We carried out a review of the data available to us about Fairmont Residential Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Fairmont Residential Limited, you can give feedback on this service.
Fairmont Residential Limited is a care home providing personal care and accommodation for up to seven people who have a learning disability and or autism. At the time of the inspection six people were living at the service.
People’s experience of using this service and what we found
People continued to receive an outstanding level of support by enough staff who were recruited safely, trained to a high level and were passionate about giving people the right level of support and independence.
Staff understood the needs of people and treated them with dignity and kindness to ensure their individual preferences were met. Staff were aware of what actions they would need to take if they had any concerns about peoples’ safety.
People's individual needs were assessed, and comprehensive care plans and risk assessments were in place to help staff support people safely. Medicines were stored and administered safely with extensive auditing taking place to ensure peoples got their medicines on time and as prescribed.
We received consistently positive feedback from relatives and professionals about the care and support that people received. We were told that the registered manager was very approachable, and staff told us they were supported well and encouraged to share ideas to achieve the best outcomes for the people they supported.
Health professionals involved with the service spoke highly of the care and support provided. Positive risk taking was encouraged to provide people with as rewarding life as possible. Staff demonstrated a high level of understanding of the people they supported.
The registered manager was keen to continually improve and develop the service and ensured this through an extensive series of audits and regular monitoring of the quality of support delivered. A positive culture was promoted within the service whereby staff felt empowered to speak up and contribute to peoples’ plans of care.
The management team maintained good links with the local communities including regular contact with local healthcare professionals such as GP practices, epilepsy and positive behaviour support teams.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
Based on our review of safe and well-led the service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture. People were supported to make choices, take risks and were supported with dignity and in the least restrictive way possible.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was outstanding (published 16 December 2019)
Why we inspected
The inspection was prompted in part due to concerns received about keeping people safe. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
The overall rating for the service has remained the same. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We found the following examples of good practice.
¿ Staff set up skittles in the garden for a person who used to go bowling each week.
¿ Staff had organised a special dinner via Zoom for a person who had always shared this with their family. Staff decorated the room and played the video link through a large television. The manager told us this made the person feel they were sitting at the table with their family.
¿ Staff had supported a person to access a medical appointment. Prior to the appointment staff contacted the hospital to agree a plan and used a variety of communication methods in line with the person's needs to help reduce their anxieties around leaving their home.
¿ The Provider had purchased additional tables and chairs and a gazebo to support people and their visitors comfort in the communal garden.
¿ Discussions were held with staff to reduce any anxieties they felt and the provider had signposted them to wellbeing services such as a 24 hours wellness support line.
Further information is in the detailed findings below.
Fairmont Residential Limited is a care home providing personal care and accommodation to 7 people who have a learning disability and or autism. Care is provided on two floors, with bedrooms and communal areas on both floors. The service can support up to 7 people.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
People’s experience of using this service and what we found
People received an outstanding quality of life, as staff quickly recognised changes in health needs and offered early interventions for people. There was a detailed and extensive assessment process to ensure people’s needs could be met before they moved into the home. They invested in support from a variety of health professionals who without exception spoke positively about the home. Staff were passionate and committed to ensuring people were supported to have 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. Staff received bespoke individual training and support that was specific for people’s individual needs. They undertook a variety of accredited training based on individual’s needs. There were also champions in place to offer staff support and drive improvement throughout the home. They ensured that people were supported to maintain good health and nutrition; and worked in partnerships with other organisations to achieve this. Innovative ways were used to ensure the environment was adapted to meet people's needs, this included considering people’s cultural and sensory needs.
The care people received continued to be extremely person-centred and delivered consistently and responsively, this ensured positive outcomes were achieved for people. People continued to have positive relationships with the staff who treated people with respect and kindness. People had a core team of staff who were specifically identified for them based on their individual needs and their protected characteristic, such as their gender and cultural need. Staff knew people exceptionally well and collaborated with people and their families to enhance their lives. There were innovative communication systems in place to assist people to express their wishes and make choices There were lots of opportunities for them to get involved in activities and pursue their interests. Staff understood and promoted the importance of people being part of their culture and community. There was a complaint procedure in place, which was provided in a format that was accessible to the people living in the home. Complaints were responded to and relatives were happy with the outcome and how the home was managed.
