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Archived: Fairhaven Inadequate

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Inspection Summary

Overall summary & rating


Updated 21 June 2017

We carried out this inspection on 27 April and 3 May 2017. The inspection was conducted in response to concerning information received by the Care Quality Commission. We last carried out an inspection at the service on 4 August 2016. At this inspection we identified serious concerns and several breaches of regulations which put people at risk of harm. As a result we have taken enforcement action against the provider to ensure that improvements are made.

Fairhaven provides accommodation and personal care for up to 21 older people. It does not provide nursing care. At the time of our inspection there were 16 people living at the home.

There was no registered manager in post. The provider had appointed a manager and who had commenced work at Fairhaven on 26 April 2017. However this person at the time of this inspection had not applied to be registered with the Commission. 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 at risk of receiving care and support that was unsafe and did not meet their needs. There were not enough staff deployed by the service to meet people’s needs. Risk assessments were not detailed enough to adequately capture risks to people or control measures to minimise these. We also found that the fire risk assessment and fire evacuation records were out of date.

We found people were still not being given opportunities to take part or be offered activities that suited the personal preferences or choices. There were not enough competent and suitably trained staff deployed by the service to meet people’s needs. People’s medicines were not managed or accounted for correctly and changes to medicines were not identified and included in people’s care plans. We also found discrepancies in the recording of people’s medicines.

People were also placed at risk from staff who were carrying out unsafe moving and handling procedures.

Some staff did not have valid employment references on their files. Existing staff did not receive regular supervision or appraisal of their performance, training or development needs. New staff had not received an induction or training and there were no systems in place to monitor or plan a schedule to train staff in the future. Not all staff understood the correct way to safeguard people from the risk of abuse or what constituted a safeguarding incident. There was no training provided to help staff to understand the Mental Capacity Act (2005) and people’s care plans did not include any information in relation to their capacity to make and understand decisions about their care and support. Staff did not always support people to make decisions and follow the legal requirements outlined in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberties Safeguards (DoLs).

People’s consent had not been obtained prior to care and support being delivered. We found that staff did not understand the principles of the Mental Capacity Act. We found that people’s human rights had been unlawfully restricted.

The service did not adequately identify people’s needs in relation to nutrition and hydration. There was no assessment or information available in people’s care plans to help staff understand the foods and drinks that were appropriate for them. There was only limited evidence that support was being sought from external healthcare professionals as necessary. People were not offered a range of choices at mealtimes and people had no access to snacks or refreshments.

People told us that some staff were kind and caring, and staff had developed positive relationships with people. However we observed staff failed to treat people with dignity or respect. In addition, there was not always enough information

Inspection areas



Updated 21 June 2017

The service was not safe.

Risks to people�s health and wellbeing were not always managed effectively to maintain their safety.

People�s medicines were not always managed safely or effectively.

The recruitment process was not consistently robust due to inadequate checks being carried out on perspective employees before they commenced work at the service.

Staff had not received training in safeguarding and did not know how to report any concerns regarding possible abuse, we observed one person being restrained unlawfully

There were insufficient staff provided to meet people�s needs safely and in a timely way.



Updated 21 June 2017

The service was not effective.

Staff did not always receive regular updates to their training and there were no systems in place to monitor this.

Staff did not receive regular supervision or appraisal of their performance.

The information contained within people�s care plans in relation to their healthcare, nutrition and hydration needs was insufficient.

No training was provided to help staff to understand the Mental Capacity Act (2005) and therefore staff did not work in accordance with the act.



Updated 21 June 2017

The service was not consistently caring.

People did not always receive personalised care and support that met their individual needs and wishes.

We observed some staff to be kind and caring. However, people were not always given choices.

There was no evidence of the involvement of people or their relatives in the care planning process.

People's privacy and dignity was not protected and maintained.

People were supported to develop relationships with staff when possible.



Updated 21 June 2017

The service was not responsive.

Care plans lacked personalisation and detail and were not reflective of people�s changing needs.

People were not offered opportunities to take part in meaningful or social activities.

Complaints were not being managed or responded to correctly.



Updated 21 June 2017

The service was not well led.

There was no registered manager in post.

People and staff felt the home was not consistently well managed, due to several changes of management in recent months.

There was inadequate governance and overall oversight which meant that systems were ineffective.