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Fairlight & Fallowfield Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 4 September 2019

About the service: Fairlight and Fallowfield is a care home made up of two distinct units, a nursing unit and a residential unit. in joined buildings; Fairlight is the residential unit and Fallowfield the nursing unit. The care home accommodates up to 55 people in total. There were 49 people aged 65 and over living there at the time of the inspection.

Why we inspected: This was a focused inspection to follow up on the enforcement action we had taken at the comprehensive inspection in January 2019. It was to see if the provider now met the regulations in the key questions Is the service safe? And Is the service well led? We were also aware of a notifiable safety incident which was being investigated under safeguarding at the time of the inspection and which raised questions about care and treatment provided to people following a fall.

Following the last inspection and the sixth repeat overall Requires Improvement rating we had met with the provider and registered manager with representatives from the local authority on 13 March 2019 to discuss their overall rating and how they might make improvements to meet the regulations. They had provided us with an improvement plan. The inspection was also to review the progress of the improvement plan where it fell under the key questions of safe and well led.

People’s experience of using this service:

We found that some improvements had been made and actions taken in respect of some concerns identified at the previous inspection in January 2019. However, other areas had not been acted on or, where they had this had not been in a robust and effective way. We found there was a continued breach of regulations in the way the home was run. There was an absence of effective systems to provide oversight over risks to people following accidents and incidents and in relation to possible risks at the service identified at the last inspection, which had not been fully addressed. There was an absence of effective oversight to ensure adequate records of people’s care were maintained.

We also found the provider and registered manager had not met the requirements of the duty of candour regulation which require registered persons to act in an open way following a safety incident about how such incidents have been responded to.

We had mixed feedback from people and relatives about the way the service was run. There was no system to ensure regular checks were carried out on people in their rooms or that staff received and understood communication at handovers or from staff meetings. The service did not proactively seek to include relatives at residents’ meetings. Audits and checks were not always effective at identifying issues.

There were no effective systems to assess and review required staffing levels. We have made a recommendation for the provider to seek suitable guidance on deciding appropriate staffing levels.

People told us they felt safe and looked after. Medicines were safely managed. There were effective recruitment measures in place. The management of people’s dietary risks which had been a concern at the previous inspection had improved and communication about these risks was more effective. Kitchen staff had received appropriate training in relation to possible choking risks.

Not all key questions were considered at this inspection and the service remains rated Requires Improvement overall. This will be reviewed again at our next comprehensive inspection.

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

Rating at last inspection: Requires Improvement report published 12 March 2019.

Enforcement: Full information about The Care Quality Commission's (CQC) regulatory response to more serious concerns found in inspections and appeals is added to reports after any representation and appeals have been concluded.

Action we told provider to take: For further information please see the ‘action we have told the provider to take’ section tow

Inspection areas

Safe

Requires improvement

Updated 4 September 2019

The service was not always safe

Details are in our Safe findings below

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 4 September 2019

The service was not always well-led

Details are in our Well-Led findings below.