CQC report explained · a residential care home
What the CQC found at Fairkytes
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Medicines, staffing, recruitment and safeguarding arrangements had improved. Risks were assessed and monitored, and infection prevention measures were in place.
- Effective?
- Good
- Does the care work? Training, consent, food and drink, working with GPs and nurses.
- Caring?
- Good
- Are people treated with kindness and dignity?
- Responsive?
- Good
- Care plans were personalised and included people's communication needs, preferences and important relationships. People were supported with activities, although relatives had mixed views about whether all desired activities were offered.
- Well-led?
- Requires improvement
- Management and quality assurance had improved, but relatives reported mixed experiences of communication, complaints and openness. The home had not re-registered as previously recommended.
What inspectors found, February 2023
Rated Good overall; inspectors found safe, personalised care, but the home still needed to improve its leadership and openness.
The inspection was carried out by one inspector over three visits. The inspector spoke with one person, two relatives and four staff members. They reviewed care records, medicines records, recruitment files and management records.
The home was rated Good for Safe and Responsive. Medicines were managed safely, staffing had improved, risks were assessed and people's communication needs and preferences were recorded. People could take part in activities and visitors could see them when they wanted.
Well-led was rated Requires Improvement. Inspectors found improvements in management and governance, but relatives had mixed views about communication, complaints and whether the home learned from incidents. The home had also not completed its re-registration with the CQC as previously recommended.
The overall rating improved from Requires Improvement at the previous inspection. Inspectors found the home was no longer in breach of regulations, although further work was needed to build a more open and positive culture.
Safer medicines
Inspectors found enough information to guide staff in storing and giving medicines. Staff were trained and their competence was checked.
“We counted 3 people's medicines, reviewed administration sheets, risk assessments, policies and audits relating to medicines and found everything in order.” from the report
Personalised care
Care plans described people's needs, preferences, communication and routines in detail. This helped staff provide care in the way each person preferred.
“Care plans were specific and personalised to individuals.” from the report
Communication support
The home used personalised guidance, pictorial menus and easy-read documents to help people express their choices.
“There were pictorial menus and easy read documents in place to assist people make their feelings and choices known.” from the report
Improved safety systems
The home had improved its risk assessments, staffing arrangements and safeguarding processes since the previous inspection.
“At this inspection we found improvements made around all three recommendations, but the service had not re-registered the service or sought guidance from CQC in this regard.” from the report
Activities and visits
People took part in activities they chose, including music, dancing, craft work and outings. Relatives were able to visit when they wanted.
“Relatives told us they were now able to visit the service when they wanted to.” from the report
Leadership and openness
needs fixingThe well-led rating remained Requires Improvement. Relatives had mixed views about how the home was managed and how openly it communicated.
“Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.” from the report
Complaints
needs fixingThe home recorded and reviewed complaints, but some relatives felt their concerns were not handled satisfactorily or that meetings did not lead to enough explanation and action.
“We looked at a number of complaints and saw that the registered manager and provider had attempted to address concerns, though having spoken to relatives, we understand this was not always to their satisfaction.” from the report
Outstanding re-registration
needs fixingThe home had not re-registered with the CQC alongside the sister service next door, despite this being raised at the previous inspection.
“The provider had made some improvements in this but had not re-registered the service.” from the report
Mixed views about learning from incidents
needs fixingInspectors saw systems for recording and reviewing incidents, but relatives disagreed about whether lessons were consistently learned and communicated.
“Relatives had mixed views about whether incidents and accidents were dealt with appropriately.” from the report
- 01What is the current position on re-registering the home with the CQC alongside the sister service?
- 02How will you make sure relatives receive clear explanations and updates after an incident?
- 03How are complaints reviewed, and how will I know what action has been taken?
- 04How do you check that one-to-one staffing is provided as planned, including when staff take breaks or absences occur?
- 05How do you make sure each person can access activities that match their individual interests and skills?
