Archived: Fairfield Care Home

Updated 9 January 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

Our first visit was carried out by two inspectors, an inspection manager and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. One inspector returned to complete the second visit.

Service and service type

Fairfield Care Home is a ‘care home’. People in care homes 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 did not have a manager registered with the Care Quality Commission. The previous registered manager had deregistered with us August 2019. This means the provider is legally responsible for how the service is run and for the quality and safety of the care provided. A new manager had started work at the home and they intended to register with us. They were present during our first inspection visit.

Notice of inspection

Unannounced inspection visits took place on 19 and 25 September 2019.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with six people who lived at the home and two people’s relatives about their experiences of the care provided. We spoke with the manager, the provider, the administrator, the senior team leader, two team leaders, the cook and three care assistants. We also spoke with one visiting health professional.

We observed the care people received. We reviewed six people's care records and six people’s medicine records. We looked at a sample of records relating to the management of the service including quality audits, action plans, training data and people's feedback. We also reviewed three staff files to check staff had been recruited safely.

Updated 9 January 2020

About the service

Fairfield Care Home is a residential care home providing personal care for up to 21 adults. There were 14 people living in the home during our inspection visits. Two of those people were in hospital.

People's experience of using this service and what we found

Medicines management was not consistently safe. We have made a recommendation about the management of some medicines.

Risks to people's safety and the environment were not always identified and mitigated and risk assessments did not always contain accurate information to help staff manage risk. A continuity plan was not in place to ensure people would receive safe, consistent care in the event of an emergency.

Governance systems to monitor the quality and safety of the service were inadequate. Completed audits and checks had not identified the concerns we found. This demonstrated lessons had not been learnt since our last inspection.

Enough staff were on duty to meet people’s needs. However, the provider could not demonstrate their staff were always recruited safely. Staff enjoyed their jobs, but they had not been supported to develop their skills and knowledge to provide high quality, safe care. Also, staff with no experience of working in a social care did not receive an induction that reflected nationally recognised induction guidance.

There had been a lack of consistent management and leadership at the service since 2015. Frequent management changes had impacted negatively on the quality and safety of care people received.

Whist people felt safe and were happy living at the home the standards of care they received had declined since our last inspection. People’s privacy and dignity was not maintained, and people’s personal belongings were not treated with respect. Staff knew people well but the language they used when they spoke about people was not always respectful.

Care was not always provided in line with people’s preferences and choices and care records did not consistently contain detailed information to help staff provide personalised care. Action was being taken to address this.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Information about the service was not provided in a format all people could understand and more needed to be done to ensure the environment was dementia friendly. Improvements had not been made to the environment since our last inspection to make sure it was a nice place for people to live. Some areas of the home were not clean.

People had enough to eat and drink and had access to health professionals when needed to maintain their health and wellbeing. People had opportunities to feedback their views on the service they received. Recent feedback showed people were happy with how their home was run.

People were supported to practice their religions and people's end of life wishes were documented if they had chosen to share this information. People were satisfied with the social activities available. People and their relatives knew how to make a complaint. No formal complaints had been received since our last inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Following our inspection, we notified the local authority commissioners about the areas of concern we

identified.

We reported that the registered provider was in breach of the Health and Social Care Act 2008 (Regulated

Activities) Regulations 2014. These were:

Regulation 10 Regulated Activities Regulations 2014 – Dignity and respect

Regulation 12 Regulated Activities Regulations 2014 - Safe care and treatment

Regulation 15 Regulated Activities Regulations 2015 – Premises and equipment

Regulation 17 Regulated Activities Regulations 2014 - Good governance

Regulation 18 Regulated Activities Regulations 2014 – Staffing

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 20 September 2018) and there was one breach of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had not been made and the provider remained in breach of regulation.

This service has been rated requires improvement for the last five consecutive inspections.

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for this service is inadequate and the service is therefore in 'special measures'. Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel

the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within

this timeframe. If not, enough improvement is made within this timeframe and a rating of inadequate remains for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration if they do not improve.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as

inadequate for any of the five key questions, it will no longer be in special measures.

Follow up: We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care.

Enforcement: Full information about CQC's regulatory response to the more serious concerns found in inspections is added to reports after any representations and appeals have been concluded.