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 Inadequate.

At this assessment the rating has changed to Good. This meant people’s needs were met through good organisation and delivery.

The service remained in breach of legal regulation in relation to governance.

This service scored 68 (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 ensure care records contained sufficient detail to support the delivery of consistently person centred care. Staff did not always have clear information about people's preferred support needs.

Care plans included detailed information about people's routines and sleeping preferences, however, guidance about how people wished to be supported with personal care was limited.

There was limited information around the practical support people required with personal care and mobility. Where records stated a person could assist with aspects of their personal care, there was limited information about how staff should support and encourage this. This meant staff were often reliant on their knowledge and experience of individuals rather than detailed, person centred guidance within care records.

People and relatives were generally positive about the care provided. One relative told us, “I feel personal hygiene is well looked after. When I come in, they [staff] have moisturised [person’s] skin. [Person] is well dressed and once a week [person’s] hair has been done.” People told us they could request additional support when needed, with 1 person saying, “Very often I will say can I have a shower today and they will organise one.”

People told us staff took a caring approach and did not rush them when providing support. Comments included, “When [staff] are with you, they don’t seem to rush things at all,” and “It does take time for them to come sometimes but when they get here, they are not rushing anything.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider worked to ensure people's care was coordinated and information was shared between staff to support continuity of care. We observed staff interacting warmly with people throughout the day. Staff spent time chatting with people and checking on those who chose to spend time in their bedrooms, helping to ensure people remained supported and their needs were monitored.

The provider held daily meetings to review people's care and identify any changes or emerging concerns. Records showed these meetings included discussions about people's nutritional needs, hydration, infections, accidents and incidents, referrals to healthcare professionals and medicines management. This helped to ensure important information was shared across the team and people received consistent support.

These systems helped staff work together to monitor people's wellbeing and respond to changes in their needs in a coordinated way.

The provider had introduced regular reviews of people's care and support, which involved people and, where appropriate, their relatives.

Records demonstrated people were given opportunities to discuss their care, express their views and contribute to decisions about how their support was planned and delivered.

Care records evidenced that people had been consulted about the sharing of their personal information and had been involved in decisions about their care.

Information-sharing arrangements across a range of areas, including access to care records by healthcare professionals, the use of CCTV and the use of equipment to support people's care and safety were in place.

The provider asked for people’s feedback and people felt their complaints were dealt with effectively. However, processes were not fully embedded, as the provider did not always take action when collecting people’s feedback.

The provider encouraged people and their relatives to give feedback and raise concerns, and people felt complaints were listened to and addressed. One person told us, “The carers are excellent. I've been here for [years specified] and I've only had to complain once and things were dealt with.” A relative said, “They are on it if I say something,” and described how management had responded promptly to concerns they had raised.

The provider had introduced systems to increase people's involvement in their care, including 6-monthly care reviews and a 'resident of the day' process.

The provider sought feedback through surveys and meetings and completed analysis of responses received. However, systems for reviewing and acting on feedback were not always effective. Whilst overall survey scores were considered, written comments were not consistently analysed or used to drive improvement. Despite this, we were assured that the provider took action following people’s concerns. The provider told us they would ensure actions were documented in the future.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People told us they were able to make choices about their daily lives and received support ways that reflected their preferences. One person said, “Lots of choices, if I want to be quiet, I can go to my room, I can get up when I want and have my meals where I want. I feel that I can make choices here.”

People were supported to access healthcare services promptly when required. Staff contacted healthcare professionals, including GPs, when concerns about people's health were identified.

The environment supported people to access care safely and comfortably. Communal areas were accessible to people using wheelchairs and moving and handling equipment, and staff understood how to minimise environmental risks.

We observed staff providing thoughtful support when assisting people to move around the home, taking care to protect them from injury and promote their comfort and dignity.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

People told us they were treated fairly and with respect. One person said, “I think that I am treated fairly, I don't think I'm not.” Another person told us, “The carers are very fair; never feel they are not.”

People were able to access care, treatment and support when they needed to and in a way which worked for them.

Staff demonstrated a good understanding of people's needs and described how support was adapted to promote their wellbeing, independence and safety.

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.

Care records contained information about people's preferences and the people they wished to be contacted in the event of their death. However, end-of-life care plans were not always sufficiently detailed to ensure people's wishes could be fully understood and respected.

Whilst records included information about resuscitation decisions, they did not consistently capture people's religious beliefs, spiritual needs or other preferences for their end-of-life care. This meant staff did not always have access to comprehensive information that would enable them to support people in accordance with their wishes and preferences at the end of their lives.