This was a follow-up inspection focused on the previous concerns and on applying the Right support, right care, right culture principles; the report gives ratings for Safe, Responsive and Well-led only. This explanation was written from the published report of 11 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 2020
Fairkytes rated Requires Improvement; inspectors found risks in medicines, staffing, safeguarding and management systems.
This was a focused inspection on 1 September 2020. Inspectors looked only at Safe and Well-led because concerns had been raised about abuse and how the home was managed. They spoke with two people, three staff members, a senior manager and two relatives, and reviewed care, medicines, staff and management records.
The home was not always safe. Controlled medicines were not supported by clear enough guidance. Staffing could be stretched when people went out, and one person was supported by fewer staff than their risk assessment required. Inspectors were also concerned about serious allegations of abuse and care plans that were not always reviewed.
Management systems were not strong enough. Some incidents and notifications to the CQC were not dealt with or sent on time. Audits had not found important problems. The home was also working closely with a neighbouring service in a way that could reduce privacy and make the home feel more like a larger institution.
The overall rating fell from Good at the previous inspection, published in February 2018, to Requires Improvement. The provider had an improvement plan, but inspectors said further work was needed and planned to monitor progress and return for another inspection.
Medicines records
Most medicines records were complete and checks showed the stock records were accurate. This did not remove the concerns about controlled medicines.
“We looked at MAR charts and found these were up to date and had been completed correctly.” from the report
Safe premises
The home carried out safety checks and had plans for people to leave safely in an emergency.
“Premises and equipment safety was maintained to ensure the home environment was safe.” from the report
Infection control
The home had cleaning arrangements and staff used protective equipment when providing personal care.
“There was a daily schedule for the home to be cleaned and disinfected every three hours, which maintained the home's cleanliness and hygiene.” from the report
Staff training
Staff said they had safeguarding training and understood how to report abuse or use whistleblowing arrangements.
“They told us they received safeguarding training and knew how to identify different types of abuse and who they should report it to.” from the report
Controlled medicines
seriousGuidance and records did not give staff enough information about the safe storage, risks and administration of a controlled medicine. Inspectors said this could lead to errors.
“We were not assured staff had the necessary guidance in relation to this medicine for them to be able to manage it correctly in accordance with controlled drugs administration.” from the report
Staffing when people go out
seriousStaffing could be too low when people needed support outside the home. One person went out with one staff member when two were required and later absconded, although they were found safe.
“One person who required two staff members with them when they went outside, only had one staff member with them, which put the person at risk of avoidable harm, as they also absconded.” from the report
Weak management checks
seriousAudits had not identified problems with controlled medicines, records or notifications. The home did not have a registered manager at the inspection.
“Due to the concerns found, there was a lack of overall good governance in the service which had led to some serious incidents and shortfalls with records.” from the report
Two services working together
needs fixingThe home shared staff arrangements and a food menu with the neighbouring service. Staff from the other service could enter, which inspectors said could affect privacy and make the home feel institutional.
“This meant the provider had not mitigated against environmental factors which could make the environment feel institutional and had not ensured they could provide truly person-centred care.” from the report
Late notifications
seriousThe provider sent some serious incident notifications late and had not notified the CQC about three liberty restriction approvals until after the inspection.
“They notified us of a serious incident six days after it occurred in the service; Notifications should be sent to us without delay.” from the report
- 01What new procedures are now in place for storing, recording and administering controlled medicines?
- 02How do you make sure there are always enough staff when people go out, including when two staff members are required?
- 03What was learned from the safeguarding and financial abuse concerns, and what safeguards are now in place?
- 04Has a registered manager been appointed, and how are audits now checking medicines, care plans, incidents and CQC notifications?
- 05How will you protect privacy and provide separate, person-centred support while the home works with the neighbouring service?
This was a focused inspection of Safe and Well-led only; ratings for Effective, Caring and Responsive were carried over from the previous comprehensive inspection. This explanation was written from the published report of 7 November 2020 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 Fairkytes
4 rated inspections over 7 years: the service has held its Good rating throughout.
- February 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2020Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2018Goodstayed GoodSafe: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 19 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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