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Fairlight & Fallowfield Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 12 March 2019

This inspection took place on 8 and 9 January 2019 and was unannounced. Fairlight and Fallowfield is a ‘care home’. People in care homes receive accommodation and nursing, or personal care as 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 55 people, across two joined buildings or units with adapted facilities, one of which focuses on residential care, and the other on nursing care. There were 52 people living at the home at the time of our inspection

At the last inspection on 22, 23 and 24 November 2017 we had found some improvement was required because sufficient staff were not always deployed to ensure people received prompt support when required. We also found that some environmental risks were not consistently managed safely at the service, call bell response times were not monitored effectively and notifications were not consistently submitted to CQC, where required. The home was again rated Requires Improvement overall for the fifth successive occasion since 2015. As part of our methodology for services repeatedly rated Requires Improvement we met with the provider on 26 January 2018 to discuss their improvement action plan to discuss what they would do to improve the key question safe and well led to good.

At the last inspection in November 2017 there was no registered manager in post. At this inspection there was an experienced registered manager who had registered as manager at the home since May 2018. 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.

At this inspection we found all the areas we had identified as requiring improvement at the last inspection had been addressed. However, we found the quality of other aspects of care and support was not effectively monitored and managed to ensure other specific risks to people’s health and safety were identified and assessed. We found two breaches of regulation as the systems to ensure oversight of risks in relation to the premises and people’s dietary needs was not always effectively managed to reduce possible risks to people. The issues we found had also not been identified by the provider’s own quality assurance systems.

You can see what action we have asked the provider to take in respect of one breach of regulation at the back of the full version of this report. However, full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded

Other aspects of the governance of the home also required some improvement. There were no regular infection control audits or checks carried out on the care provided at night. Some issues identified were not always addressed promptly. While there was informal discussion and regular handovers between shifts; there was an absence of visible processes such as meetings to aid communication and oversight of the home. People’s views about changes to the service were not always consistently sought.The service has again been rated Requires Improvement for the sixth time.

Improvements were required as although there were systems in place for the monitoring and investigating of accidents, incidents and safeguarding; there was no clear system to ensure trends or learning was consistently identified. We also found some improvements were needed to ensure people’s diverse rights were identified, respected and supported and to evidence people and their relatives’ involvement in the care review process.

People and their relatives told us they felt safe at the home. Staff understood how to safeguard people and

Inspection areas

Safe

Requires improvement

Updated 12 March 2019

The home was not consistently safe.

Some risks to people were identified and assessed but risks in relation to the use of the stairs had not been assessed or identified.

There were systems in place to manage emergencies and to identify and monitor other risks in relation to premises and equipment.

There were systems in place for the monitoring and investigating of accidents, incidents and safeguarding. However, there was no clear system to ensure trends or learning was consistently identified.

Staff understood how to safeguard people from possible harm or abuse and understood the action to take if they had any concerns.

There were enough staff to meet people’s needs and staff recruitment practices complied with the regulations.

Medicines were stored, managed and administered safely.

Staff understood how to reduce the risk of infection.

Effective

Good

Updated 12 March 2019

The home was effective.

People’s physical, mental and social needs were assessed before they moved into the home.

Staff were supported to do their job and received regular training, supervision and annual appraisals of their work performance.

People told us they enjoyed the food and were supported to eat a well-balanced diet.

People were supported to maintain their health and well-being and were referred to health professionals when needed.

There were arrangements in place which ensured the service complied with the Mental Capacity Act 2005 (MCA 2005).

Overall the home environment was suitably maintained and adapted to meet people’s needs.

Caring

Good

Updated 12 March 2019

The home was caring

People and their relatives told us staff knew them well and were kind and caring.

People told us they were consulted about their care and support. They were encouraged to be as independent as possible and supported to maintain important relationships.

People and their relatives told us their privacy and dignity was respected.

Responsive

Requires improvement

Updated 12 March 2019

The home was not always responsive.

People’s diverse needs were not always consistently identified or met.

People were involved in making decisions about their care, although this was not always clearly recorded.

There were a range of activities available to meet people’s interests and needs.

The home had achieved the highest award for end of life care from a recognised scheme and provided care and support to people at the end of their lives.

People and their relatives knew how to make a complaint and these were responded to in line with the complaints policy.

Well-led

Requires improvement

Updated 12 March 2019

The service was not consistently well led.

There was now an experienced registered manager in place. They had addressed the issues found at the last inspection. However, we found other concerns that were not identified by the provider’s quality monitoring.

The system of oversight of some risks in relation to an aspect of the premises and people’s dietary needs was not effectively managed and there was a risk of inappropriate care.

Some area of quality monitoring required improvement to work effectively or not regularly carried out.

People’s views about the home were sought through surveys and meetings. They told us these were acted on. However, it was not clear that they were consulted about some changes that took place within the home.

There were regular handovers but otherwise there were limited arrangements for the monitoring of risk and sharing of information across the home.

Staff spoke positively about the leadership at the home and the provider and changes they had introduced.