routinely offered opportunities for a bath on specific days. We raised this with the registered manager and spoke with staff about providing opportunities to bathe. We were provided with assurances bathing once a week on a specific day was peoples preferences, however we could not see any evidence documented this was their preference. We also heard this rota was created to “split the load.” This did not respect people's preferences or reflect person-centred care.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Systems and processes in place did not always ensure continuity of care and support. People did not always experience consistent or positive care. Whilst some people were able to advocate for themselves, others were not, we were not assured of how people’s care was provided. Where people were not able to advocate for themselves, the service had not ensured advocacy services were in place to support people.

We observed mixed interactions from staff towards people living at the home. Some staff were positive and engaged with the people they were supporting, while other staff did not always interact with people.

The provider did not always supply appropriate, accurate and up-to-date information in formats tailored to individual needs.

There was a lack of signage, and many doors did not have any discerning features to make them different from other doors to support people living with dementia or cognition issues.

People we spoke with were not always aware of their care plans or risk assessments and there was no evidence of consideration to provide information in a user-friendly format. This meant we were not assured people always had accessible information available to them to be involved in their care, or to make informed decisions and choices over their daily lives.

The provider did not make it easy for people to share feedback and ideas, or raise complaints about their care, treatment, and support. Staff did not involve people in decisions about their care or tell them what had changed as a result.

People told us complaints in the past had been resolved; however some people were not always clear on who they would report concerns to or were not asked about their care. We heard “If I did have complaints I would probably speak to my friends and then I would speak to the staff,” and “I'm not asked if I'm okay, but they know that I am” and “If I did have complaints. I won't be able to get through to the owner to tell them my complaint. It does bother me that I have no communication.”

People were not asked to provide feedback about their care and support, we heard “I'm not involved in planning my care routines.” There were no meetings in place with people to ensure people were involved with the running of the home.

There was some evidence feedback raised by relatives had been actioned, however surveys were only in place for families, there was no oversight of these surveys to demonstrate what actions had been taken following this feedback, and when this feedback was collected.

This put people at risk of not receiving person centred care.

The provider did not always make sure people could access the care, support and treatment they needed when they needed it.

The registered manager had not been effective in identifying the areas of improvement in the home environment to reduce the risk of people injuring themselves. Information around accidents and incidents documented were not clear, there was no evidence these were reviewed in order for people to access the care support and treatment they needed. For example, some people who injured themselves were supported to seek medical attention, however other people were not. There was no indication of how these decisions were made, or how incidents had been managed.

Staff and leaders had not always made appropriate referrals to health care professionals to ensure people’s needs were met.

The registered manager did not meet with people to review their needs and find out if further support was needed. Care plans did not show involvement of people or their representatives in these processes.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

Care records for people contained limited information on their equality and diversity needs. Most people living at the home were elderly, many of whom were living with dementia. However, information within peoples care plans were limited and there was no information on how to involve people in communicating, expressing their needs or wishes.

Processes were not in place to gather information from people, there were no meetings in place for residents or their relatives to collect feedback, however there was a newsletter in place to keep people up to date on changes in the home.

We completed observations on people in communal areas during the inspection. Staff did not always engage with people.

People were at risk of not receiving person centred care.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Details in relation to end of life wishes were not consistently in place in peoples care plans. Care plans lacked detail and had not explored people’s faith needs or gave guidance to staff as to how this might impact them at the end of their life.

There was no evidence that people had been involved with planning their care. Therefore, their preferences were not reflected in their care plans to ensure future wishes were respected.