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Fairlawn Residential Home Good

Reports


Inspection carried out on 4 December 2018

During a routine inspection

We inspected the service on 4 and 5 December 2018. The inspection was unannounced.

Fairlawn Residential Home is a ‘care home’. People in care homes receive accommodation and 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. Fairlawn is registered to provide accommodation and personal care for a maximum of 26 frail and elderly people, some of which were living with dementia. The service is a large extended property and people’s accommodation is provided over two floors with a stair lift available to support people to the upper floor.

There was a registered manager at the service. 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 the last inspection on 2 and 3 October 2017, we told the provider to take action to make improvements. This was because people, their relatives and staff told us there were not enough staff to meet the needs of those using the service. Additionally, we found shortfalls in the registered manager had not ensured that effective systems were in operation to monitor and improve the quality and safety of the service.

At this inspection we found there were enough staff deployed to meet the needs of people. Staffing levels had increased which had a positive impact on people using the service. The registered manager had improved quality monitoring procedures and audits, and had a better oversight of the quality of care being provided.

People were protected from the risk of abuse. Staff were trained in how to identify abuse and knew how to report it. Risks to people and the environment were assessed, recorded and staff took steps to minimise them. New staff were recruited safely in line with best practice and nationally recognised guidance. People received their medicines safely. Staff received training and had their competency checked regularly. People were protected by the prevention and control of infection. The registered manager took steps to learn from accidents, incidents and when things went wrong. They used information to help prevent future accidents.

People had their care and support delivered in line with current legislation and best practice guidance. Newly recruited staff received an induction which included training courses and shadowing more experienced staff. Other staff received refresher training that was built around those using the service. People’s nutrition and hydration needs were being met. People were involved in developing menus. Staff sought and followed guidance from health professionals if people had health conditions. People had access to health care and treatment. People’s needs were met by the design and adaptation of the premises. People were able to decorate and furnish their rooms as they wished. Staff were knowledgeable about the Mental Capacity Act (MCA) 2005, and worked in line with its principles.

Support was provided to people in a personalised way. Each person had their own care plan which had been reviewed taking into account their preferences and views. People were supported to take part in activities of their choosing. People said they knew how to make a complaint, and would do so if the need arose. Complaints were managed in accordance with the registered provider’s policy. People were supported at the end of their lives to have a dignified death. Their preferences were gathered and staff worked closely with health professionals.

The registered manager had the skills and experience to lead the service. The culture at the service was honest and transparent. Staff said they felt proud to work at the organisation. They had oversight of the daily culture in

Inspection carried out on 2 October 2017

During a routine inspection

We inspected Fairlawn on the 2 and 3 October 2017. The inspection was unannounced.

Fairlawn Residential Home is registered to provide accommodation and support to up to 26 older people. There were 21 people living at the service at the time of our inspection.

There was a manager in post who was registered with the CQC. 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.

Risks were managed effectively to ensure people’s safety and welfare. People were kept safe from abuse by staff who knew how to identify signs of potential abuse and were confident to respond appropriately. Staff used the safeguarding policy to guide them when reporting concerns and the registered manager investigated any concerns thoroughly.

Medicines were managed safely and effectively by trained staff. The registered provider had effective policies and procedures in place to help ensure the environment was kept safe and well maintained for the people living there.

There were insufficient numbers of staff to ensure that the needs of people were being met. The service did not use a systematic approach when determining the number and skills of staff required. Safe recruitment practices were carried out by the provider to ensure people were only supported by staff who were suitable to work with the people living in the service. Staff received training to help equip them with the right skills and knowledge to support the people in the service. The registered manager supported staff with regular supervision, but appraisals of staff performance did not take place. We have made a recommendation about this.

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

People were happy with the food provided, and were supported to have a nutritious diet that met their needs. Communication between the kitchen and care staff was good. People were supported to have regular and appropriate access to health care professionals such as the dentist, optician, chiropodist and the GP.

