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Faircross Care Home London Limited Requires improvement

Reports


Inspection carried out on 19 December 2018

During a routine inspection

About the service: Faircross Care Home London Limited is a residential care home that provides personal and or nursing care for up to five people with learning disabilities. At the time of the inspection there were three people living at the service receiving care.

People’s experience of using this service:

People and relatives told us they were happy with the care provided by Faircross Care Home London Limited. One person told us, “I like living here and I am going to stay a little while longer.” One relative told us, “Overall I’m happy – I’ve seen the best the worst and the in-betweens and They provide really good care for [person].” Another relative said, “They are very good, practically family.”

There were safeguarding processes in place and staff knew what to do if they suspected abuse. Risks to people were recorded and reviewed, however, there was no input from people and their relatives within the review process. Lessons were learned when things went wrong and we found incidents had been recorded and referred to the local authority appropriately. Recruitment practices were robust. There were sufficient staff working at the service. Medicines were recorded and managed properly. There were robust infection control measures in place.

Some staff had not completed their mandatory training though the person applying to be the registered manager was aware of this and had plans to correct it in early 2019. Staff received inductions, supervisions and appraisals. We checked whether the service was working within the principles of the Mental Capacity Act (MCA), legislation that protects people with mental capacity and memory issues, and found them to be compliant. However, some staff had not received training on the MCA. People’s needs were assessed before they received a service. People were supported to eat and drink healthily. Staff communicated effectively with each other about people’s needs using a variety of methods. People were supported to lead healthier lives.

People and their relatives told us staff were caring. People and their relatives were supported to express their views and were involved in decision making about people’s care and treatment. People’s privacy was respected and their independence promoted.

People’s needs and preferences were recorded in care plans and they received care from staff who knew them. People and their relatives knew how make complaints and the service responded to these appropriately. People’s end of life wishes were recorded and some staff were trained to work with people if they were at end of life, though no one was at the time of our inspection.

The person applying to be registered manager was highly thought of and had a positive impact on the service. They were aware of their responsibilities and knew there were still areas of the service that required improvement. There were adequate quality assurance measures at the service. People, relatives and staff were engaged and involved with the service through meetings and surveys. The service had good links with others.

Rating at last inspection: The home was last inspected on 26 April and 02 May 2018 when it was found to be in breach of seven health and social care regulations. These breaches related to safe care and treatment, safeguarding adults, complaints, good governance, staffing and fit and proper persons employed. The home was rated Inadequate overall and therefore this service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection, the provider demonstrated to us that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures. However, we found some areas that required further improvement and therefore the home has been rated 'Requires Im

Inspection carried out on 26 April 2018

During a routine inspection

This inspection took place on 26 April and 2 May 2018 and was announced. The provider was given 48 hours’ notice as the service is a small home for adults with learning disabilities who are often out during the day. We needed to be sure someone would be in during out inspection.

This was the service’s first inspection since it registered with us in January 2017.

Faircross Care Home London Limited is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Faircross Care Home London is a terraced house in east London. It can accommodate up to five people. At the time of our inspection four people were living in the home. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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 not protected from avoidable harm and abuse. The registered manager had not appropriately identified or escalated incidents to the local safeguarding team. Incident records had been compled using inappropriate language and there was no recorded follow up action to ensure incidents were not repeated.

Care plans and risk assessments lacked detail. Significant risks faced by people had not been appropriately identified and measures in place to mitigate risk were insufficient. Assessments of people’s needs were not robust and this was reflected in the lack of detail in the care plans. People lived with complex health conditions, but staff had insufficient information about how to respond to ensure people received appropriate care and support.

Staff had not been recruited in a way that ensured they were suitable to work in a care setting. Staff had not received the training and support they needed to perform their roles.

The provider’s complaints policy did not inform people of the expected timescale for response to their complaint, and contained inaccurate information about the role of CQC in complaints. Survey’s showed relatives had raised concerns but these had not been captured as complaints.

There was no clear vision or strategy for the service. The registered manager and provider did not complete audits or checks on the quality and safety of the service. There was no plan in place for the improvement of the service.

Information about people’s capacity to consent to their care was not always clear. When people had been assessed as lacking capacity to consent to their placements appropriate applications had been made under the Mental Capacity Act (2005) to deprive them of their liberty. People who were not subject to deprivation of liberty safeguards were able to access the community when they wished.

People and staff had developed strong relationships with each other. We observed positive, compassionate interactions between staff and people who lived in the home.

People were supported to eat and drink in line with their preferences.

People were supported to maintain relationships that were important to them.

We identified breaches of seven regulations relating to person centred care, safe care and treatment, safeguarding adults, complaints, good governance, staffing and fit and proper persons employed. Full information about CQC’s regulatory response to the more serious concerns found during inspecti