CQC report explained · a residential care home
What the CQC found at Fairholme House
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, July 2023
Fairholme House rated Good; inspectors found significant improvements in safety, staffing, care planning and management.
This was an unannounced focused inspection. Inspectors visited on 30 May and 7 June 2023. They spoke with people living in the home, relatives and staff. They also reviewed care records, medicines records, recruitment files, complaints, incidents and quality checks.
Inspectors rated Safe, Effective, Responsive and Well-led as Good. They found enough staff, safe medicines systems, better risk management and care records that reflected people's needs. Food, activities and support with healthcare were also viewed positively.
The home had previously been rated Requires improvement in July 2022. The provider had made the improvements set out in its action plan and was no longer in breach of the regulations checked at this inspection. The overall rating changed to Good.
Enough staff
Staffing levels had improved, and the home was not using agency staff. Inspectors saw people receiving support promptly and without being rushed.
“There were sufficient staff deployed to meet people's needs.” from the report
Safe medicines
People received medicines as prescribed. Storage, administration records, staff training and checks of staff competence were all found to be safe.
“People received their medicines as prescribed, and the service had safe medicine storage systems in place.” from the report
Food and drink
People had a pleasant dining experience, with homemade food and different choices. Staff knew people's preferences and supported them with eating and drinking.
“The service provided good quality food with a variety of different options to choose from each day prepared by a knowledgeable kitchen staff.” from the report
Activities and choice
Activities had improved and included music, gardening, jewellery making and celebrations. People could choose not to attend, and staff offered individual activities instead.
“People had access to a variety of activities which included music sessions, gardening, jewellery making and special holiday celebrations.” from the report
Stronger oversight
The provider had introduced electronic records and audits to monitor care, medicines, safety and quality. Inspectors found that concerns were identified and acted on more quickly.
“The provider had introduced a significant amount of effective quality assurance systems.” from the report
Inspectors raised no specific concerns in this report.
- 01How are you checking that the improvements in medicines, fire safety and risk management are being maintained?
- 02How often are care plans and risk assessments updated, and how can relatives see or contribute to those updates?
- 03How will you make sure there are enough permanent staff to meet people's needs if staffing changes?
- 04How are activities matched to each person's interests, including people who choose not to attend group activities?
- 05What quality checks are carried out now, and what happens when an audit identifies a problem?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected and the overall rating also used ratings from the previous inspection. This explanation was written from the published report of 5 July 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, July 2022
Fairholme House was rated Requires Improvement; inspectors found risks with medicines, fire safety, records and management systems.
This was an unannounced focused inspection on 31 May 2022. Inspectors spoke with people, relatives, staff and health professionals. They observed care and reviewed care records, medicine records, recruitment files, training records, complaints, incidents and management audits.
The home was not always safe. Medicines records and stock checks were unreliable. Fire risk information and training were out of date or incomplete. Accident and incident records were not reviewed well enough to identify lessons. Some care records contained conflicting or outdated information.
People were generally described as receiving kind care. Staff supported choice, nutrition and access to healthcare. However, activities were limited, staff induction and supervision needed improvement, and quality checks did not find the problems identified by inspectors.
The overall rating changed from Good at the previous inspection to Requires Improvement. The home must send an action plan, and the CQC said it would monitor progress and take further action if needed.
Kind and respectful care
People and relatives said staff were caring. Inspectors saw staff supporting people's independence and respecting their choices.
“People and relatives told us staff were caring.” from the report
Food and mealtimes
People were offered choices and received home-cooked food. Mealtimes were not rushed, and staff supported people who chose to eat in their rooms.
“The dining experience was pleasant, and food was home cooked and presented in an appetising way.” from the report
Healthcare support
The home made timely referrals and worked with outside health and social care professionals.
“Staff make timely referrals. We have had no issues with falls, weight loss or food provision.” from the report
Safeguarding awareness
Staff knew how to identify and report abuse. Records showed regular safeguarding training and updates.
“They were able to tell us about different types of abuse and what steps they would take if they believed people were at risk of harm.” from the report
Medicines were not always safe
seriousMedicine stocks did not always match the records. Administration records had gaps, some people lacked guidance for medicines given when needed, and staff competency checks had not been completed.
“We found some discrepancies in medicine stocks.” from the report
Fire safety risks
seriousThe evacuation list was out of date, there was no trained fire marshal on duty on the inspection day, and staff had not completed fire drills.
“Records showed staff had not completed any fire drills.” from the report
Care records were inaccurate
seriousSome records did not match people's current medicines, weight or blood sugar information. Inspectors said this meant they could not be sure care was always personalised to current needs.
“People's care records were not up to date and did not reflect current care.” from the report
Weak oversight and learning
seriousAccidents and incidents were recorded but not reviewed for trends or followed by action plans. Audits were inconsistent and failed to identify important shortfalls.
“There was no system in place to identify any trends for accidents and incidents, therefore no lessons were learnt.” from the report
Limited activities
needs fixingThe home had no activities coordinator and activities were provided alongside staff members' main caring duties. There was little evidence of individual activities for people who did not attend group sessions.
“People had access to limited activities which included music sessions, baking and special holiday celebrations.” from the report
Induction and supervision needed improvement
needs fixingThe induction for new staff did not fully include the Care Certificate. Staff were not always receiving regular supervision and appraisal.
“We recommend the provider consider current good practice guidance on staff training, induction and supervisions and take action to update their practice accordingly.” from the report
- 01What has been changed to check medicine stocks, medicine records, PRN guidance and staff competency?
- 02When was the fire risk assessment last updated, and have all staff completed fire training and a fire drill?
- 03How are care records checked so that medicines, weight, blood sugar and other current needs are accurately recorded?
- 04Has the management structure been strengthened, and who now checks audits, accidents and incidents?
- 05What regular activities and individual activities are now available, and has an activities coordinator been appointed?
This was an unannounced focused inspection of Safe, Effective, Responsive and Well-led; Caring was not inspected as part of this visit. This explanation was written from the published report of 20 July 2022 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 Fairholme House
4 rated inspections over 7 years: the service has held its Good rating throughout.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2021Inspected but not ratedSafe: Inspected but not ratedEffective: Inspected but not ratedWell-led: Inspected but not rated
- January 2018Goodstayed GoodSafe: GoodEffective: GoodResponsive: OutstandingWell-led: Good
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2013
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- March 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 26 November 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.
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38 live-in carers within about an hour of Oxfordshire
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 £980 to £1,300 a week. 32 can care for a couple. 12 years' experience on average.
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