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Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 July 2018

This inspection took place on 12 April 2018 and was unannounced.

At our last inspection in February 2017 we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care plans and risk assessments were not always completed or updated and did not always provide clear information and guidance for staff on how to safely manage risks identified. Personal evacuation plans were not always completed to ensure people would be safely evacuated in the event of an emergency. People's food and fluid charts and Malnutrition Universal Screening Tool (MUST) were not always adequately completed or monitored. Not all staff had DBS checks carried out before they started work. Best interests meetings were not always carried and decisions documented. Following that inspection, the provider wrote to us to tell us the action they would take to address our concerns.

At this inspection, we found that the provider had addressed the individual concerns identified at our last inspection. However, we found further breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were not enough staff deployed to meet people's needs. There were not enough hoists to meet people’s needs in a timely manner. Risks to people had been assessed and minimised, but risk management plans did not list the equipment required and used to mobilise people. People were not always protected from the risk of infection as individual hoist slings were not used when mobilising people. Processes were in place to monitor the quality of the service but these were not always effective as they did not identify the issues we found at this inspection.

Fairmount provides accommodation and personal care for up to 38 older people and specialises in caring for people living with dementia. There were 29 people using the service at the time of the inspection. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

There was a registered manager in place, who was on leave at that the time of this inspection. The deputy manager and area manager were available on the day. 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 told us they felt safe. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse. Staff understood the types of abuse that could occur and were aware of the action to take if they had any concerns. Staff knew about the home’s whistleblowing procedure and told us they would use it if required. The home recorded accidents and incidents acted on them in a timely manner. Medicines were stored, administered and managed safely. Appropriate recruitment checks were carried out before staff started work to ensure that they were suitable.

Staff received appropriate training and were supported through supervisions and appraisals so that they were effectively able to carry out their roles. The registered manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA). 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 told us they asked for people’s consent before they provided care. People were supported to have enough to eat and drink and had access to healthcare professionals when required to maintain good health.

People told us staff were kind, caring and respected their

Inspection areas

Safe

Requires improvement

Updated 19 July 2018

Aspects of the service were not safe.

There were not enough staff deployed to meet people's needs.

There was not enough equipment, namely hoists to meet people’s needs in a timely manner.

Risks to people were not always managed safely as risk management plans did not list the equipment people required to mobilise. People were not always protected from the risk of infections.

There were appropriate safeguarding and whistleblowing procedures in place.

Medicines were managed safely.

Appropriate recruitment checks took place before staff started work.

Effective

Requires improvement

Updated 19 July 2018

One aspect of the service was not effective

Bedroom doors did not have people’s names, a photograph or memory boxes displayed. Corridors where people’s bedrooms were situated and bedroom doors were painted plain white. This meant people could not orientate themselves easily.

Staff were supported through adequate training and received regular supervisions and appraisals.

People’s needs were assessed prior to them joining the service to ensure the home could meet their care needs.

The service complied with the Mental Capacity Act 2005 (MCA) and staff sought people’s consent prior to assisting them.

People were supported to have enough to eat and drink. People were supported to access healthcare services when required.

Caring

Good

Updated 19 July 2018

The service was caring.

People told us staff were caring and kind.

People and their relatives were involved in decisions about their daily care needs.

People's privacy and dignity was respected and people were encouraged to be as independent as possible.

People were provided with information about the service in the form of a service user guide to inform them of the service and facilities the home offered.

Responsive

Good

Updated 19 July 2018

The service was responsive.

People and their relatives were involved in planning their care.

Care plans were regularly reviewed and included guidance for staff on how to support people in line with their individual needs.

People’s diversity needs were recorded and they were supported to meet their individual needs.

People and their relatives were aware of the complaints procedure and knew how to make a complaint.

Well-led

Requires improvement

Updated 19 July 2018

The service was not well-led.

There was a registered manager in post.

Quality assurance processes were not effective as they did not identify the issues we found at this inspection in relation to staffing, equipment and infection control.

Regular resident and staff meetings did take not place in order to obtain feedback about the home and drive improvements if needed.

The provider took into account the views of people by carrying out an annual survey.

People and staff were complimentary about the registered manager.