CQC report explained · a residential care home
What the CQC found at Fairfield House Residential Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Inspectors found continuing risks around dehydration, pressure equipment checks, care records and anticoagulant assessments. They said the provider was still in breach of Regulation 12.
- Effective?
- Good
- This key question was not assessed in this targeted inspection.
- Caring?
- Good
- This key question was not assessed in this targeted inspection, although people and relatives spoke positively about staff.
- Responsive?
- Good
- This key question was not assessed in this targeted inspection.
- Well-led?
- Requires improvement
- Inspectors found unclear staff responsibilities, several management changes and weak follow-up of audit actions. They said the provider was still in breach of Regulation 17.
What inspectors found, October 2023
Fairfield House Residential Care Home is rated Requires Improvement; inspectors found improvements but ongoing risks with hydration, care records and management oversight.
This was an unannounced targeted inspection on 23 and 30 August 2023. Inspectors checked whether earlier warning notices had been met. They also looked at infection control, staffing levels and the mix of permanent and agency staff.
People and relatives generally said they felt safe and well cared for. Improvements included a new electronic care system, a new call bell system, better recording of accidents and incidents, and action to improve fluid monitoring during the inspection.
However, inspectors still found risks. On the first day, fluid intake was recorded on two systems without enough checking, some people did not have water in their rooms for several hours, and care records were not always updated when needs changed. Staff were also unclear about their responsibilities and management checks did not always ensure that identified actions were completed.
The overall rating remained Requires Improvement. Safe and well-led were inspected but not rated because this was not a full inspection of either area. The provider was still in breach of Regulations 12 and 17.
People felt safe
People and relatives generally spoke positively about the care and said staff were kind and helpful.
“People told us they felt safe and well looked after at the home.” from the report
Infection control
Inspectors were assured about infection prevention, use of protective equipment and the home's ability to manage an outbreak.
“We were assured that the provider was using PPE effectively and safely.” from the report
New call bell system
A new system had been installed since the previous inspection. It allowed managers to monitor how quickly staff responded.
“Since the last inspection the provider has had a new call bell system installed.” from the report
Accident records
Accidents and incidents were recorded, and managers knew what had happened and what action had been taken.
“Accidents and incidents were well recorded by staff and the management team were aware of all accidents and incidents at the home and actions that had been taken.” from the report
Risk of dehydration
seriousOn the first day, two recording systems were being used without adequate checking. Some people also did not have water in their rooms for several hours.
“People continued to be placed at risk of dehydration.” from the report
Care records not kept up to date
seriousCare plans and risk assessments were reviewed monthly but were not always updated promptly when people's needs changed. Information was spread across different systems.
“these were not updated promptly when peoples' needs changed.” from the report
Unclear responsibilities
seriousStaff were not always sure who was responsible for checks, care plan updates and other tasks. This could lead to important work being missed.
“staff were not clear about their roles and responsibilities” from the report
Management oversight
needs fixingThere had been several managers, and the current manager was dividing time between two homes. Audits identified problems, but the process for making sure actions were completed was not robust enough.
“We discussed with the manager the need for a more robust process to ensure actions were followed up and completed.” from the report
Pressure equipment checks
seriousEquipment settings had been improved, but there was no robust daily system to check that the settings stayed correct.
“there was not a robust system to monitor these settings daily, to ensure they remained correct, so people were not placed at risk.” from the report
- 01How do you now record and check each person's fluid intake, and how do you act if someone is not drinking enough?
- 02How do you make sure people have fresh water in their rooms throughout the day?
- 03Who is responsible for updating care plans and risk assessments when a person's needs change?
- 04How often are pressure-relieving equipment settings checked and recorded?
- 05How do you make sure audit actions are completed, and who is responsible for checking this?
This was a targeted inspection of specific parts of Safe and Well-led, including earlier warning notices, infection control and staffing concerns; it was not a full inspection of all five key questions. This explanation was written from the published report of 5 October 2023 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 2023
Requires Improvement; inspectors found people at risk from gaps in care planning and oversight, and warning notices were issued.
