• Care Home
  • Care home

Archived: Fairview House

Overall: Good read more about inspection ratings

37 Clatterford Road, Newport, Isle of Wight, PO30 1PA (01983) 718681

Provided and run by:
Fairview Care Home Ltd

Important: The provider of this service changed. See new profile

All Inspections

28 June 2017

During a routine inspection

Fairview House is a care home registered to provide accommodation for up to 24 people, including people living with a cognitive impairment. At the time of our inspection there were 19 people living in the home. The inspection was unannounced and was carried out on the 28 and 29 June 2017 by two inspectors.

At our previous inspection in November 2016, we identified three breaches of regulations. The provider had; failed to assess and mitigate risks to the health and safety of people using the service effectively; failed to ensure that the premises and equipment used by people were clean and properly maintained and failed to ensure that sufficient numbers of suitably qualified, competent and skilled staff were deployed in order to meet their needs. At this inspection we found action had been taken and all these areas had been addressed.

People, their families and staff all felt that there had been substantial improvements in all areas of the service over the last six months. These improvements included staffing levels; the atmosphere; the cleanliness of the home; the level of care provided and the overall running of the service.

There was a registered manager in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

People and their families told us they felt the home was safe. The risks relating to people’s health and welfare were assessed and these were recorded along with actions identified to reduce those risks in the least restrictive way.

Accident and incident records were clear and detailed and these were reviewed daily to see if any immediate action was required and monthly to identify any patterns. This enabled the registered manager to identify any actions necessary to help reduce the risk of further incidents.

Risks posed by the environment had been assessed and were being managed appropriately. There was a clear and detailed cleaning schedule in place, which domestic staff and care staff worked to, and daily spot checks were completed to assess the cleanliness of the home.

There were sufficient staffing levels to meet the needs of the people which enabled staff to engage with people in a relaxed and unhurried manner. Staff received an induction into the home, appropriate training and supervision to enable them to meet people’s individual needs.

Staff and the registered manager were able to demonstrate an understanding of the provider’s safeguarding policy and explain the action they would take if they identified any concerns.

There were suitable systems in place to ensure the safe storage and administration of medicines. Medicines were administered by staff who had received appropriate training and assessments of their competence. Healthcare professionals, such as chiropodists, opticians, GPs and dentists were involved in people’s care when necessary.

Staff followed legislation designed to protect people’s rights and ensure decisions were the least restrictive and made in their best interests.

People were supported to have enough to eat and drink and staff supported people, when necessary, in a patient and friendly manner.

Staff developed caring and positive relationships with people, were sensitive to their individual choices and treated them with dignity and respect. People were encouraged to maintain relationships that were important to them.

People and when appropriate their families were involved in discussions about their care planning, which reflected their assessed needs.

There was an opportunity for families to become involved in developing the service and they were encouraged to provide feedback on the service provided both informally and through an annual questionnaire. They were also supported to raise complaints should they wish to.

People’s families told us they felt the home was well-led and were positive about the registered manager who understood the responsibilities of their role. Staff were aware of the provider’s vision and values, how they related to their work and spoke positively about the culture and management of the home.

15 November 2016

During a routine inspection

This inspection took place on 15 & 17 November 2016 and was unannounced. The home provides accommodation and personal care for up to 24 people, including people living with dementia. There were 20 people living at the home when we visited.

The home 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.

At our previous inspection in December 2015, we identified a breach of regulation as the provider had not displayed their CQC performance rating as required. At this inspection we found action had been taken; the rating was displayed prominently on the premises and on the provider’s website.

People’s safety was compromised in some areas. The risks of people falling were not managed effectively. There was no clear policy or procedure in place to protect people with a history of falls; advice from specialists was not always followed and use was not made of equipment that could monitor people’s movements. The registered manager did not analyse the incidence of falls, so could not take remedial action to reduce them.

People told us there were not always enough staff deployed to meet their needs. On the morning of the first day of our inspection, there were not enough care staff and people did not receive the necessary support with their care needs. When additional staff arrived later in the morning, the atmosphere calmed and people were attended to promptly. Staff told us, and the duty rotas confirmed that the staff shortages had been common in recent weeks.

