6 April 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 16 February 2018, the inspection was unannounced. The inspection team consisted of one inspector and an expert by experience. The expert-by-experience had an understanding of caring for elderly people.
Before the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also reviewed the information we held about the service including previous inspection reports. We looked at notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.
We observed care in communal areas. We spoke with nine people and five visiting relatives or friends about their experience of the service. We spoke with 11 staff including the registered manager, a senior carer, six care workers and the chef. We looked at records held by the provider and care records held in the service. This included five care plans, daily notes; a range of the providers policies including safeguarding, medicines and the complaints policy; the recruitment and training records of four staff employed; the staff training programme and health, safety and quality audits. We asked the provider to send us further information about equipment servicing, cleaning schedules and dependency assessments. This was received in a timely manner.
The service, under the new provider had been registered with us since 10 February 2017. This was the first inspection carried out on the service to check that it was safe, effective, caring, responsive and well led.
6 April 2018
The inspection was carried out on 16 February 2018. The inspection was unannounced.
This service is a care home service without nursing. People in care services 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. The service provided residential accommodation and personal care for up to 28 older people with mild to moderate care needs, some of whom were living with short term member loss or cognitive impairment associated with dementia. There were 18 people living in the service when we inspected. The accommodation was provided over two floors, a lift was available to take people between floors.
The service had previously been registered under another provider. ARMA Care Services Limited took over the service and registered as the provider in February 2017. They took over responsibility for people, the staff and the premises from that date. ARMA Care Services Limited had worked to improve the environment, management of medicines, staff training and introduced new policies.
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.
The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. Restrictions imposed on people were only considered after their ability to make individual decisions had been assessed as required under the Mental Capacity Act (2005) Code of Practice. The management team understood when an application should be made. Decisions people made about their care or medical treatment were dealt with lawfully and fully recorded.
Risks assessments continued to be updated and in place for the environment, and for each individual person who received care. Assessments identified people’s specific needs, and showed how risks could be minimised. Management systems were in use to minimise the risks from the spread of infection, staff received training about controlling infection and carried personal protective equipment like disposable gloves and apron’s.
Staff were deployed in sufficient numbers to meet the needs of the 18 people currently living at Fairways. People’s care was delivered safely and staff understood their responsibilities to protect people who were frail from potential abuse. Staff had received training about protecting people from abuse. The management team had access to, understood the safeguarding policies of the local authority, and when needed followed the safeguarding processes.
The premises and equipment in the service was clean, odour free and maintained to protect people from infection. Safety systems in the service, like fire alarms were serviced by an engineer and tested to maintain people’s safety. Risks within the service had been assessed and maintenance issues were reported and dealt with in a planned and timely manner. The fire procedure was in date and was regularly practiced by staff.
The management team involved people in planning their care by assessing their needs prior to and after they moved into the service. People were asked if they were happy with the care they received on a regular basis.
When new staff started working at the service, they received an induction and followed a recognised pathway of basic training to gain the skills required to meet people’s needs. Training was on going and included supervision and appraisal.
We observed that staff knew people well, staff displayed a kind and caring attitude and people had been asked about who they were and about their life experiences.
We observed staff were welcoming and friendly. Staff provided friendly compassionate care and support. Staff were trained and understood the importance of respecting people’s privacy and dignity.
People were encouraged to get involved in how their care was planned and delivered. Staff upheld people’s right to choose who was involved in their care and people’s right to do things for themselves was respected.
The activities in the service provided people with opportunities to get involved and participate in learning new skills and building new friendships. Community participation was encouraged and supported.
There were policies and a procedure in place for the safe administration of medicines. Staff followed these policies and had been trained to administer medicines safely.
People had access to GPs, community nurses and they accessed opticians, dentists and foot care professionals. People’s health and wellbeing was supported by prompt referrals and access to medical care if they became unwell.
Incidents and accidents were recorded and checked by the management team to see what steps could be taken to prevent incidents happening again. The risks in the service were assessed and the steps to be taken to minimise them were understood by staff.
The providers had planned for foreseeable emergencies, so that should they happen people’s care needs would continue to be met. There was an up to date procedure covering the actions to be taken in emergency situations.
Recruitment policies were in place. Safe recruitment practices had been followed. The management employed enough staff to meet people’s assessed needs. Staffing levels were kept under review as people’s needs changed.
Staff were made aware of equality and diversity issues and received training about this. Staff understood the health and challenges associated with ageing people faced and supported people to maintain their health by ensuring people had enough to eat and drink.
The provider had a policy and provided information to people about how to raise concerns or make complaints about their care.
The provider and the management team consistently monitored the quality of the service and made changes to improve the service, taking account of people’s needs and views. The registered manager had provided good leadership to staff. The provider and registered manager implemented plans to improve the service.