Archived: Fairfield House

We found the following examples of good practice.

Comprehensive policies and procedures were in place to manage any risks associated with COVID-19. This included the management of people with a COVID-19 positive diagnosis. The policies and procedures were updated regularly following any changes in national guidance.

The registered manager had identified, assessed and mitigated COVID-19 related risks to people, staff and visitors.

A programme of regular COVID-19 testing for both people in the home, staff, essential carers and visitors to the home was implemented. All visitors, including professionals were subject to a range of screening procedures, including showing evidence of vaccination and a negative lateral flow test before entry into the home was allowed.

There was an ample supply of PPE for staff and visitors to use. Hand sanitiser was readily available throughout the service. Staff had received additional training during the pandemic in the use of PPE and we observed staff wearing it correctly during the inspection.

Increased daily cleaning schedules were implemented including regular touchpoint cleaning.

People living in the home and their relatives were supported to maintain contact. The provider had installed an outdoor visiting area so relatives could see their loved ones regularly. Indoor visiting was also facilitated as restrictions eased.

Fairfield House is a care home in Newcastle that provides accommodation and care for up to 11 people with support needs relating to their mental health. There were nine people using the service at the time of inspection.

At our last inspection in December 2015 we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 who used the service felt safe and there were appropriate risk assessments and systems in place to ensure risks were reduced and lessons were learned from incidents. People’s needs, such as medicines, the premises and staffing levels and pre-employment histories were managed safely.

There was effective liaison with external primary and secondary healthcare professionals, with people achieving good health and wellbeing outcomes. Documentation was generally accessible and sufficiently detailed, with a range of appropriate training and staff support in place.

Staff we spoke with had a good understanding of the Mental Capacity Act 2005. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who used the service received an excellent continuity of care from staff who knew their needs extremely well and had built mutually trusting relationships with them. Feedback from relatives and external professionals was exceptional in this regard. People who used the service had developed improved independence and confidence with the help of dedicated and compassionate staff. People’s emotional wellbeing was respected and supported by staff and a registered manager who consistently exceeded good standards of care and ensured people could thrive in a caring environment.

The atmosphere at the home was welcoming and calm. Staff interacted warmly with people who used the service and demonstrated an in depth understanding of peoples likes, dislikes and individualities. People received a continuity of care from a well-established staff team.

The service had built good community links, which afforded people who used the service a range of learning and social opportunities. There were plans to build on these in the future.

The registered manager and deputy manager lead the service well, combining hands-on day to day responsibilities and accountability with a commitment to pursuing continuous service improvement. Staff confirmed they were well supported and people who used the service interacted comfortably with staff at all levels, including management. The culture was in line with the provider’s literature, caring and with a focus on people achieving and maintaining independence.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

Risk assessments were in place. All risks to people living in the home, their relatives and staff were regularly assessed and appropriate steps taken to minimise such risks. People were supported and encouraged to maintain their independence and this was balanced with the risk to the person. Audits were carried out which helped the provider learn from accidents and incidents and the necessary action was taken to keep people safe. Information was available to show that the service worked with other agencies to help ensure people's mental health needs were met and to prevent admissions to hospital wherever possible.

Staffing levels were in place to ensure all the needs of the people who lived at the service were met to ensure their safety. A member of the management team was available on call in case of emergencies.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. We were told the necessary applications had been submitted and one person was subject to Deprivation of Liberty orders. We saw proper policies and procedures were in place.

Is the service effective?

People told us that they were happy with the care that had been delivered and their needs had been met.

We observed and spoke with people who said they had the opportunity for activities and outings if they wanted. One person told us they were looking forward to attending another music concert. Some people belonged to a walking group. We were told some people carried out voluntary work. We saw people were supported to maintain personal relationships with their friends and relatives.

Staff had received regular training to meet the needs of the people who used the service.

Is the service caring?

People told us they were supported by kind staff, who showed patience and gave encouragement when supporting them. People commented how helpful and friendly staff were. Some people we spoke with commented how pleased they were with the care provided by staff at the service. One person commented; "I'm quite happy here." Another person said; "I am well looked after."

Is the service responsive?

People's needs had been carefully assessed before they moved into the service. People told us they had been asked for their views and these had been recorded. Records confirmed people's needs had been recorded and care and support had been provided in accordance with their wishes.

Is the service well-led?

The home had a registered manager in post. We saw the ethos of the service was for people to be involved in decision making in their daily lives and future living arrangements. People we spoke with talked well of the support provided by staff. They said they were kept informed and involved in the running of the service. Staff told us they were clear about their roles and responsibilities. They said they felt supported by the manager and advice and support was available from the management team. We saw a system was in place to ensure management were supported in their role. An external quality assurance system was in place to audit the services provided.

We found the home was well maintained and clean. We saw the provider has systems in place to undertake regular checks to ensure the building was safe for people to live in.

Staff told us they felt there were enough staff to meet people's needs. People who used the service said they had no complaints about staffing. One person commented, "Staff help us with things when we ask them." We found the provider had systems in place to monitor staffing levels.

People who used the service said they had opportunities to express their views about the service they received. We found the provider had recently developed a system of quality audits which included gathering the views of people who used the service.

We found that care records were sometimes difficult to follow and understand. In particular we were unable to establish whether care records contained the most up to date information. We found that care plan evaluations were not always up to date.

People told us how they maintained and developed their lifeskills and were being supported to move onto more independent accommodation. People commented "I am in control and make choices" and "staff try and help when they can." We found that people's needs were assessed and care was planned and delivered in line with their individual care plans.

We found that medicines were handled appropriately and that some people managed their own medication to promote their independence. We found that staff had a good understanding of the medication procedure and all staff had completed safe handling of medicines training.

People told us they were happy with the care that staff provided and said "staff are quite good", "staff are good at their job", and "staff are very good and sort them out".

People were aware of the complaints system and knew how to complain. We found that information about how to complain was made available and that people could be assisted to make a complaint if necessary.