A cleaner was supporting the care staff, but this had had a knock-on effect with their work. We found some people’s bedrooms smelt of urine as the floors had not been mopped; one person’s sheets were badly stained and another person’s mattress was spattered with a brown substance. Instead of being changed, the mattresses had been turned over and made ready for the person to sleep on.

Staff knew how to prevent, identify and report abuse. However, money kept on behalf of people was not stored securely and put people at risk of financial abuse. We discussed this with the registered manager who took immediate action to store it securely.

There was a clear management structure in place, but responsibilities had not been delegated to senior staff. This put a heavy burden on the shoulders of the registered manager who did not have the time to take an overview of the service or identify and implement the necessary improvements.

The registered manager was not supported to access advice or guidance from their peers, so were not up to date with current practice, such as the requirements around the duty of candour regulations. Consequently, they had not provided written information to the relative of a person who had sustained a serious injury during a fall. Links had not been developed with community groups and people were not supported to leave the home and access the community.

Regular checks were conducted to make sure the building was safe for people and there were arrangement in place to deal with foreseeable emergencies. There were appropriate arrangements for managing medicines. Pre-employment checks were conducted to help ensure staff were suitable to work at the home.

Sttaff were skilled and suitably trained. New staff completed a comprehensive induction programme and all staff were suitably supported in their roles by the managers.

Staff followed legislation to protect people’s rights and freedoms. They sought consent from people before providing care or support.

People praised the quality of the food. Their dietary needs were met and staff provided people with appropriate support at lunchtime to help ensure they ate and drank enough. Staff monitored people’s weight and took action if they started to lose unplanned weight. People could access healthcare services and were referred to doctors and specialist nurses when needed.

People were usually cared for with kindness and compassion. Staff interacted with them in a positive way. They spoke about people warmly and demonstrated a detailed knowledge of them as individuals. They were skilled at communicating with people living with dementia.

Staff protected people’s privacy and involved people in the care planning process. They kept family members up to date with any changes to their relative’s needs.

Arrangements were in place to help ensure people experienced a comfortable, dignified and pain-free death. Staff had received training in end of life care and, following feedback from relatives, had signed-up to refresh this training by completing an extended course at a local college.

People received personalised care and support that met their needs. Care plans had been developed which provided staff with information about how to meet people needs. People were encouraged to make choices about every aspect of their daily lives and had access to a range of activities within the home.

The provider sought and acted on feedback from people. There was an appropriate complaints procedure in place and people knew how to make a complaint.

A quality assurance process had been developed. This had identified and addressed some areas that needed improvement. The provider promoted the value of dignity, which staff worked to.

We identified breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

4 & 9 December 2015

During an inspection looking at part of the service

This inspection took place on 4 and 9 December 2015 and was unannounced. The home provides accommodation and personal care for up to 24 people, including people living with dementia. There were 17 people living at the home when we visited.

At our previous inspection, on 8 June 2015 we identified that records relating to decisions made on behalf of people were not recorded appropriately and records relating to people’s care were not always up to date. At this inspection we found action had been taken and the provider was meeting the fundamental standards of care and safety.

The home had a registered manager in place. 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.

Providers are required to display their performance rating on their public website and prominently within the home. The provider had not done this, although their rating was displayed in the home on the second day of the inspection.

Most medicines were managed appropriately, although there was a lack of information about when to administer ‘as required’ medicines and topical creams were not always managed safely. Suitable infection control processes were followed, other than the storage of clinical waste in the laundry which posed a risk of cross infection.

The risks of people falling or developing pressure injuries were managed effectively. However, one person’s pressure relieving mattress was set at the wrong level and a door wedge was being used which would have prevented a fire door from closing in an emergency. Where accidents had occurred, appropriate action was taken to reduce the risks.

Legislation designed to protect the rights and freedom of people was followed. Staff sought consent from people before providing care and support. Staff were suitably trained and supported in their role, although supervision meetings were only held sporadically for some staff.

There was a system in place to regularly assess and monitor the quality of service. Changes were made when they were identified, but audits had not picked up the lack of information about ‘as required’ medicines or that the system to manage topical creams was not being followed.

Most people felt the home was run well. A high level of staff turnover had unsettled the staff team, although team work was improving. There was a clear management structure on place and staff understood their roles.

