Archived: Fairfield View

Updated 7 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was undertaken by 3 inspectors, a medicines inspector, and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fairfield View is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fairfield View is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post. However, they were currently not in work and the service was being overseen by an external management company, specialising in management of care homes.

Notice of inspection

This inspection was unannounced on both days of our site visit.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. This included information of concern and notifications the service is required to submit regarding any significant events happening at the service. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used information gathered through multi agency meetings held, and updates from the provider about their progress with their improvement action plan. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. All this information was used to plan the inspection.

During the inspection

We reviewed staffing levels and walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with 10 people who use the service, 6 relatives and 13 members of staff including members of the external management company, unit managers, care workers, and auxiliary staff including kitchen staff.

During the inspection we visited both units, reviewed 10 medicine administration records and looked at medicines related documentation. We observed medicines administration, checked storage and spoke to 3 staff about the management of medicines.

We reviewed a range of records including 8 people's care records. We looked at 4 staff files in relation to recruitment, training and support. A variety of records relating to the management of the service, including policies and procedures were examined during and following the site visits.

Updated 7 July 2023

About the service

Fairfield View is a residential care home providing personal care for up to 54 people. The service mainly provides support to older adults and people living with dementia. At the time of our inspection there were 38 people using the service. Care is provided across two units, with 'The Elms' providing specialist dementia support. People have their own bedrooms, some of which are ensuite. Communal spaces including bathrooms, living spaces and a secure garden were available.

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

Systems of governance and oversight had been introduced but were not currently being effectively used to ensure the safety and quality of the home. We found information used for oversight of people’s needs, including dietary information and wound care was not being accurately maintained. Systems to ensure people received the correct care had either not been implemented or was not being used effectively. Communication and involvement of people using the service had improved, although further work was needed. Staff needed further support to understand and develop in their roles, in order to support the governance processes within the service.

People's needs, and risks were not always being safely managed in relation to modified diets and skin integrity. Medicines were not always being safely managed. Safe recruitment of staff was being completed and there were generally enough staff to support people. Environmental improvements were found, and plans were in place to address shortfalls. Action to address most, but not all safety issues had begun. Equipment had been obtained to promote better infection prevention and control but some areas of the home including furniture and shared bathrooms needed further work.

People did not always have accurate and up to date needs assessment information. Oversight of needs and guidance in handover records and care plans was sometimes inaccurate or inconsistent. Observations and records did not assure us that people’s needs were being consistently met. People's view of the food was mixed, and it was not clear that people were having their dietary needs met. Improvements to the environment had begun but further work was needed to ensure shared and frequently used areas, such as communal bathrooms were suitable for use. People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service were in place to support good practice. Staff felt well supported and training was available. Further work to support staff to complete and understand all aspects of mandatory training was needed.

People’s care plans had been developed, but further work was needed to ensure these were accurate, completed and person centred. An activity worker began at the home during the inspection and staff tried to support people to engage in activities where time allowed. However, people told us they were bored, and we observed there was a lack of stimulation.

People and families spoke positively about the staff, and we observed kind and caring interactions. People's dignity was respected, and choice was generally, but not always promoted.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 08 November 2022) and there were multiple breaches of regulation. The provider completed an action plan after the last inspection as part of the multi-agency meeting approach, to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Enforcement

We have identified breaches in relation to the management of individual risk; the management of medicines; the provision of person-centred care; knowledge, training and skills of staff; and systems for management and oversight of the service.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The overall rating for this service is ‘Requires improvement’. However, the service remains in 'special measures'. We do this when services have been rated as 'Inadequate' in any Key Question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.