Archived: Fairhaven Residential Home

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found '

Is the service safe?

During our last inspection we found the provider could not ensure that medicines were prescribed and given safely in order to protect people. The provider wrote to us with an action plan of improvements which would be made. During this inspection we found the provider had made significant improvements to the management of medicines.

We spoke with three people living at Fairhaven. They all told us they felt safe living there. They said they had confidence in staff's abilities to provide the care and support they needed.

We spoke with one person's relative who told us 'The staff are brilliant. I have every confidence my family member is well looked after.'

Care plans provided guidance for staff on how to meet people's needs in a way which minimised risk for the individual. People's diversity, values and human rights were respected. We observed people were treated with respect and dignity by the staff.

Medication was administered safely and at the correct times to ensure people's health and well-being.

Care staff told us they received supervision and had undertaken training in the safeguarding of vulnerable people. This ensured that staff were able to identify unsafe practices and take appropriate action to resolve them.

Staff we spoke with told us that if they witnessed practices they felt were unsafe that they would raise their concerns with management.

Recruitment practices were safe and thorough. Appropriate checks had been undertaken during the recruitment process to ensure that staff of good character were employed.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care settings. While no applications had been submitted, appropriate policies and procedures were in place. Staff had received training in the Mental Capacity Act and the application of DoLS. Care staff were able to explain what actions they would take if they felt that people were unable to express their choices and wishes.

The service was safe, clean and hygienic. Equipment was well maintained and serviced regularly therefore not putting people at unnecessary risk.

Is the service effective?

People's care and welfare needs were assessed with them, and/or their relatives, as appropriate. Care plans were detailed and clearly identified people's needs and how they should be met. They were reviewed regularly and changes were made to meet people's changing needs. People and their relatives told us their healthcare needs were well met. Specialist dietary and equipment needs had been identified in care plans where required. One person told us 'They support me to manage my diet, they know what food I can or can't have.' A relative said 'they really know my family member well.'

It was clear from our observations and from speaking with care staff that they had a good understanding of the people's care and support needs.

The provider had effective systems in place for the obtaining, storage, administration, recording and disposal of medicines.

Is the service caring?

We saw people were supported by attentive and caring staff. We observed one staff member offering reassurance to a person, who had become distressed, in a kind and sensitive manner.

Care staff we spoke with confirmed they were responsible for reading people's care plans and for ensuring they were up to date with any changes. Care plans we reviewed reflected people's needs, preferences and diversity.

The home worked with other healthcare specialists to ensure people's welfare was maintained and any changes to their health were addressed.

Is the service responsive?

Prior to people being admitted to Fairhaven theyhad their needs assessed. This information was then transferred in to a person centred care plan. This meant the service was able to respond to the needs of each individual living at the home.

People knew how to make a complaint if they were unhappy. No complaints had been received in 2014. People told us they could speak with staff if they had any worries. They said they felt 'listened to and supported.' A relative we spoke with told us they were confident that any concerns would be listened to and any action required taken''.

Is the service well-led?

During our previous inspection we found the home did not have a registered manager in post. A new manager had been appointed and was applying to become the registered manager .

They were currently undertaking a review of the service and working practices. They told us about new systems they were implementing to ensure people received a quality service. They were also in the process of reviewing all policies and procedures to ensure that they were 'fit for purpose'.

The service had a quality assurance system in place. Records seen by us showed identified shortfalls were addressed. As a result the quality of the service was being maintained or improved.

Care staff we spoke with told us some of the benefits of the changes which had already taken place. Care staff were clear about their roles and responsibilities and the needs of the people they were supporting. This helped to ensure that people received a good quality service.

People who used the service received care and support from staff who were competent to carry out their roles. All staff received a comprehensive induction when they started their job. Further learning and development of staff was identified based on the needs of the people they were supporting.

We spoke with people who use the service, the general manager, a visiting professional and staff. During our visit we observed there was a relaxed atmosphere with people choosing where they wished to spend their time. We observed staff treating people with kindness and patience whilst respecting their privacy and dignity. We observed staffs understanding of the care and support needed. One person said staff were "very pleasant" and another said they enjoyed having a "laugh" with staff.

We looked at people's individual records which incorporated their personal profile, care plans and risk assessments and found they encompassed the safety and well-being of people who use the service. We reviewed the provider's quality management system and records and found that people were given the opportunity to provide feedback on the service and staff had received relevant training.

We reviewed the medication records and found shortfalls in the way daily recordings were completed which may have an impact on the people who use the service.

We found that people and their representatives had been involved in planning their care. We saw that the staff were familiar with people's needs and gave them opportunities to make choices.

The home had effective systems in place to ensure that safeguarding incidents were robustly dealt with. Staff were appropriately trained and were able to explain the process for reporting safeguarding incidents. There was safeguarding information displayed around the home for the staff and people using the service to refer to.

Staff had received an appropriate induction and were provided with regular supervision and appraisals. Training was appropriate to staff roles and regular refresher training was provided. Staffing shortfalls were covered by staff wherever possible; the home did not use any bank or agency staff.

The home's quality assurance systems effectively ensured that the performance of the home was adequately monitored, and the views of people living in the home and their representatives were taken into consideration.