People told us they felt safe at Fairview House. Staff had received training in safeguarding adults. They knew how to identify, prevent and report abuse and responded appropriately to allegations of abuse.

There were enough staff to meet people’s needs and appropriate recruitment practices were in place. People were complimentary about the food and were encouraged to eat and drink well. People were supported to maintain good health and had access to healthcare services.

People and their relatives described staff as “kind” and “caring”. We observed positive interactions between people and staff. Staff knew people well and spoke about them fondly. They engaged in meaningful conversations and encouraged people to remain as independent as possible.

People’s privacy and dignity were protected at all times. They, and their relatives when appropriate, were involved in planning the care and support their received. Care was delivered in a personalised way and people were supported to make choices.

Care plans included clear guidance about how people wished to receive care and support. They were updated regularly and staff were responsive to changes in people’s needs. A range of activities was provided. Feedback from people about the service was sought and acted on.

People had agreed to the use of a CCTV system to monitor communal areas of the home. This was used to investigate complaints and allegations of abuse. The provider notified CQC of all significant events. The registered manager was aware of key strengths and areas for development for the service and there was a development plan in place.

We identified a breach of Regulation 20A of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

8 June 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of Fairview House on 19 and 20 January 2015, at which a breach of legal requirements was found. This was because information relating to people’s ability to make decisions, pain management and incidents of behaviour that challenged was not recorded appropriately.

After the comprehensive inspection, the provider sent us an action plan detailing what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on 8 June 2015 to check they had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Fairview House’ on our website at www.cqc.org.uk’.

The home provides accommodation and personal care for up to 24 people, including people living with dementia. There were 21 people living at the home when we visited.

The home 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 and associated Regulations about how the service is run.

At our focussed inspection on 8 June 2105 we found action had been taken and some improvements had been made. However, the provider was not meeting the regulations fully.

All the people using the service had cognitive impairment to some degree and were unable to make certain decisions, such as to receive personal care and medicines from staff. Staff had made decisions on behalf of people and family members had been consulted. However, the decisions had not been documented in a way that showed the relevant legislation had been followed.

The registered manager had re-introduced forms used to record incidents where people became particularly anxious or distressed. These helped the provider and health professionals design suitable support plans. By working closely with dementia care specialists, staff had managed to reduce the frequency of such incidents.

Information had been developed and recorded about the signs displayed by people who were unable to tell staff when they were in pain. The information had helped staff provide appropriate pain relief.

People received appropriate care and support in accordance with their individual needs. Care plans provided comprehensive information about how people wished to be cared for and these were reviewed regularly. Family members were kept up to date with any changes to their relative’s needs.

We identified a breach Regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

19 and 20 January 2015

During a routine inspection

This inspection took place on 28 November and 1 December 2014 and was unannounced. The service provides accommodation and personal care for up to 24 people, including some people living with dementia. There were 21 people living at the service when we visited.

The service had a registered manager in place. 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 were not always protected from the risks of inappropriate care as some records were not fully completed. Where people lacked the capacity to make certain decisions, records of the decisions made on their behalf were not always kept. Staff did not have access to information to help them identify when people needed pain relief. When people displayed behaviours that challenged others, staff did not record the triggers or the responses that were most effective, so appropriate strategies could be planned. The quality assurance system had not picked up these concerns.

People and their relatives spoke positively about the care they received and told us their needs were met. One person said, “Oh, it’s lovely here, I really like it.” A relative told us “The care is excellent.” Care plans were personalised and provided comprehensive information about how people wished to be cared for.

People were cared for with kindness and compassion. One person told us “Staff are wonderful.” Another person said of the staff, “The best thing is they listen to you.” A community nurse described staff as “engaging, concerned about their residents, caring and supportive.” Staff knew people well, protected their privacy and involved them in planning their care.

People told us they felt safe at the home. Staff had received training in safeguarding adults and knew how to identify, prevent and report abuse. The risks of people falling, developing pressure injuries or being harmed by bed rails were managed safely.

Medicines were stored securely and appropriate arrangements were in place for obtaining, recording, administering and disposing of them. People received their medicines safely and as prescribed.

There were enough staff to meet people’s needs and people were attended to quickly when they called for assistance. The process used to recruit staff was safe and ensured staff were suitable for their role.

