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Inspection carried out on 29 October 2018

During a routine inspection

This inspection took place on 29 October 2018 and was unannounced.

Fair Haven Care Home 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. Fair Haven Care Home is registered to accommodate 20 people with mental health conditions. At the time of our inspection there were 19 people living in the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the overall rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. However, at this inspection, we rated the service as ‘requires improvement’ under the responsive domain. Details about this can found below.

This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Whilst there were adequate staffing levels to keep people safe, there were not enough staff to provide people with meaningful activity throughout the day. Activities, including use of the local community, were not happening on a regular basis.

There was a registered manager in post. 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.

People felt safe. We saw that staff had been appropriately recruited in to the service and security checks had taken place. There were adequate levels of staff to keep people safe. People received their prescribed medicines safely.

The service was regularly cleaned by the staff. Several areas were in need of decoration and refurbishment, and the registered manager showed us that this work was booked in to be carried out imminently.

The care that people received was effective. Staff had access to the support, supervision, training and ongoing professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in place supported this practice.

People continued to be treated with empathy and kindness and their individuality was respected. The staff were friendly, caring and compassionate. Positive relationships had been developed between the people and staff.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open culture. The provider was committed to developing the service and actively looked at ways to continuously improve the service. There were effective quality assurance systems and audits in place; action was being taken to address improvements identified.

Inspection carried out on 8 June 2016

During a routine inspection

This unannounced inspection took place on 8 June 2016. This residential care service is registered to provide accommodation and personal care support for up to 21 people with mental health needs and learning disabilities. At the time of the inspection there were 19 people living at the home.

There was a registered manager in post at the time of our inspection. 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.

People felt safe in the home. Staff understood the need to protect people from harm and knew what action they should take if they had any concerns. Staffing levels ensured that people received the support they required at the times they needed and recruitment procedures protected people from receiving unsafe care from care staff unsuited to the job.

Staff followed the information held in care records which contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe. People were supported to take their medicines as prescribed and medicines were obtained, stored, administered and disposed of safely.

People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person and people were actively involved in decisions about their care and support needs. There were formal systems in place to assess people’s capacity for decision making under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). People were supported to maintain good health and had access to healthcare services when they were needed.

People received care from compassionate and supportive staff which promoted positive relationships with each other. Staff understood the needs of the people they supported and used their knowledge of people’s lives to engage them in meaningful conversations. People were supported to make their own choices and when they needed additional support the staff arranged for an advocate to become involved.

Care plans were written in a person centred manner and focussed on giving people choices and opportunities to receive their care how they liked it to be. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to choose where they spent their time and what they did. People were able to raise complaints and they were investigated and resolved promptly.

People and staff were confident in the management of the home and felt listened to. People were able to provide feedback and this was acted on and improvements were made. The service had audits and quality monitoring systems in place which ensured people received good quality care that enhanced their life. Policies and procedures were in place which reflected the care provided at the home.

Inspection carried out on 30 June 2014

During an inspection looking at part of the service

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; is the service safe? is the service effective? is the service caring? is the service responsive? is the service well lead?

This is a summary of what we found-

Is the service safe?

People were cared for in an environment that was now safe because the garden fence and the emergency lighting had been repaired and the required safety checks had been conducted. Quality assurance systems were in place and had identified areas for improvement within the environment.

Is the service effective?

When people engaged in activities that put them at risk; the risks were adequately assessed and effective controls were put in place to reduce and manage the risks.

Is the service caring?

We saw that staff treated people with consideration and respect and were mindful of people�s privacy. Staff referred to people by their preferred name and involved them in decisions about their care and support.

Is the service responsive to people�s needs?

When people engaged in activities that put them at risk the risks were adequately assessed and effective controls were put in place to reduce and manage the risks.

Is the service well lead?

At the time of our inspection the provider did not have a registered manager in post.

Essential repairs to the environment had been completed and safety checks had been conducted. Staff recruitment systems had been improved to ensure that all the right checks had been done and recorded in the staff files. When people engaged in activities that put them at risk the risks people were adequately assessed to ensure that effective controls were put in place to reduce and manage the risks.

Inspection carried out on 1 April 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we had inspected to answer questions we always ask; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well lead?

This is a summary of what we found-

Is the service safe?

People told us that they felt safe living at Fair Haven; however people had been cared for in an environment that was not safe because of delays in essential repairs. Medication systems were not always safe because essential guidance had not been obtained from the dispensing pharmacist. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to medication and quality assurance.

Is the service effective?

People were happy with the care that had been delivered, one person said �We do lots of things here we play bingo and go on outings, I love it here�. However records showed that when people engaged in behaviours that put them at risk; the risks were not always managed effectively. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to care and welfare and quality assurance.

Is the service caring?

People told us the staff were nice to them and that there were enough staff to meet their needs. We saw that people were involved in decisions about their care and any restrictions were made in their best interest and with their consent.

Is the service responsive to people�s needs?

People we spoke with told us they felt there were enough staff on duty to meet their needs; we saw that staff were mindful of people�s privacy and that they treated them with respect.

Is the service well lead?

Quality assurance processes had not identified that the staff records did not contain all the required information. Also when people engaged in behaviours that put them at risk, the risks were not always managed appropriately. We have asked the provider to tell us how they will make improvements and meet the requirements of the law in relation to quality assurance.

Inspection carried out on 21 May 2013

During a routine inspection

We spoke with five people during our inspection at Fair Haven Care Home, they told us that the staff involved them in decisions about their care and explained their care needs to them before providing care and support.

All of the people we spoke with told us that they were well looked after, that the staff knew the care they needed and how they wished to be supported. One person commented �I have lived here a long time, I love it, nobody will make me move away from here�.

People also told us that they were comfortable living at Fair Haven Care Home. One person told us �I really like my room, it�s very comfortable and I like to keep it nice and tidy�.

People told us that they felt safe and that the staff were nice to them. They told us that they thought that the staff had the right skills to care for them safely.

Inspection carried out on 27 August 2012

During a routine inspection

We spoke with four people during our visit to Fair Haven Residential Care Home. They told us that the staff explained procedures and asked for their permission before providing care and treatment. All of the people we spoke with told us they were well looked after and that the staff knew how they wished to be supported. One person that we spoke with told us that they were pleased that the staff looked after their medication for them. They also said they were well supported by the staff to take their medication in the right way. People told us they thought the staff had the skills to care for them appropriately and that they knew how to complain if they needed to do so.

Inspection carried out on 23 January 2012

During a routine inspection

People told us that they liked living at Fair Haven, they felt they were well looked after and that the staff knew how they needed and wished to be supported. They also told us that the staff were nice to them, that they felt safe and that they knew how to raise any concerns should they need to do so.

All of the people that we spoke with said that they were able to make choices about their routines and how to spend their time. People told us that they enjoyed taking part in domestic activities in the home such as baking, washing up, laying the tables and decorating vacant rooms. They also said that they were happy with the quality of the service provided at Fair Haven and that staffing levels had improved since the appointment of the new manager.

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