Fairhope

Fairhope is a domiciliary care agency providing person care and support to people in their own houses and flats. The service provides support to older people. At the time of our inspection there were 22 people receiving personal care.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

People and their loved ones told us they received a safe service from Fairhope. Staff were dedicated to their role and felt supported. Staff were recruited safely and most had worked at the service for many years.

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. Risks to people’s wellbeing and safety were identified, assessed and staff worked in ways to reduce the risks people faced. Lessons were learnt within the service and analysis of accidents and incidents supported ongoing safe practices.

Infection prevention and control procedures were robust, and staff had access to enough personal protective equipment (PPE). Medicines were managed safely, staff were trained and had their competency assessed. Staff received a thorough induction and communication between the team of staff was effective.

Systems were in place to monitor the quality and safety of the service. However, it was not always clear how the service continuously improved. The registered manager immediately sought to develop the systems to ensure they evidenced the improvements they made within the service.

People, their relatives and staff told us Fairhope was well led. Positive feedback was received about the leadership of the service. Staff were proud to work at Fairhope and the service they provided. The service sought to make links and connect people to their community. The service had established a good reputation by working well with external health and social care professionals.

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 (published 11 April 2018).

Why we inspected

We had not inspected and visited this service since 2018. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 remained good based on the findings of this inspection.

Follow up

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

The service is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 24 people.

This service is a domiciliary care agency. It provides personal care to people living in their own apartments in the community. It provides a service to older adults, younger adults, people with dementia, physical disability or sensory impairment. Not everyone using Fairhope receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Fairhope office is situated in Wimborne. It provides support to people living in Bournemouth, Poole and surrounding areas.

There was 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.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of the risks that people faced and understood their role in managing these to ensure people received safe care.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

People received their medicines as prescribed and staff worked with healthcare professionals to ensure that people received joined up, consistent care.

People were supported from the spread of infection by staff who understood their role in infection control and used appropriate Personal Protective Equipment (PPE).

People were supported to make choices about all areas of their support and staff understood the principles of mental capacity.

People were supported to have enough to eat and drink. People’s preferences for meals were well known and staff offered people choices about what they ate and drank.

Where people had medical decisions in place around their end of life care, these were recorded. Some care plans reflected that end of life wishes and preferences had been discussed. The registered manager told us that they would ensure that people’s choices and preferences were consistently discussed and reflected in people’s care plans.

People and those important to them were involved in planning the support they would receive and were asked for their views about the support and any changes to people’s needs. Reviews identified where people’s needs had changed and reflected changes to the support provided in response to this.

People were supported by staff who respected their individuality and protected their privacy. Staff understood how to advocate and support people to ensure that their views were heard and told us that they would ensure that people’s religious or other beliefs were supported and protected. Staff had undertaken training in equality and diversity and understood how to use this learning in practice.

Interactions with people were kind and caring and relatives told us that they had peace of mind that their loved ones were receiving safe, compassionate care.

People were supported to access healthcare professionals when required and the service worked with a number of external agencies to ensure that people received joined up, consistent care.

Staff were confident in their roles and felt supported by the registered manager and office team. Feedback from people and relatives indicated that the manager was approachable, listened and took actions where necessary.

Quality assurance measures were used to highlight whether any changes to policy, processes or improvements in practice were required. The registered manager and provider were working on ensuring that systems were proportionate to the type and size of service and provided consistent oversight.

Fairhope is registered to provide personal care to people living in their own homes. The agency provides care and support to a wide range of people including older adults, people living with dementia and or with a sensory impairment or physical disabilities. At the time of our inspection there were 39 people receiving personal care from the service. There was a central office base which had two rooms. One was shared by the registered manager, risk assessor and care coordinator and the other room was used for staff training and meetings.

The service had a registered manager in place. 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.

Fairhope was not effective. Consent to care and support was not always sought in line with legislation and current guidance. It was not clear how staff were assessing people’s capacity and inconsistent approaches were being used by staff due to a lack of guidance and no best interest decisions being in place.

This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 (Part 3). You can see what action we told the provider to take at the back of the full version of the report.

Management meetings were not recorded and it was unclear how incidents were being recorded and data analysed for trends, improvements and learning.

People and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they lived their life. Each person had a care file which also included guidelines to make sure staff supported people in a way they preferred. Risk summaries were completed, regularly reviewed and up to date.

Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, nutrition and dementia.

Most staff received regular supervisions and annual appraisals which were carried out by the registered manager. Records showed that at the time of inspection that eight out of 25 staffs supervisions were between three and four months overdue.

People were supported to eat and drink enough whilst maintaining a healthy diet. Food and fluid intake was recorded for those who were under monitoring for this.

People were supported to access healthcare services as and when required and staff followed professional’s advice when supporting people with ongoing care needs.

People told us that staff were caring. During a home visit we observed positive interactions between the staff member and person. People said they felt comfortable with staff supporting them. Staff treated people in a dignified manner and had a good understanding of people’s likes, dislikes, interests and needs.

People had their care and support needs assessed before using the service and care packages reflected people’s needs. We saw these were regularly reviewed by the risk assessor with people, families and other health and social care professionals.

The service had systems in place to capture and respond to people’s feedback. People were asked if they were happy with the support they received and if they would like any changes made during people’s regular review meetings. General feedback from the 2016 survey was positive and actions had been completed.

There was a system in place for recording complaints which captured the detail and evidenced steps taken to address them. We saw that there were no outstanding complaints in place.

Staff, people and families told us that the thought the management was good at Fairhope. We found that the registered manager promoted an open working environment and was flexible.

We saw that spot checks and competency assessments were in place and completed regularly by the registered manager and care coordinator. These captured findings, observations and actions were appropriate.