People received appropriate support to eat and drink and were offered a choice of nutritious meals including fresh fruit and a range of drinks. They had access healthcare services and were referred to doctors and specialists when needed.

Staff were skilled and knowledgeable about the needs of people living with dementia and how to care for them effectively. The received appropriate training and were supported through the use of one to one supervision and yearly appraisals.

There was an open and transparent culture within the home. Visitors were welcomed and there were good working relationships with external professionals. Staff worked well together which created a relaxed and happy atmosphere, which was reflected in people’s care.

The provider sought feedback from people and staff on an ongoing basis. The registered manager was aware of key strengths and areas for development for the service and there was a development plan in place.

We have made a recommendation about creating suitable environments that support people living with dementia.

The lack of recorded information about some people’s needs was a breach of Regulation 20 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

6 September 2013

During an inspection looking at part of the service

Our previous inspection in June 2013 identified that care was not always delivered in accordance with people's care plans. The methods used to support people to eat did not promote independence or encourage a good dietary intake. During this inspection we found improvements had been made.

We looked at six care plans and related records of care. We saw they provided comprehensive information and gave detailed instructions on how staff should provide support to people.

We used a variety of methods to help us understand the experience of people using the service. We spoke with three people, spoke with two family members and observed care and support being delivered.

During the lunchtime meal we saw people were supported appropriately and according to their individual needs. We saw some members of staff ate at the same time as people they were supporting, which made the mealtime a social occasion and encouraged people to eat well.

We found people's needs were known and met. One person told us, 'I'm well looked after'. A family member said, 'I've no complaints, they look after (my relative) well'. We spoke with the manager and four members of staff. Each demonstrated a good understanding of people using the service, their individual preferences and the care and support they required.

21 June 2013

During a routine inspection

We used a variety of methods to help us understand the experience of people using the service. We spoke with three people, spoke with four family members and observed care and support being delivered. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.'

We saw staff interacting positively with people. We heard staff checking that people were happy to accept care and support before it was delivered.

Family members told us their relative's needs were met. One family member said, 'Staff are lovely, they do look after them'. Another told us, 'I can't fault any of the care here'. However, we found methods used to support people to eat did not promote independence or encourage a good dietary intake.

We found people were cared for in a clean, hygienic environment. Effective systems were in place to reduce the risk and spread of infection. Two visiting health care professionals told us they were satisfied with the standard of cleanliness in the home.

Staff received appropriate training and professional development. They were supported to gain relevant qualifications.

The provider was responsive to comments made by people using the service and staff. Improvements had been made as a result.

2 January 2013

During a routine inspection

We visited the home in October 2011 and judged that it was non compliant with two regulations. The recording of food and fluids was not consistent, and medicines were not being managed safely. We told the provider to take action to improve these areas.

We visited the home again on the 2 January 2013. On this occasion we found that care was being delivered effectively and medicines were being managed safely. We also spoke with three people and four family members who were visiting. They all told us they were happy with the care provided. One person said, 'Staff are very good and very helpful'.

Care plans were person centred and contained comprehensive information about how care should be provided. We spoke with six members of staff, including the manager. They demonstrated a good understanding of the care needs of people. We saw this being delivered effectively, although not all staff had an understanding of how to support people appropriately with eating.

We also spoke with two community health care professionals who praised the care that was delivered. One said, 'They are very proactive and always take our advice'. Recruiting and selection procedures were effective and showed that the provider conducted all necessary checks before people started work.

People's personal medical records were accurate and fit for purpose. Staff records and other records relevant to the management of the service contained the necessary information and were accessible.

30 November 2011

During a routine inspection

We spoke to some of the residents and their relatives as part of this visit. People said that the staff had carried out an assessment of their needs before their relative moved into the home.

People told us that they were happy with the care they were receiving. They said that the staff were very nice but there was not always enough staff People described the staff as very kind, helpful and very friendly.

They told us that they felt that their dignity and privacy was respected. The comments were that their relatives were always dressed appropriately. They said that there were problems with their relatives wearing other people's clothing at times.

People said that the food was 'always very good' and they had choices. One person told us that their relative did not like fish and they were always provided with an alternative.

They said that some activities were provided and the residents would benefit from an in house activity co-ordinator.

Relatives said that they would be happy to approach the manager with any concerns.