CQC report explained · a nursing home
What the CQC found at Fairfield Nursing Home
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, February 2023
Fairfield Nursing Home was rated Requires Improvement overall, with safety rated Inadequate because inspectors found unsafe medicines management and poorly managed care risks.
Inspectors visited unannounced on 22 and 27 September 2022. They spoke with people living in the home, relatives and staff, and reviewed care records, medicines records, recruitment files and management documents.
They found serious safety problems. Medicines records were unclear or incomplete, some risks were not properly assessed, and an unexplained injury had not been reported through safeguarding procedures. Information for staff was sometimes missing or contradictory.
The home was rated Inadequate for Safe, and Requires Improvement for Effective and Well-led. The overall rating changed from Good at the previous inspection, published in November 2017.
There were also positive findings. Inspectors found enough staff on duty during the visit, appropriate recruitment for permanent staff, suitable infection control arrangements, and a clean and welcoming environment. The provider was asked for an action plan and said it had put some new systems in place after the inspection.
Staffing on the visit
Inspectors saw enough staff on duty during the inspection to meet people's needs. Permanent staff recruitment was described as appropriate.
“There were enough staff on duty on the day of inspection to meet people's needs.” from the report
Infection control
Inspectors were assured that infection prevention measures, personal protective equipment and visiting arrangements were being managed safely.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Food and dining
People and relatives spoke positively about the food and the dining experience, although the home did not reliably share dietary risks with catering staff.
“The people we spoke with told us the food was considered to be good.” from the report
Medicines
seriousSome medicines records were unclear or incomplete. Inspectors found problems with prescribed creams, end of life medicines, thickened drinks and medicines given when needed.
“The provider failed to manage medicines safely so people were placed at risk of harm.” from the report
Unmanaged care risks
seriousSome people's medical needs, swallowing risks, pain and pressure wound risks were not assessed or monitored properly. Inspectors also found an unexplained injury that had not been reported through safeguarding procedures.
“The provider had not ensured risks in relation to people's care were properly managed to prevent avoidable harm.” from the report
Consent and capacity
seriousThere was not always evidence that people had consented to care or that best-interest decisions had been properly made. This included the use of bed rails and records about powers of attorney.
“The provider failed to ensure appropriate consent was sought.” from the report
Agency staff checks
seriousFiles for some agency staff did not contain enough evidence to show they were suitable and fit to work at the home. The provider supplied evidence of a new system after the inspection.
“We identified that over a two week period six staff had worked in the home with no information held about their fitness and suitability.” from the report
Dietary information
needs fixingCatering staff did not always have accurate, current information about allergies, food preparation or other dietary risks. This could lead to people receiving unsuitable food.
“There was no adequate system in place to ensure catering staff had accurate information on people's dietary needs or risks.” from the report
Management records and oversight
seriousCare records, audits and management checks did not reliably identify problems or show that care was being reviewed. There was no registered manager in post during the inspection.
“The governance arrangements in place were not robust and records were not always adequately maintained.” from the report
- 01What changes have been made to medicines records, including records for creams, end of life medicines and medicines given when needed?
- 02How are swallowing, pain, pressure wound and other care risks now assessed, recorded and reviewed?
- 03How do you check that agency staff are suitable, trained and given up-to-date information before working at the home?
- 04How do you make sure catering staff know about allergies, altered diets and other dietary risks?
- 05Who is currently managing the home, and how are care records, safeguarding concerns and quality audits being checked?
This was a focused inspection prompted by concerns about medicines, recruitment and governance; Safe, Effective and Well-led were inspected, while Caring and Responsive were not given new ratings. This explanation was written from the published report of 14 February 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, November 2017
Rated Good; inspectors found safe, kind and well-organised care, with some staffing and activities issues being addressed.
This was an unannounced inspection on 4 October 2017. Inspectors spoke with people living at the home, relatives and staff. They looked at care plans, medicines, staff records, safety records and management information.
The home was rated Good overall and Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found a clean, comfortable and well-maintained home, safe medicines management, suitable training and enough staff to meet people's needs.
People described staff as kind and approachable. Care plans were individualised and kept up to date. The home had a complaints process and quality checks. The report says the home remained Good, matching its rating at the previous inspection in October 2015.
Safe environment
The home was clean, comfortable and well maintained. Inspectors found suitable safety checks, equipment and emergency arrangements.
“The home provided a comfortable, safe and well-maintained environment for people to live in.” from the report
Kind staff
People and relatives spoke positively about staff. Inspectors observed calm and respectful interactions.
“During the day I observed positive interactions between staff and residents and staff appeared to treat residents kindly” from the report
Individual care planning
Care plans covered physical, mental health and social needs. They were clear, regularly reviewed and up to date.
“These were individualised and covered all aspects of a person's needs including physical, mental health and social needs.” from the report
Food and nutrition
People enjoyed the meals and received the help they needed. The home catered for special diets and monitored people's weight.
“The meal was "delicious" and everyone seemed to enjoy it. Staff were attentive and people received the help they needed with their meal.” from the report
Quality monitoring
The manager used audits to check medicines, care plans, the environment and the quality of care.
“The manager completed a series of auditing tools in order to monitor medication, care plans, the environment, and the quality of care” from the report
Weekend staffing
needs fixingOne relative felt there were not enough staff at weekends and said this sometimes meant their relative stayed in their room. The manager said an additional care worker was expected during mornings.
“The numbers are not enough at the week-end. Sometimes Mum is kept in her room.” from the report
No activities co-ordinator
minorThere was no activities co-ordinator when inspectors visited. Recruitment was in progress, while the manager and care staff arranged some activities in the meantime.
“At the time of the inspection there was no activities co-ordinator but recruitment was in progress.” from the report
- 01What is the current staffing level at weekends, and has the additional morning care worker been recruited?
- 02How do you make sure people are not kept in their rooms because of staffing levels?
- 03Has an activities co-ordinator been appointed, and what activities are currently available?
- 04How will you involve our relative and family in reviewing the care plan?
- 05How do you monitor medicines, care plans and the quality of care now?
This was an unannounced inspection covering all five CQC questions and the overall quality of the service; the report says all ratings remained Good from the previous inspection in October 2015. This explanation was written from the published report of 1 November 2017 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 Nursing Home
3 rated inspections over 7 years: the service has slipped, from Good to Requires improvement.
- February 2023Requires improvementcurrent ratingdown from GoodSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 4 January 2011.
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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