People who used the service spoke highly about the caring nature of staff. Staff knew people well and were able to take this into account when providing care and support. Relatives told us they were happy with the support provided, and with the caring nature of staff. People and their relatives were involved with the planning of care. Relatives were kept up to date with any changes, incidents or concerns involving their loved ones.

People at the service had access to a range of activities, but these were not always tailored to the interests of the people using the service. We have made a recommendation about this. People and their relatives were positive about the input from the activities coordinator. Where people could not attend communal activities, individual sessions were provided.

The registered manager was seen to be open and transparent and welcomed comments and input from staff, people using the service and their relatives. There was a complaints procedure in place. Outcomes of investigations were shared with relevant people.

The registered manager was not carrying out any structured quality assurance of the care and support provided at the service. A new procedure was being developed at the time of the inspection.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.

Inspection carried out on 7 October 2015

During a routine inspection

The inspection was carried out on 7 October 2015 and was unannounced.

The service provided accommodation and personal care for up to 26 older people some of whom were living with dementia. The accommodation is arranged over two floors. There is a stair lift to assist people to move between floors. There were 21 people living in the service when we inspected.

There was a manager employed at the service who had applied to the Care Quality Commission to become the 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.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. At the time of the inspection, the manager had applied for DoLS authorisations for some people living at the service, with the support and advice of the local authority DoLS team. The manager understood their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments and decisions made in people’s best interest were recorded.

The manager, supported by two senior staff, provided leadership to the staff and had oversight of all areas of the service. Staff were motivated and felt supported by the manager and senior staff. Staff told us the manager was approachable and they were confident to raise any concerns they had with her.

People were treated with kindness and respect. People’s needs had been assessed to identify the care they required. Care and support was planned with people and reviewed to make sure people continued to have the support they needed. People were encouraged to be as independent as possible. Detailed guidance was provided to staff about how to provide all areas of the care and support people needed.

Staff listened to what people told them and responded appropriately. People were treated with respect and their privacy and dignity was maintained. People told us that they had no complaints and if they did they would speak to the staff.

Accurate records were kept about the care and support people received and about the day to day running of the service and provided staff with the information they needed to provide safe and consistent care and support to people.

People told us they felt safe. Staff had received training about protecting people from abuse, and they knew what action to take if they suspected abuse. Risks to people’s safety had been assessed and measures put in place to manage any hazards identified.

People participated in activities of their choice within the service and local community. There were enough staff to support people to participate in the activities they chose.

People had access to the food that they enjoyed and were able to access drinks with the support of staff if required. People’s nutrition and hydration needs had been assessed and recorded.

People received their medicines safely and when they needed them. Policies and procedures were in place for the safe administration of medicines and staff had been trained to administer medicines safely.

Recruitment practices were safe and checks were carried out to make sure staff were suitable to work with people who needed care and support.

Inspection carried out on 21 August 2014

During a routine inspection

One inspector carried out this inspection over a period of six hours. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at. The home could accommodate 26 people and, when we visited, there were 25 people who lived in the home. People who lived at the home had a range of needs including dementia.

We spoke with three people living in the home and with two of their relatives. We looked in detail at three care plans. The manager was on holiday at the time of our inspection and so we spoke with the provider, the senior staff member who was the team leader, another staff member, the administrator, chef and an activities co-ordinator.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

The home conducted assessments to ensure the right level of care was available and staff were guided in their work by detailed care plans. Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. Staff were trained and competent to deliver a safe level of care. This meant people were receiving a safe service.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

We found that staff had received appropriate training and frequent supervision to ensure that their skills were up to date and appropriate to meet the needs of the people who lived at the home. This included regular updates in areas such as manual handling, first aid and fire safety. In addition, there was additional training in areas such as dementia.

Staff used effective practices, for example, to prevent falls. We also found care staff sought advice, where appropriate, from senior staff and from other health care professionals. The home provided an effective service.

Is the service caring?

We saw that the staff offered a caring service for people living in the home and that they were considerate and sensitive. One person who lived in the home said, "I like it here, I am very happy".

