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Archived: Fairways Residential Home Requires improvement

The provider of this service changed - see new profile

Reports


Inspection carried out on 6 September 2016

During a routine inspection

This inspection took place on 6 and 7 September 2016 and was unannounced. The previous inspection was carried out in September 2015 and concerns relating to the management of medicines, some areas of infection control, obtaining consent from people and quality management were identified. At that time and we asked the provider to send us an action plan about the changes they would make to improve the service. At this inspection we found that actions had been taken to implement these improvements. However, some areas required further improvements.

Fairways Residential Home is registered to provide personal care and accommodation for up to 28 people .There were 23 people using the service during our inspection; who were living with a range of health and support needs.

Fairways is a large detached house situated in a residential area in Littlestone, close to the seafront. There were 25 bedrooms, three being able to offer double occupancy. People’s bedrooms were provided over two floors, with a passenger lift in-between. There were sitting and dining rooms on the ground floor and a quiet lounge on the first floor. There was an enclosed patio and garden area to the rear.

The service had a registered manager, who was present throughout the 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 and associated Regulations about how the service is run.

Risks to people had generally been assessed and minimised but medicines had not always been recorded or stored appropriately. Clear, individual guidance was not available for ‘as required’ medicines.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were enough staff on duty, although at times, people were left with little to stimulate or occupy them. Planned activities were offered between 3-4pm.

Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people’s needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives. Staff received supervisions but did not receive annual appraisals.

At time people were left with little to occupy or stimulate them. Regular activities were offered between 3-4pm each afternoon, at other times activities reflected staff availability rather than individual choice. Planned events took place such as trips out once a quarter, visiting entertainers twice a month and a summer fete.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about whistle blowing and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Some people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLS authorisations for people who w

Inspection carried out on 2 and 3 September 2015

During a routine inspection

This inspection took place on 2 and 3 September 2015 and was unannounced.

Fairways Residential Home provides care and support for up to 28 older people. There were 23 people living at the service at the time of our inspection. People cared for were all older people; some of whom were living with dementia and some who could show behaviours which may challenge others. People were living with a range of care needs, including diabetes and Parkinson’s. Many people needed support with all of their personal care, and some with eating, drinking and mobility needs. Other people were more independent and needed less support from staff. No one was receiving end of life care when we inspected.

Fairways Residential Home is a large domestic-style house. People’s bedrooms were provided over two floors, with a passenger lift in-between. There were sitting/dining rooms on the ground floor and a quiet lounge on the first floor. There was an enclosed patio/garden area to the rear. Fairways was situated in a residential street in Littlestone; close to the sea front.

The service had a registered manager in post at the time of our visit. 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 service had not always adequately mitigated risks to people’s health and well-being. People’s likelihood of developing skin wounds and needing nutritional support had not been properly assessed to identify when people required closer monitoring. Problems with skin breakdowns and poor nutrition are often found amongst older people. Although people had generally been referred to the district nurse or dietician when necessary, there were some occasions when this had not happened appropriately. This meant that some people did not receive prompt reviews by external professionals.

The service was found to be clean and tidy overall but some areas were not hygienic; which could place people at risk of the spread of infection. This risk had not been fully recognised or addressed. Other environmental and physical risks to people had been properly assessed and mitigated appropriately.

Medicines had not been audited effectively and we found that some practice during the inspection was unsafe, because medicines were not kept secure. Following the inspection the registered manager told us that she had changed this practice to keep medicines safe all the time. Staff had been trained to give medicines and other areas of administration practice were safe.

Proper assessments about people’s capacity to make decisions for themselves had not been made and staff had limited understanding of the requirements of the Mental Capacity Act. The service could not therefore evidence that it was always acting in line with people’s rights and wishes.

There were enough trained staff deployed to meet people’s needs and appropriate pre-employment checks had been made. Staff knew how to report any suspected abuse and people felt safe because they could speak openly to staff with any concerns.

People enjoyed plentiful, nutritious meals and special foods had been sourced for people who had favourites. Staff supported people who needed assistance with their meals and picture menus were in use to help people choose meals.

Staff had received a raft of mandatory training and had attended courses about specific conditions which affected people using the service. This helped them to care appropriately for people with those conditions.

People were treated with kindness and their privacy and dignity was respected. They were involved with everyday decisions about their care; and their independence was promoted wherever possible.

Care plans presented a detailed picture of people’s life histories, their needs and preferences and staff knew people well. Each person had been assigned a keyworker who regularly reviewed their needs and support.

A variety of meaningful activities were on offer and people were encouraged to pursue hobbies and interests. People were given choices and opportunities to voice their opinions about the service. Changes had been made in response to complaints or concerns to improve the quality of the service provided.

There was inconsistent oversight of the safety and quality of the service. Audits had not always taken place to identify any shortfalls; or audit tools were inadequate. Other audits had been properly used to highlight trends and prompt action plans to be put in place.

There was a calm, happy atmosphere within the service and staff described a good, open culture. Staff understood their responsibilities to report any concerns about care provided and felt supported by the registered manager.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 23 September 2013

During a routine inspection

We carried out this inspection to check that the provider had made the required improvement following our last inspection.

Our last inspection of 22 January 2013 found that training had lapsed for most staff in some key areas such as safeguarding and infection control.

At this inspection we found that staff had received the training they needed to effectively and safely care for people.

We spoke with staff and some of the people who lived at the service. Staff told us that they had received effective and informative training. People that we spoke with told us that they were confident that the staff had the skills required to support them effectively and safely. One person commented “I have complete faith in the staff”.

Inspection carried out on 22 January 2013

During a routine inspection

Although most of the people who lived at Fairways Residential home spoke with us, to help us more fully understand the experiences of all of the people who used the service, we also looked around the service and observed how staff interacted with people.

The people we spoke with told us that they enjoyed living at the service. They spoke positively about the environment, the staff and the care provided. Comments people made included “The staff are marvellous, they are all very helpful” and “I enjoy living here, I am safe and warm”.

When we looked around the service we saw that it was recently decorated, comfortable and well furnished. People commented that they liked their rooms, they felt the staff were caring and that the atmosphere was relaxed. People were complimentary about the quality and choice of meals and spoke positively about activities arranged by the service which included outings as well as events within the service.

We saw positive interactions between staff and the people who lived at the service, they were offered choices and we saw that their dignity and independence was respected. Staff assisted people in a professional, yet warm manner and explained what they were doing when they supported them.

During this inspection we noted that a number of key staff training areas had lapsed. We drew these to the attention of the manager and have set a compliance action to ensure they are addressed.

During a routine inspection

One person told us “It’s very good here, and the staff are excellent. It’s got everything we want, and we get to go out. They’re very caring.” Someone else said “There’s bingo, quizzes, crafts, word games. And we have residents’ meetings.”

One person we spoke with about feeling safe at the home said “Feel safe? Oh yes.”

One person told us “We have a residents meeting every three months. I take the minutes. We get to talk about what we think of the food, the accommodation, entertainment, and the staff.”