Archived: Fairways Residential Home

Updated 12 October 2016

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 06 and 09 September 2016 and was unannounced. The inspection was carried out by one inspector.

Before the inspection we reviewed information we held about the home, including previous inspection reports. We considered the information which had been shared with us by the local authority and other people, looked at any safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events which the provider is required to tell us about by law.

During the inspection visit we observed staff carrying out their duties, communicating and interacting with people to help us understand the experiences of people. We spoke with six of the people who lived at Fairways. Not everyone was able to verbally share with us their experiences of life in the service. We therefore spent time observing their support. We spoke with three people's relatives. We inspected the home, including the bathrooms and some people's bedrooms.

We spoke with three staff members, the registered manager and the owner.

We reviewed a variety of documents. These included four care files, staffing rotas, four staff recruitment files, medicine administration records, minutes from staff and resident meetings, audits, maintenance records, risk assessments, health and safety records, training and supervision records and quality assurance surveys.

Updated 12 October 2016

This inspection took place on 6 and 7 September 2016 and was unannounced. The previous inspection was carried out in September 2015 and concerns relating to the management of medicines, some areas of infection control, obtaining consent from people and quality management were identified. At that time and we asked the provider to send us an action plan about the changes they would make to improve the service. At this inspection we found that actions had been taken to implement these improvements. However, some areas required further improvements.

Fairways Residential Home is registered to provide personal care and accommodation for up to 28 people .There were 23 people using the service during our inspection; who were living with a range of health and support needs.

Fairways is a large detached house situated in a residential area in Littlestone, close to the seafront. There were 25 bedrooms, three being able to offer double occupancy. People’s bedrooms were provided over two floors, with a passenger lift in-between. There were sitting and dining rooms on the ground floor and a quiet lounge on the first floor. There was an enclosed patio and garden area to the rear.

The service had a registered manager, who was present throughout the inspection. 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 and associated Regulations about how the service is run.

Risks to people had generally been assessed and minimised but medicines had not always been recorded or stored appropriately. Clear, individual guidance was not available for ‘as required’ medicines.

A system to recruit new staff was in place. This was to make sure that the staff employed to support people were fit to do so. There were enough staff on duty, although at times, people were left with little to stimulate or occupy them. Planned activities were offered between 3-4pm.

Staff had completed induction training when they first started to work at the service. Staff were supported during their induction, monitored and assessed to check that they had attained the right skills and knowledge to be able to care for, support and meet people’s needs. There were staff meetings, so staff could discuss any issues and share new ideas with their colleagues, to improve people’s care and lives. Staff received supervisions but did not receive annual appraisals.

At time people were left with little to occupy or stimulate them. Regular activities were offered between 3-4pm each afternoon, at other times activities reflected staff availability rather than individual choice. Planned events took place such as trips out once a quarter, visiting entertainers twice a month and a summer fete.

People were protected from the risk of abuse. Staff had received safeguarding training. They were aware of how to recognise and report safeguarding concerns. Staff knew about whistle blowing and were confident they could raise any concerns with the provider or outside agencies if needed.

Equipment and the premises received regular checks and servicing in order to ensure it was safe. The registered manager monitored incidents and accidents to make sure the care provided was safe. Emergency plans were in place so if an emergency happened, like a fire, the staff knew what to do.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards. The registered manager and staff showed that they understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Some people at the service had been assessed as lacking mental capacity to make complex decisions about their care and welfare. At the time of the inspection the registered manager had applied for DoLS authorisations for people who were at risk of having their liberty restricted.

The care and support needs of each person were different, and each person’s care plan was personal to them. People had care plans, risk assessments and guidance in place to help staff to support them in an individual way.

People were supported to maintain good health and attended appointments and check-ups. Health needs were kept under review and appropriate referrals were made when required.

Staff encouraged people to be involved and feel included in their environment. Staff knew people and their support needs well.

Staff were caring, kind and respected people’s privacy and dignity. There were positive and caring interactions between the staff and people and people were comfortable and at ease with the staff.

People were encouraged to eat and drink enough and were offered choices around their meals and hydration needs. Staff understood people’s likes and dislikes and dietary requirements and promoted people to eat a healthy diet.

Quality assurance audits were carried out to identify any shortfalls within the service and how the service could improve. Action was taken to implement improvements.

Staff told us that the service was well led and that they felt supported by the registered manager to make sure they could support and care for people safely and effectively. Staff said they could go to the registered manager at any time and they would be listened to.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the end of this report.