People continued to receive care that was safe and based on their individual needs. There were enough dedicated staff available to support them and they were recruited to ensure that they were suitable to work with people. People were protected from the risk associated with their medicines and received their medicines safely. The home was clean and infection control procedures were followed. The provider had ensured that lessons were learnt from when things went wrong and action taken.
There was a positive culture which put people at the centre of the service. The whole staff team worked closely with other professionals and valued their input in assisting them with positive outcomes for people. Governance systems were fully embedded in the home to continue to drive improvements, this was closely monitored and reviewed. Staff felt involved with the running of the home, there was clear levels of delegation and they spoke positively about the company and the support they received. We were notified of significant events that occurred in the home and the previous rating was displayed in line with our requirements.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (27 June 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
We inspected this service on 27 April 2017. This inspection was announced one day before our visit to ensure people using the service and their staff support would be at home. Our last inspection took place 24 March 2015 and at that time we found the home was meeting the regulations that we looked at.
This service is registered to provide accommodation with personal care for up to seven people with a learning disability and associated autistic spectrum disorder. At the time of our inspection six men were using the service.
The service had a registered manager in post. 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 registered manager and management team demonstrated an open, reflective management style and provided strong values-based leadership to the staff team. There were systems in place to support, supervise and manage all staff. This ensured staff’s practice was monitored and identified when additional support or training was required. Staff were empowered to professionally develop. People were at the heart of the service. Staff understood how to communicate with people and knew what was important to them. An accredited evidenced based programme that used structured teaching and social stories, specifically designed for people with autism was in place. This enhanced people’s quality of life and their well-being because it enabled them to understand social situations and communicate their needs and preferences. Staff worked in partnership with people and their families to ensure they had a meaningful and enjoyable life.
Positive communication was encouraged and feedback from people that used the service, their representatives and the staff team was sought by the provider to further develop the service and drive improvement. Complaints were used as an opportunity for learning and improvement. People’s representatives knew how to make a complaint and were confident that their complaint would be fully investigated and action taken if necessary. The provider and registered manager regularly assessed and monitored the quality of support provided to ensure national and local standards were met and maintained. A culture of continuous improvement was in place to promote further enhancement of the service.
People’s safety was promoted by staff that understood how to support them in a way that reduced identified risks, whilst promoting their rights and choices. People were supported to take their medicine when needed and this was done in a safe way. Staff understood what constituted abuse or poor practice and systems and processes were in place to protect people from the risk of harm. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Checks were made before employment to confirm staff were of good character and suitable to work in a care environment.
Staff had time to ensure each person led a fulfilling life and were trained to meet people’s specific needs. Staff had a detailed understanding of people’s needs and preferences. Staff understood people’s individual capacity to make decisions and supported them to make their own decisions. Staff understood the issues involved in supporting people when they were unable to make these decisions. People and their relatives were closely involved in planning and reviewing the support they received.
People’s needs and preferences were met when they were supported with their dietary needs. The culture of the home empowered people to maintain their dignity and privacy. People were treated in a caring way and they were supported to maintain good health. Staff had developed strong relationships with local healthcare services which meant people received specialist support when needed.
The provider understood the responsibilities of their registration with us. They had reported significant events to us and were displaying the rating given, following their last inspection.
We inspected this service on 24 March 2015. This was an unannounced inspection. Our last inspection took place in July 2014 and at that time we found the home was meeting the regulations we looked at.
This service is registered to provide accommodation with personal care for up to seven people who require care and support due to severe learning disabilities and associated autistic spectrum disorder. At the time of our inspection this was an all male facility and seven people were using the service.
The service 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.
