Fairfax Road

Fairfax Road is a residential care home providing personal care to up to 4 people. At the time of our inspection there were 4 people using the service.

People’s experience of using this service and what we found.

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support: The service maximised people’s choice, control, and independence. Staff were safely recruited and received an induction followed by training from the provider. The provider followed current best practice guidelines to effectively manage people's medicines, and risks associated with infection prevention and control (IPC). People and their relatives were positive about the care provided. People told us they liked their home and the staff who supported them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. If people lacked capacity to make certain decisions appropriate support was sought.

Right care: Care was person-centred and promoted people's dignity, privacy, and human rights. Staff supported people to learn new skills and maintain important contacts. Staff knew people well and understood their support needs which empowered people to make decisions about their care.

Right culture: People who used services had inclusive and empowered lives through care staff's ethos, values, attitudes, and behaviours. Regular communication between the service and family members and medical experts helped to support positive working relationships.

Rating at last inspection

The last rating for this service was good (published 27 September 2017).

Why we inspected.

We inspected due to the length of time since the last inspection.

We undertook a focused inspection. This report only covers our findings in relation to the Key Questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed not changed. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairfax Road on our website at www.cqc.org.uk.

Follow up.

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

The home had prominent and clear infection prevention control (IPC) signs with helpful information and best practice guidance.

The home was clean. We saw evidence of cleaning records to support the cleaning process around the home.

Staff were seen to be correctly wearing personal protective equipment (PPE).

The home was accessing regular testing for both staff and residents.

We found the following examples of good practice.

Hand washing facilities, personal protective equipment (PPE) and signage on infection control procedures were available near the entrance and throughout the care home.

Peoples rooms and communal areas were visibly clean and hygienic.

Staff had completed training to develop their knowledge on safe COVID-19 practices.

The provider had appropriate arrangements to test people and staff for COVID- 19 and was following government guidance on testing. This ensured people and staff were tested for COVID- 19 in a consistent way in line with national guidance.

Staff ensured people using the service could maintain links with family members and friends.

Appropriate risk assessments were carried out to assess the impact of COVID- 19 on people and staff.

Further information is in the detailed findings below.

We have also signposted the provider to resources to develop their approach.

The inspection took place on 6 June 2017 and was announced. We gave the provider 24 hours’ notice of our inspection because we wanted to ensure a member of the management team was present to assist us with the inspection.

A registered manager was in post whose time was split between this service and another small service run by the same provider. 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 in January 2015 we rated the service ‘good’ overall. At this inspection, the service maintained this rating.

People were protected from abuse whilst living in the home. Risks associated with people’s care and support were assessed and measures put in place to help keep them safe. People’s healthcare needs were assessed and clear and person centred plans of care put in place. People were supported to attend appointments such as annual health checks. People’s needs were assessed and care plans were in place which were regularly reviewed. Staff had a good understanding of people’s plans of care. We concluded care needs were met.

Medicines were managed in a safe and proper way. People received their medicines as prescribed and clear and consistent documentation was maintained. The premises were well maintained and suitable for its purpose. Key safety checks were undertaken on the building and equipment.

There were enough staff deployed to ensure people received the care, support and supervision needed to keep them safe and ensure their welfare. Staff were subject to safe recruitment procedures to check they were suitable to work with vulnerable people. Staff received regular training and support to allow them to effectively undertake their role. Staff felt well supported and told us that morale was good within the service.

The service was acting within the legal framework of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity to make decisions, best interest processes were followed. People were involved to the maximum extent in the decision making process.

People were supported to maintain a balanced diet. Action was taken to protect people against the risks of malnutrition. People were supported by kind and caring staff who treated them with dignity and respect. Staff knew people well and how they liked to be supported.

People’s independence was promoted and encouraged. People who used the service were supported to set goals, in order to achieve their full potential. People were fully involved in this process and goals were subject to regular review. A range of activities and social opportunities were available to people. This included the visits of external entertainers and maintaining links with the local community.

We found an open and inclusive atmosphere within the home. People, relatives and staff praised the way the service was run and told us management were approachable. Audits and checks were carried out by members of the management team to help continuously improve the quality of the service provided. People’s feedback was sought and used to make improvements to care, support and the overall quality of the service.

Below is a summary of what we found. The summary is based on speaking with people who used the service and their relatives, the staff supporting them and from looking at records.

The detailed evidence supporting our summary can be read in our full report.

Is the service safe?

Medication care plans had clear instruction for administering and supporting people to take their medication. This included medicines prescribed to be taken 'when required'. Medicines were stored safely, securely and were only accessible to staff who were authorised to handle them.

Staff we spoke with had a clear understanding of their roles and responsibilities within the team, and were knowledgeable about the service.

In the main, care and support was planned and delivered in a way that ensured people's safety and welfare. Care files identified risks and how these were managed. Some people who used the service could be at risk of developing pressure ulcers but this risk had not been formally assessed. This meant the person's needs or any changes could be overlooked.

Is the service effective?

The provider supported staff to deliver care to an appropriate standard. Training records showed that appropriate training was being delivered. Staff we spoke with told us everyone worked well together and they felt well supported.

Is the service caring?

One person who used the service told us they liked living at the home and were well looked after. Other people were not able to tell us their experiences.

Staff we spoke with said good systems were in place to make sure people's privacy, dignity and confidentially were maintained, and gave examples of how they did this. One member of staff said, 'We always knock, give the ladies time, give people respect. You learn it as soon as you start, it's a natural inclination.'

We observed staff supporting people who used the service. Staff were friendly, patient, polite and treated people in a respectful way. During lunch staff encouraged people to be independent and make choices but at the same time assisted people when they required support.

Is the service responsive?

People's needs were assessed and care and support was planned and delivered in line with their care plan. Care records contained good information about how care and support should be delivered. We saw in each person's documentation what is 'a good day' and 'a good night' and 'what is important to me'.

Care records had some information to show how to involve people in making decisions but this was not always detailed. It had been identified that one person's care records should be agreed by a person acting on their behalf, however, this had not been followed up. Documentation that related to capacity had not been completed. This meant people who used the service or those acting on their behalf may not be appropriately involved in making decisions.

Is the service well led?

The provider had an effective system to regularly assess and monitor the quality of the service that people received. We looked at a selection of reports which showed the provider had assessed and monitored the quality of service provision.

People experienced care, treatment and support that met their needs and protected their rights. We observed staff treating people kindly and with regard to their dignity and privacy.

One person we spoke with told us they liked living in the home and were looking forward to going on a trip later that week. We looked at the feedback from satisfaction questionnaires which the home sent to people's relatives. One relative stated, 'It's nice to be able to relax knowing that (person's name) is well looked after and loved.' Another one commented, 'We are very happy with the way (person's name) is treated and looked after.'

There were effective systems in place to manage and reduce the risk of infection.

The service had effective recruitment and selection processes in place. Appropriate checks were made before people were employed by the service to make sure they had the necessary skills and experience needed for their role.

The home had systems in place to monitor the quality of the service provided.