One relative we spoke with said, "The staff we have seen have been caring and considerate.�

Is the service responsive?

We saw that staff responded promptly to call bells and helped people with eating, drinking and moving about the home. We found evidence in the care plans that staff contacted appropriate healthcare professionals when required and informed relatives of any changes.

The provider invited and listened to feedback and made changes where they were reasonably practicable. Recent changes had included different arrangements for personal correspondence and changes to the menu. People we spoke with said they enjoyed the food and drink and we saw that the food they received suited their individual needs. The provider was responsive to the needs of people living in the home.

Is the service well-led?

The home was well managed with a qualified team of professional care staff. The staff we spoke with said that they felt supported in their work.

There was also an annual survey to take feedback and suggestions from people who lived in the home and their relatives. Feedback from the relatives we spoke with was positive and the people who lived in the home told us they were happy with the care they received.

Inspection carried out on 17 December 2013

During a routine inspection

People told us they were happy living in this home and were satisfied with all aspects of the service. They said, �I have no complaints.� �They are very good here.�

People were asked for their consent before care was given.

People received care and support that was well planned and sensitively delivered.

People received the medicines they needed when they needed them.

People were supported by staff who had received appropriate training.

Effective quality assurance procedures ensured that people were provided with a good service.

Overall we found that this service was safe, effective, caring, responsive and well-led and had achieved compliance with all the standards we inspected. We have made some comments that the provider may find it useful to note to make sure that the home continues to provide a good service.

Inspection carried out on 5 February 2013

During a routine inspection

We saw staff interacting with people used the service, listening to them and responding to them in a polite and courteous way, ensuring that they given time to ask questions and respond at their own pace.

We also saw that staff supported and gently encouraged people to eat and drink at their own pace. One person who used the service said "The food was good and we get lots of choices."

People�s needs were assessed and peoples likes and dislikes were identified including, the time they like to get up and go to bed, what they like to eat and drink.

We saw that evidence that a safe staff recruitment procedure was in place. We saw that staff received regular training and updates. All staff had received safeguarding training and policies and procedures were in place.

Staff we spoke to told us that they received regular supervision, people said they felt that the homes training programme enabled them to carry out their role competently and that the management team was supportive and accessible.

We saw the provider regularly assesses and monitors the quality of the service provided to protect people who used the service from the risk of inappropriate or unsafe care and treatment.

Monthly audits are carried out reviewing key areas such as care plans, risk assessment, medication, accidents, incidents, compliments and complaints, fire safety and the building environment. Appropriate actions are taken to address any concerns and identify areas of good practice.

Inspection carried out on 12 October 2011

During an inspection in response to concerns

People told us that staff were kind and caring and that the home met their individual needs.

They appreciated being able to maintain as much independence as they could in a setting where they had the amount of support they each needed.

People said that they were treated with dignity and respect by staff and could make decisions about their daily lives such as when to get up and go to bed, when to go out and what to eat. They told us there was plenty to do at the home and staff had time to talk with them as well as to complete essential care and domestic tasks.

People liked their accommodation and said the home was clean and well kept. They said that overall meals were good with plenty of choice.

People told us they had opportunities to comment on and to be involved in the running of the home. There was individual consultation and �residents� meetings were held.

Inspection carried out on 7 January 2011

During an inspection in response to concerns

We spoke to people who use the service and staff members. It was not appropriate at this time to conduct any formal interviews with service users, however people who use the service were able to give us general impressions about living at Fairlawn Residential Home.

People told us they were happy living in the home. We saw and talked to people during breakfast and lunch. They told us the food was good. People said the home was clean. They told us they liked the staff and there were enough staff to make sure they had the care they needed. They told us they were well looked after.

One person told us that �This is a lovely place, I couldn�t be more happy�. Another resident said, �The staff are excellent, there is a lovely atmosphere and I have just had a very nice lunch.�

Care staff told us that �This is a very caring home, we always put the residents first.� Another staff member said, �I love working here, it�s a very supportive home, we all help each other out.�

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