CQC report explained · a residential care home
What the CQC found at Fairlawn
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found that risks were assessed and reviewed, safeguarding systems were understood, medicines were audited and the home was clean and safe. Crisis plans were in place for people who might be at risk of self-harm.
- Effective?
- Good
- People's needs were assessed before and after moving in. Staff had relevant training and supported people with mental health, physical health and nutritional needs, including access to outside professionals.
- Caring?
- Good
- People described staff as caring, thoughtful, friendly and respectful. Inspectors saw calm and sensitive interactions, and found that people were involved in their care planning and encouraged to develop independence.
- Responsive?
- Good
- Care plans reflected individual needs, choices, routines and future aims. People were supported with activities, relationships, community involvement and plans to move towards more independent living.
- Well-led?
- Good
- Inspectors found clear management arrangements, regular audits and a person-centred culture. The provider used feedback, monitoring and partnership work to improve care.
What inspectors found, February 2020
Fairlawn was rated Good; inspectors found safe, kind and personalised care, with improvements since the previous inspection.
The inspection took place on 10 September 2019. One inspector and a specialist mental health nurse spoke with two residents, staff, a relative and health and social care professionals. They also checked care plans, risk assessments, medicines records, staff files, complaints records and quality checks.
The home supported up to five people with mental health conditions. Four people lived there at the time. Inspectors found that people were safe, treated with dignity and supported to make choices. Care plans reflected people's wishes, mental health recovery goals and daily preferences.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The previous rating was Requires Improvement, with two breaches of regulation. The report says improvements had been made and the home was no longer in breach.
Safety planning
Risks were assessed when people moved in and kept under review. Individual crisis plans helped staff respond safely when someone's mental health changed.
“People had crisis plans in place to assist staff to safely support them at a time of crisis, for example people at risk of self-harm.” from the report
Personalised recovery care
Care plans included people's wishes, preferences, aspirations and recovery goals. Staff supported people to build independence in daily life.
“Staff developed care plans with people, to ensure these plans were person-centred and took account of people's own ideas and wishes to achieve recovery with their mental health.” from the report
Kind and respectful staff
People said staff listened and treated them respectfully. Inspectors observed patient, calm and empathetic support.
“People's rights to be cared for with dignity and privacy were respected by a caring and compassionate staff team.” from the report
Activities and community life
People were supported to take part in activities such as gardening, the gym, bowling, the cinema and restaurants. Activities aimed to reduce isolation and support recovery.
“Activities were planned to support people to combat social isolation and promote their mental health recovery.” from the report
Improved management
The provider had audits and monitoring checks covering areas such as medicines, health and safety and care quality. The report says action was taken when improvements were needed.
“The provider had clear systems in place to monitor and audit the quality of people's care and support, and take corrective actions to respond to any deficits they found.” from the report
Inspectors raised no specific concerns in this report.
- 01How will you keep my relative's risk and crisis plans up to date if their mental health or daily routine changes?
- 02What training do staff currently have for the mental health needs and behaviours that may challenge people living here?
- 03How do you assess and review support for self-administering medicines?
- 04What activities and community opportunities would be available for my relative, based on their interests and recovery goals?
- 05How would you support my relative to move on to more independent accommodation if that became their aim?
This was a planned inspection based on the previous rating and covered all five CQC questions; the previous rating was Requires Improvement. This explanation was written from the published report of 22 February 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.
What inspectors found, October 2018
Rated Requires Improvement; inspectors found kind care, but safety, records and management systems were not consistently strong.
This was the home's first inspection since it registered in 2017. Inspectors visited on 3 and 9 May 2018. The first visit was unannounced. They spoke with people, staff, relatives and professionals, and checked care plans, medicines, staff records and quality checks.
People said they felt safe and were treated kindly. Staff supported people with health appointments, medicines, choices and independence. Inspectors also found enough staff, safe recruitment and positive relationships between people and staff.
However, important risks were not always fully assessed or clearly recorded. The provider did not always report safeguarding and police incidents to the CQC. Training for people's specific mental and physical health needs was limited, care plans lacked detail, some activities were not provided, and the provider's audits had missed problems.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were rated Requires Improvement. Caring was rated Good. The report identified two breaches of regulations and required the provider to send an action plan.
Kind relationships
People and relatives described staff as compassionate and caring. Inspectors saw positive, cheerful interactions and people appeared at ease with staff.
“People and their relatives told us staff were compassionate and kind.” from the report
Choice and independence
Staff encouraged people to make everyday choices, learn household skills and work towards more independent living.
“Staff supported people to make their own choices and increase their independence.” from the report
Health support
People were supported to attend medical appointments and received follow-up support. Records included appointment outcomes and required actions.
“People were supported to attend health care appointments and meet their health care needs.” from the report
Staffing and recruitment
There were enough staff to support people's needs and activities. Recruitment checks included identity, references, right to work and criminal record checks.
“The staffing levels were sufficient to meet people's needs, and enable staff to support people to attend health care appointments and social events.” from the report
Incomplete risk assessments
seriousSome important risks were not fully assessed or explained in care records. This included self-harm, meeting people through social media, sexual health and alcohol misuse.
“The risk management plans did not consistently contain the required level of detail to provide sufficient guidance for staff.” from the report
Incidents not reported
seriousThe provider did not promptly tell the CQC or the local safeguarding team about a person being hit. A police visit was also not reported to the CQC.
“The provider had not informed the Care Quality Commission without delay when a person who used the service was hit by another person and therefore physically abused.” from the report
Limited specialist training
needs fixingStaff had mandatory training and supervision, but there was not enough additional training about the particular needs of people living at the home.
“However, staff did not receive additional training in specific topics in relation to the individual needs of people using the service such as epilepsy, drug and alcohol misuse, sexual health” from the report
Care plans lacked detail
needs fixingCare plans recorded people's history and goals but did not always explain clearly how staff should provide support, such as help with budgeting.
“There was a lack of attention to detail in the guidance for staff about how to meet people's needs.” from the report
Activities not always followed up
needs fixingA range of activities was available, but some people's requested activities had not been explored or arranged.
“Some people had not yet been supported to attend activities of their choosing.” from the report
Weak quality checks
needs fixingThe provider's audits often recorded only brief comments and did not identify issues that inspectors found in care records and other areas.
“However, issues that we had identified in the records had not been identified by the provider.” from the report
- 01How do you now assess and update risks relating to self-harm, social media contacts, sexual health and alcohol misuse?
- 02What is your process for reporting safeguarding concerns, police visits and other incidents to the CQC and safeguarding authorities?
- 03What extra training do staff receive about the specific mental and physical health needs of people living here?
- 04How do care plans now explain the practical support each person needs, including budgeting and medicines?
- 05How do you make sure people's chosen activities are followed up and that your audits identify problems?
This was the home's first unannounced comprehensive inspection, covering both the premises and the care provided. This explanation was written from the published report of 9 October 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 Fairlawn
2 rated inspections over a year: the service has improved, from Requires improvement to Good.
- February 2020Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2018Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2017
Registered with the Care Quality Commission on 23 May 2017.
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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