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Fairmount Nursing Home Requires improvement

Reports


Inspection carried out on 24 April 2019

During a routine inspection

About the service:

Fairmount Nursing Home provides accommodation, care and support for up to 37 people over 65 years old including people living with dementia, people receiving end of life care and people on respite care. There were 31 people living at the service on our first inspection day and 30 people on the second.

People's experience of using this service:

People and relatives told us they had a positive experience with the care provided. One person said, “I would highly recommend this place to anyone, they are always pleasant and when I ask for something I get it.”

We found the service had deteriorated in the safe domain and continued requiring improvement in the well led domain since our last inspection. The service met the characteristics of requires improvement in two out of the five key questions. This was the first time this service is rated as ‘requires improvement.’

We found one breach of the regulations in relation to safe care and treatment because of risks to people due to inconsistencies in the management of medicines and management of some risks to people's care.

At this inspection, we found improvements were still required in how the service was managing people’s medicines. Medication was administered in a kind and person-centred way however, we found inconsistencies in the administration of thickeners prescribed to manage people’s swallowing difficulties and records did not always confirm time specific medication had been administered as required.

The management of risks was not always consistent. We found concerns with the support people were receiving with their moving and handling requirements. We could not be certain people who required specialist seating equipment to meet their postural and pressure relief needs were using the appropriate equipment.

There was a regular and varied programme of activities at the home and people spoke positively about the activities coordinator. However we found people, in particular those living with dementia, spent periods of time without being offered social stimulation.

The provider had several systems in place to monitor the quality of the service, but these had not always been effective in identifying or addressing the issues found at this inspection.

People and relatives spoke positively about the relationships established with staff. People’s care plans were personalised, however this information was not always kept secure. We made a recommendation about respecting people’s rights to dignity and privacy.

People were supported by staff who were motivated, enjoyed their job and felt well supported through regular supervisions and training.

The provider had developed several links with the community and partnerships to support care provision and service development.

Feedback from people, relatives and staff was positive and they felt the service was well-led. They told us the management team were always available to speak with and were approachable. The registered manager was responsive in addressing the issues found at this inspection and told us about plans they had to improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At our last inspection the service was rated Good (report was published on 28 October April 2016).

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people received safe, high quality care.

Further inspections will be planned for future dates.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Inspection carried out on 17 August 2016

During a routine inspection

The inspection took place on 17 August 2016 and was unannounced. This means the provider did not know we were coming. We last inspected Fairmount Nursing Home in November 2013. At that inspection we found the service was meeting the legal requirements in force at the time.

Fairmount Nursing Home provides nursing and personal care for older people, including some people with dementia-related conditions. At the time of our inspection there were 32 people living at the home.

The service had a registered manager. 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.

We found that there were established systems for protecting people from abuse and avoidable harm. The service responded appropriately to any safeguarding concerns. Measures were in place to prevent risks associated with people’s care. Care was provided in a safe, clean environment.

New staff were checked and vetted before they started working at the home. There was enough experienced staff to provide people with safe and consistent care. Staff were appropriately trained and supported in their personal development.

People were suitably assisted in meeting their health care needs and taking their prescribed medicines. A balanced diet was offered to ensure good nutrition and where necessary, specialist advice was obtained. Support with eating and drinking was provided and people told us they enjoyed the food.

People and their families were consulted about and able to direct the way their care was given. The service upheld people’s rights under mental capacity law when they were unable to make important care decisions. Feedback was sought and any complaints received were properly investigated and resolved.

People and their relatives were happy with the care and spoke highly of the staff. We observed staff were caring in their approach and respectful of people’s privacy and dignity. The service gave people the information they needed and supported them to express their views.

Care was planned according to people’s individual needs and preferences and adapted in response to any changes. A range of activities and good leisure facilities were made available to help people meet their social needs.

The home had a registered manager who was supportive and provided leadership to the staff team. They promoted transparent communication and were committed to improving the service. The quality of the service was checked to make sure standards were being maintained, though we have made a recommendation to reintroduce audits of the management of medicines.

Inspection carried out on 4 November 2013

During a routine inspection

During the inspection we had the opportunity to speak with five people who used the service, a staff nurse, two domestics, two relatives and three staff members.

The people who used the service and their relatives told us they were looked after very well and felt safe with the care and treatment provided. Their comments included: "I like it here", “They are lovely” and “It’s like my family”.

We found that service had appropriate systems in place to ensure consent was gained before staff proceeded with personal care.

We spent time observing the lounges and dining area during the day of our inspection. We looked at how people spent their time and how staff interacted with people.

The interactions we saw between staff and people who used the service and visitors were respectful. We saw some people engaged in activities with members of staff such as arm chair exercises.

Inspection carried out on 15 February 2013

During a routine inspection

During the visit we had the opportunity to speak with four people who used the service and two relatives. Everyone told us they were "more than happy" with the care and support provided at Fairmount. They said the staff were "great and friendly," "approachable and accommodating" and "professional and caring." People told us they could make choices and decisions about how they wanted to spend time at the home and staff encouraged them to be fully involved in making decisions about their care and treatment. A relative told us they were involved in discussions and decisions about their relatives care needs and were kept informed about any changes. They said "my relative loves it here, the staff are so friendly and considerate they will do anything for you they are very courteous." People who lived in the home and their relatives said the food was very good and the home was clean, nice and comfortable.

During an inspection to make sure that the improvements required had been made

Due to the specific focus of this review, we did not speak with the poeple who use the service on this occassion.

Inspection carried out on 7 July 2011

During a routine inspection

All the people we spoke to who use services were very complimentary about the care they received from all the staff. They felt actively involved in their care and staff treated them with respect. They felt safe and comfortable in talking to the staff and staff listened to them.

Reports under our old system of regulation (including those from before CQC was created)