Fairfield House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Records showed staff followed processes when reporting incidents and made sure people were kept safe. Staff could confidently tell us how they would report and record incidents or accidents, such as those involving people coming to harm.

Processes for investigating, analysing, and responding to accidents, incidents, complaints, and safeguarding alerts were in place. Incidents were entered into the electronic care management system and triaged by the manager and clinical lead, who then completed a root cause analysis. This was shared with staff for their learning.

People and their relatives were encouraged and supported to raise concerns and knew who to contact if they had any issues. One relative told us, “The home is safe, caring and managed effectively and currently have no complaints but feel if they did then management would bend over backwards to sort it out.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The management team worked with professionals and partner agencies to ensure there was continuity of care for people, including when they moved between different services. When people were placed in the home, their needs were assessed and reviewed to ensure they were suited to the environment and living with other people.

In the case of an emergency admission to hospital, a ‘emergency hospital pack’ would be printed off and given to the ambulance crew. This would include significant information related to the person’s current health, care, wellbeing, and any communication needs.

Staff worked alongside other social care and health organisations to ensure people received appropriate care. There was regular contact with local authority, social workers, and doctors. Staff told us they knew how to contact the local GP surgeries and pharmacies and told us of collaborative work they undertook.

People were supported to maintain their health attend appointments both inside and outside of the service. People's care records showed referrals had been made to healthcare professionals where concerns had been identified. The management team worked hard to ensure continuity of care for people when they were discharged from hospital or moved into the home from their local community. This helped support people when transitioning to other services through the care pathway.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The management team had taken active steps to ensure there was an open culture. There was evidence that concerns would be raised safely, poor or unsafe practice was identified and challenged.

People were supported by staff who were aware of the signs of abuse and knew how to report safeguarding concerns. Relatives told us their loved ones were ‘safe and cared for’.They also told us they were confident the management team would address any concerns regarding people’s safety and well-being and make the required referrals to the local authority.

Staff understood their responsibilities to protect people from abuse and harm. They received training and knew how to recognise the signs of abuse and how to report these. Staff were confident their managers would take any concern seriously. Staff told us, “I would report it to the senior carer, manager, or safeguarding lead.”

Where people required any deprivation of liberty in order to keep them safe, the provider had applied for lawful authorisation from the local authority. Information about deprivation of liberty safeguards (DoLS) was clearly recorded in people’s care records. The manager maintained a record of all DoLS applications which alerted them to when a person’s DoLS was due for renewal. We saw best interest decisions were recorded where decisions were made about restrictive practices. For example, we saw a person’s mental capacity was assessed and a best interest meeting was held with their family which considered the least restrictive options to ensure their safety.

Staff understood people’s capacity to make decisions about their care and support and used people’s preferred method of communication to act according to their wishes.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risks associated with people’s individual care needs had been assessed and were regularly reviewed. This included the risk of developing pressure sores, mobility risk assessments and falls risk assessments. Where risks were identified, a care plan and risk assessment were developed so staff knew what action to take to reduce any risk of harm, including what to do in an emergency.

Risk assessments were person-centred and gave guidance to staff about how to manage people’s risks. For example, where a person was at high risk of falls, their falls risk assessment outlined the equipment and level of staff support they required to maintain their day to day safety, as well as for times when their ability fluctuated.

Records showed where people required to be supported with repositioning to prevent pressure sores. We noted these were accurate and up to date. People had been provided with equipment such as specialist beds, bed rails and hoisting equipment to mitigate risks. Staff were knowledgeable about people’s identified risks and told us that they received training in a range of areas including moving and handling. A staff member told us, “We are informed through handovers and there are care plans about each resident’s needs and risks like choking.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The home employed a maintenance person who was responsible for the overall upkeep of Fairfield House. This included completing regular checks on the physical environment and equipment to minimise the potential for harm.

We saw records to show equipment was serviced and checks were undertaken on electrical items, moving and handling and fire safety equipment to ensure that it was safe to use. Health and safety checks had been undertaken to ensure safe management of utilities, food hygiene and hazardous substances.

The premises and garden were free of obstacles and hazards, and we observed people moving safely and independently with or without staff assistance around the care home. We saw staff support people with equipment in a safe way.

Fire safety and evacuation processes were adequate to ensure people were kept safe and staff understood what action to take in the event of an emergency. Personal emergency evacuation plans (PEEPS) outlined the levels of support people required in the event of an emergency. Regular fire safety checks and evacuation tests were carried out.

People also told us they were happy with the home and their rooms, which they were able to personalise.

The provider did not always make sure there were enough qualified, skilled and experienced staff. Staff received effective support, supervision and development. They did not always work together well to provide safe care that met people’s individual needs.

The provider had assessed the staffing levels needed in the home both during the day and at night. The manager told us they had recruited new staff since the last inspection to ensure they were able to meet the staff numbers required. Staff told us; “Most nights we have enough staff, but if someone calls in sick, it can feel short-staffed, and care may feel rushed” and, “There are enough staff.” The registered manager told us sickness for nights was very rare and staffing levels were sufficient.

Staff completed mandatory training and an induction in courses such as safeguarding adults, infection control, food and nutrition and equality and diversity. However, more specific training relating to people’s individual needs was required. When this was highlighted, the registered manager and provider took immediate action to source appropriate training. A relative told us, “The staff are well trained and although many are not from the UK with English as a second language, I can see they care about doing a good job.” Staff told us, “There is enough training and there is one to one supervision with a senior member of staff.”

Safe recruitment practices were implemented to ensure staff were appropriately and safely recruited. The manager ensured processes were followed correctly. This included obtaining applicant’s employment history, proof of identification, work permits, references and carrying out criminal record checks with the Disclosure and Barring Service (DBS). Staff told us they were well supported and records showed they received supervision and appraisals for their continuous development.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean and well maintained. Regular checks and audits were completed to ensure staff followed the provider’s infection prevention and control (IPC) policies to keep people safe and the service clean. Personal protective equipment (PPE) was available, we observed staff used and disposed of PPE. We saw that cleaning schedules were completed, and regular audits were carried out. A relative told us, “The home is always clean and tidy.”

Staff received training in infection prevention and control and had a good understanding of IPC principles and followed correct procedures. They told us, “I know which type of PPE is needed for different things. I have received training and we receive updates in meetings.”

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Improvements have been made to the way medicines were managed in the home, but further improvements and work was still ongoing. People received their medicines in a safe way as prescribed for them. Staff were knowledgeable about residents and their medicines. When medicines were given, they were now being recorded on a new electronic medicines system.

When medicines were prescribed to be taken ‘when required’ there was personalised information available in protocols to guide staff when these might be needed for each person.

There were suitable arrangements for ordering, storage and disposal, including for medicines needing cold storage and those requiring extra security. Improvements were being made to the way fridge temperature ranges were recorded going forwards, to show that these medicines were always stored correctly.

Improvements were being made to records for anyone needing covert administration of their medicines. These were in the process of being reviewed to make sure clear information was available on the best way to give each medicine safely and to ensure these were kept under regular review. However these had not yet been fully completed.

Staff had training and competency checks to make sure they gave medicines safely. Regular medicines audits took place and we saw that these identified areas and actions for improvement. Any errors or incidents were reported and investigated appropriately, so that any actions to prevent a recurrence could be put in place.

Risk assessments were being updated, but were not in place for some high-risk medicines such as blood thinning medications called anticoagulants and for paraffin-containing preparations (which have an increased fire risk associated with the build-up of residue on clothing and bedding). We were not assured that people’s individual risks had been considered.