This was an unannounced focused inspection. Inspectors visited on 4 and 11 May 2023, spoke with people, relatives, staff and health professionals, and reviewed care, medicines, recruitment and management records.
The home was not always safe. Inspectors found weak checks around dehydration, skin damage, blood-thinning medicines, infection risks and the environment. Some records did not show that care had been given as planned.
The home was also not consistently well-led. Audits had missed important problems, staff were unclear about responsibilities during management changes, and feedback was not always acted on quickly. The overall rating remains Requires Improvement, as does the rating for Safe and Well-led. The other key question ratings were carried forward because they were not inspected.
Safe medicines practice
Medicines were ordered, stored, administered and disposed of safely. Staff who administered them had been trained and assessed as competent.
“Medicines were managed safely. There were safe processes for the ordering, storage and disposal of medicines.” from the report
Safeguarding
Staff knew how to recognise and report abuse. The home made safeguarding referrals appropriately, and people told inspectors they felt safe.
“People were consistently safe from the risk of abuse.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely and had arrangements to prevent and manage infections.
“We were assured that the provider was using PPE effectively and safely.” from the report
Staff knowledge of people
Staff knew people well, and people described good relationships with staff. Inspectors also saw staff responding to people and answering call bells in a timely manner.
“Staff knew people well, we received feedback such as, "The staff are very pleasant I don't think you would get much better attention anywhere else.” from the report
Risks of dehydration
seriousFluid monitoring was not reliable for three people. Records showed very low fluid intake on some days and missing output records where these were needed.
“People had been placed at risk of dehydration. Systems were not robust to monitor and assess the risks to 3 people who had been placed on fluid intake and output charts.” from the report
Risk of skin damage
seriousSpecialist equipment was not always set correctly, and some people were not repositioned as their care plans required. This increased the risk of pressure sores.
“Repositioning records showed people had not been repositioned according to their care plan.” from the report
Weak oversight
seriousAudits failed to identify problems with high-risk medicines, infection risks, care plans and records. The provider's governance systems were still not robust enough.
“Audits were either not in place or effective at identifying shortfalls found during our inspection.” from the report
Management changes
needs fixingThere had been several management changes. Staff were not always clear about who was responsible for tasks or what was expected of them.
“Staff told us, due to the changes in management and inconsistency in leadership they were not certain who was responsible for certain tasks and what was expected of them in their job roles.” from the report
Incomplete records
needs fixingSome recruitment checks, care plan reviews and mental capacity records were incomplete. Care charts were not always completed at the time care was given.
“Records had gaps and were not completed fully which posed a risk that they were either not effective records reflective of the care delivered to the person or showed care was not being delivered as per their care plan.” from the report
- 01What has changed to make sure every person at risk of dehydration has complete fluid and output records?
- 02How do you now check that specialist equipment is set correctly and that people are repositioned when their care plan says?
- 03What risk assessments and care plans are in place for people taking blood-thinning medicines?
- 04Who is currently responsible for managing the home, and has that manager applied to become registered with the CQC?
- 05How are you checking that the new computer system, care plan reviews and call bell improvements are working in practice?
This was an unannounced focused inspection of Safe and Well-led only; the other key question ratings were carried forward from the previous inspection. This explanation was written from the published report of 27 May 2023 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 Residential Care Home
5 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- October 2023Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Fairfield House Residential Care Home →
- May 2023Requires improvementstayed Requires improvement
Read what inspectors found at Fairfield House Residential Care Home →
- March 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- March 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- December 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2014
Report published without a new overall rating.
- March 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- November 2012
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 7 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
15 live-in carers within about an hour of Dorset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,040 to £1,340 a week. 11 can care for a couple. 10 years' experience on average.
“Even when things get a bit chaotic (as they sometimes do!), you’ve handled it with patience and a sense of humour — which is gold.”
“Nina was patient, focussed on my aunt's physical well-being, and unfazed by what at the time was a new and uncertain situation”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.