People’s safety risks were recognised, managed and reviewed and the staff understood how to keep people safe. There were sufficient numbers of suitable staff to meet people’s needs and keep people safe. Staff received regular training that provided them with the knowledge and skills to meet people’s needs.
People’s medicines were managed safely, which meant people received the medicines in the way they preferred and when they needed them.
People who used the service were unable to make certain specific decisions about their care. In these circumstances the legal requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS) were being followed.
People were supported with their daily diet and nutritional requirements. Where concerns were identified support and guidance from health care professionals was sought. People were supported to access external health care services when it was required to ensure their health and wellbeing needs were met.
People were supported to make choices about their care and daily lives; staff respected the choices people made. Staff understood and had a good knowledge of people’s communication styles and behaviours and they knew how to respond to these behaviours to reduce the risk of people coming to harm.
Care was planned and personalised. People were involved in the assessment and review of their care. Discussions with staff, observations and records demonstrated that people using the service were at the centre of the care being delivered.
Staff supported and encouraged people to access the community and maintain relationships with their families and friends.
Staff analysed people’s responses and behaviours to identify if they were happy with their care. If people showed they were unhappy, staff took action to make improvements to their care and well-being.
There was a progressive and lively atmosphere within the home, the registered manager and provider regularly assessed and monitored the quality of care to ensure standards were met and maintained.
Below is a summary of our findings based on our observations of the service and people who used the service. We spoke with the staff who supported people and we looked at records. We considered our inspection findings to answer the questions we always ask '
Is the service safe?
Medication was stored safely in various areas of the service.
Senior staff and managers received regular training in medication management, received practical assessments and had regular competency checks to ensure they were able to administer medication safely.
Is the service responsive?
Records were completed when medication was prescribed and needed to be administered at very regular times of the day. This ensured staff were aware of the specific prescribing instructions.
Is the service caring?
People who used the service were supported by staff with visits to their doctor and other health care professionals when they were needed.
Is the service effective?
People who used the service had regular medication reviews and health screening checks to ensure that they did not experience any side effects from the medication they were prescribed.
The service had a homely medication policy, which was agreed with the doctor. This ensured that people were able to have over the counter medication swiftly when they were needed.
Is the service well led?
The service has identified the need for a senior member of staff to be on the premises over the 24 hour period to ensure people are offered and can have occasional medication when they need it.
We spoke with the manager, the provider, the quality assurance manager and three members of staff.
The new manager told us that the registered manager had recently left the post and that they had only been in post for two weeks. They told us they were in the process of applying to register as a manager of the service.
In this report the name of the last registered manager appears. They were not in post and not managing the regulatory activities at this service at the time of the inspection. Their name appears because they were still a registered manager on our register at the time of the inspection.
We spoke with three parents of people who used the service and one professional who knew the service well.
One relative told us: 'I am quite happy with the service and my son seems happy here. There is good communication between us and the staff there'.
We looked at how the care and welfare needs of people who used the service were met and how this was recorded.
We looked at safeguarding procedures in place at the service. We were told how staff were trained to identify signs of abuse and how they dealt with it appropriately.
We looked at how the service supported people to manage their medication by looking at protocols, support and guidance in place.
We looked at the processes in place to ensure staff were suitably trained and supported.
One person told us, "I like living here. I like horses and went horseriding today."
Due to the nature of the needs of people living at the home, we were not always able to obtain their direct opinions about the home. We used other methods to better understand their opinions to include surveys and conversations with their relatives.
We found that people who used the service were supported and encouraged to express their views and make decisions about how they wanted to spend their time by using individualised communication methods.
We spoke with two relatives. They told us they had no worries about the care of people who used the service. They said that they felt people who used the service were kept safe from the risk of harm.
One relative told us, 'I can't praise the service enough. [My relative] has settled well there. They have got it spot on.'
We looked at five key outcomes to establish whether people were involved and participated in the service they received; whether care was provided appropriately; whether the service could adequately ensure people's safety; whether there were sufficient staffing levels and whether there was a system for ensuring ongoing quality assurance within the home.