CQC report explained · a nursing home
What the CQC found at Fairfield House
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2019
Fairfield House was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The inspection was unannounced and took place on 23 and 24 April 2019. One inspector spoke with people, relatives, staff and healthcare professionals. They observed care and checked care plans, medicines records, staff files, training records, incident records and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe medicines practices, personalised care, respectful staff and good links with health professionals.
The home had improved since the previous inspection, which was rated Requires Improvement. The earlier problems with quality checks, mental capacity assessments, staff training records and respectful language had been addressed. The new manager and owner had strengthened oversight and helped create a more positive staff team.
Enough staff
Inspectors found staffing levels were sufficient for people's needs and that staff responded promptly when people asked for help.
“There were enough staff to meet people's needs in a timely and flexible way.” from the report
Kind and respectful care
Staff communicated respectfully and protected people's privacy and dignity during personal care and everyday interactions.
“They (staff) are definitely kind and caring. I like the way they communicate with people.” from the report
Personalised support
Care plans recorded people's needs, abilities, life histories and preferences. Staff knew this information and used it to provide person-centred care.
“People received person-centred care. Their needs, abilities, life history, and preferences were documented, known and supported by staff.” from the report
Good healthcare links
The home worked with health and social care professionals and made referrals when people's health needs changed.
“They refer in good time and follow our advice.” from the report
Improved management
The new manager introduced more regular and detailed checks and helped create a happier, more united staff team.
“This more regular and detailed oversight helped ensure that quality performance, risks and regulatory requirements were understood and managed.” from the report
Recording views about cameras
minorCameras had been installed in outside and communal areas. At the inspection, the owner still needed to contact relatives and legal representatives to record their views and any objections.
“The owner agreed to contact relatives and people's legal representatives to document their views and discuss any objections they may have about the cameras that had recently been installed.” from the report
End of life training
minorSome staff had received end of life training, but more training was still being introduced. No one living at the home needed this type of care during the inspection.
“Some staff had received training in end of life care although at the time of our inspection there were no people at the home requiring this type of care.” from the report
- 01How are relatives and legal representatives now consulted about the cameras in communal and outside areas?
- 02What end of life training has been completed since the inspection, and who provides it?
- 03How do you make sure care plans and risk assessments remain up to date when a person's needs change?
- 04How are relatives involved in care reviews and decisions when a person cannot communicate their wishes?
- 05How do you check that staffing levels remain sufficient when people need more help?
This was a planned, unannounced inspection of the whole care home and all five CQC questions, including care, premises, records and management systems. This explanation was written from the published report of 15 May 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2018
Rated Requires Improvement; inspectors found safe, responsive care, but concerns about capacity decisions, respectful practice, training oversight and quality monitoring.
The inspection was unannounced on 26 February 2018 and continued on 5 March 2018 with the home's agreement. One inspector spoke with people, relatives, staff and health professionals. They also observed care and checked care records, staff files, medicines, training and management records.
The home was rated Good for Safe and Responsive. Inspectors found that people received their medicines safely, risks were recorded, staffing was sufficient and care plans were personalised. People had choices, support with food and drink, activities and access to healthcare.
The home was rated Requires Improvement for Effective, Caring and Well-led. Capacity assessments and best-interest decisions did not always follow good practice. Staff did not always use respectful language or approaches, and there was not enough oversight of relevant training, DoLS records or the quality of care.
An overall Requires Improvement rating means the home was not consistently meeting the expected standard in some areas. The registered manager said work was under way to improve the systems and staff culture.
Safe medicines
Inspectors found that medicines were given as prescribed, recorded accurately and stored securely. The home also used pain assessment tools when people could not explain their pain.
“People received their medicines as prescribed and these were recorded accurately in people's Medicines Administration Records (MAR).” from the report
Personalised care
Care plans recorded people's histories, preferences, beliefs and changing needs. Relatives and professionals were involved when people could not explain what mattered to them.
“People had personalised care plans in place which included details about their histories, likes, dislikes and preferences.” from the report
Activities and relationships
People were offered one-to-one time, informal social support and planned activities. Visitors were welcomed, and relatives were involved in reviews and kept informed.
“People were supported to engage with different activities and had one to one time with staff.” from the report
Capacity decisions
needs fixingSome capacity assessments were not specific to the decision being made. Some best-interest decisions were recorded before the capacity assessment, and links to relatives' legal powers were not always clear.
“During this inspection we found that assessments of people's capacity were not all decision specific and in some cases, best interest's decisions were recorded for people on dates before their capacity had been assessed.” from the report
Respectful communication
needs fixingInspectors saw staff discussing residents' support in a way that was not person-centred. Some staff also assisted people with meals while standing, rather than sitting beside them.
“Staff referred to whether people had "been done" or still "needed to be done".” from the report
Relevant staff training
needs fixingStaff had access to training, but the home did not have a system to identify which additional subjects were needed for the people living there or to check completion.
“There was no guidance or system in place to identify and ensure that training completed was relevant for the people living at the service.” from the report
Management oversight
needs fixingQuality checks did not cover all areas of care. The home did not have effective monitoring of DoLS authorisations, training needs or disrespectful language and interactions.
“Quality assurance systems did not consistently provide effective oversight of the service delivery.” from the report
- 01How are capacity assessments and best-interest decisions now made for each specific decision?
- 02How do you monitor DoLS applications, expiry dates and any conditions attached to authorisations?
- 03What training do staff now complete for dementia, mental health needs and behaviours that can challenge, and how is completion checked?
- 04How do managers check that staff use respectful language and sit with people when helping them eat?
- 05What quality audits are now used to identify and correct problems in care and staff practice?
This was a comprehensive inspection covering all five CQC questions, based on visits on 26 February and 5 March 2018, observations, discussions and records reviewed. This explanation was written from the published report of 17 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Fairfield House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Requires improvement
- February 2016GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- October 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- November 2012
Registered with the Care Quality Commission on 14 November 2012.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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