CQC report explained · a residential care home
What the CQC found at Fairlea
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were safeguarded from avoidable harm, risks were assessed, staffing levels were based on people's needs and medicines were generally managed safely. Inspectors raised concerns about some medicines records and the manager acted during the inspection.
- Effective?
- Good
- Staff sought consent, followed the Mental Capacity Act principles and had suitable training and supervision. People were supported with food, drink, health appointments and contact with other professionals.
- Caring?
- Good
- Staff treated people with kindness, respect and compassion. They understood people's communication methods, supported choice and respected privacy, dignity, beliefs and relationships.
- Responsive?
- Good
- Care was personalised and records explained people's needs and preferences. People took part in a range of activities and there was a complaints process, although end of life care had not yet been included in current care plans.
- Well-led?
- Good
- There was an open culture, staff felt able to raise concerns and relatives and others could give feedback. Audits and checks were in place, although safe staffing assessments were still being developed.
What inspectors found, November 2018
Rated Good; inspectors found kind, personalised care and improvements since the previous inspection, but medicines records needed attention.
This was an unannounced comprehensive inspection on 30 October 2018. The inspector observed care, spoke with staff and relatives, and checked care, medicines, training and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people were protected from abuse, received their medicines as prescribed, and had enough staff to meet their needs.
Staff supported people to make choices, maintain relationships and take part in activities. Care records were detailed and regularly reviewed. Staff also worked with health and social care professionals to support people's health.
The service had previously been rated Requires Improvement after three breaches in November 2017. Inspectors found the provider had made improvements and met the requirement notices.
Kind and respectful support
Staff understood how people communicated and responded promptly to requests. They supported privacy, dignity and emotional wellbeing.
“Staff treated people with kindness, respect and compassion.” from the report
Personalised care
Care records gave detailed guidance about people's needs and preferences. These records were reviewed when people's needs or health changed.
“People received personalised care that met their needs.” from the report
Improvement since 2017
The previous inspection found three breaches and rated the service Requires Improvement. Inspectors found the provider had made the required improvements.
“At this inspection we found improvements had been made and the provider had met the requirement notices.” from the report
Medicines records
seriousSome staff signed medicines records for the day after the inspection, and records were not clear when medicines went with people on family visits and returned. Retraining, stock checks and a home leave protocol were put in place.
“There was also concern about the lack of clear records for medicines leaving and being returned to the home when people went home to their family.” from the report
End of life planning
needs fixingCurrent care plans did not include end of life care information. The manager said this would be reviewed and a template was available.
“We discussed end of life care with the area manager as this had not been included in the current care plans, although there was a template ready to use.” from the report
Staffing assessments
minorThe home had enough staff at the inspection, but formal assessments covering staffing numbers, skills and competence were still being developed.
“Safe staffing assessments were to be developed which would ensure the service not only had sufficient staff but they had the right skills and competencies to meet people's needs.” from the report
- 01How are medicines records checked now, especially when medicines go with someone on a visit home?
- 02What retraining have permanent and bank staff completed on medicines management?
- 03Have end of life wishes and support been added to people's current care plans?
- 04How do you assess that there are enough staff with the right skills and experience for each person's needs?
- 05How are people and their families involved in reviewing care plans, activities and changes in support?
This was an unannounced comprehensive inspection covering all five rating areas, using observation, discussions with staff and relatives, and checks of care, medicines, training and management records. This explanation was written from the published report of 30 November 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.
What inspectors found, December 2017
Rated Requires Improvement; inspectors found kind, personalised care, but serious legal, medicines and management recording issues.
This was an unannounced inspection on 7 November 2017. One inspector reviewed the service, spoke with one person, the manager and staff, and looked at one person's care records and management records.
The home was rated Good for Caring and Responsive. Staff knew people well, treated them with dignity, supported their choices and helped them maintain family relationships, activities and independence. Health needs were met and one person's move into the home was carefully planned.
The home was rated Requires Improvement for Safe, Effective and Well-led, giving an overall rating of Requires Improvement. Inspectors found medicines stock records were not always accurate, some care records were difficult to find, and the manager had not properly checked accidents and incidents.
There was no registered manager. The provider had not completed required mental capacity assessments or made a needed DoLS application, meaning one person was deprived of their liberty without lawful authority. Inspectors found three breaches of regulations and told the provider to take action.
Kind and respectful staff
Staff had caring relationships with people and supported privacy, dignity and individual routines.
“Staff spoke to people in a polite, patient and caring manner and took notice of their views and feelings.” from the report
Personalised support
Care plans included people's needs, preferences and goals. Staff encouraged independence and responded to support needs.
“People received a personalised service that met their needs.” from the report
Support with health
The home worked with health professionals and supported people to attend health checks and access services.
“People were supported to maintain their health and wellbeing.” from the report
Careful transition planning
One person's move into the home was planned over several weeks around their individual needs, with family involvement.
“We saw how careful planning had taken place to support one person moving into the home.” from the report
Unlawful restriction of liberty
seriousThe provider had not completed a mental capacity assessment or made a DoLS application for one person who was restricted in the home. Inspectors said this meant the person was deprived of their liberty without lawful authority.
“The lack of appropriate assessments and deprivation of liberty safeguards meant that people were being deprived of their liberty without lawful authority.” from the report
Medicines stock records
seriousMedicines were stored and given safely in the main, but records for liquid medicines did not always show how much had been given or the running stock total.
“Medicines were not always managed safely as accurate records were not always kept regarding stock.” from the report
Care records hard to find
needs fixingOne person's records were still on paper and spread across different places. Inspectors said this could make it difficult for new or temporary staff to find the information needed to provide care.
“For the other person, their records were still in paper format and not on the electronic system used by the provider and could not be found easily” from the report
Accidents not reviewed
seriousThe manager had not overseen or analysed accidents and incidents to identify patterns and reduce the risk of them happening again.
“Systems had not been implemented to ensure accidents and incidents were followed up to ensure appropriate action had been taken.” from the report
Weak quality checks
needs fixingAudits were not always effective or frequent and had failed to identify problems with mental capacity assessments, DoLS, medicines and care plans.
“Quality assurance systems were not always effective or frequent and had not identified issues found in relation to mental capacity assessments, Deprivation of Liberty Safeguards (DoLS), medicines and accessibility of care plans.” from the report
No registered manager
needs fixingThere was no registered manager, despite a registration condition requiring one. The manager also oversaw another service and daily management was left to the deputy and senior care staff.
“At the time of our inspection there was no manager registered with CQC.” from the report
- 01Has the mental capacity assessment been completed and has the required DoLS application been made?
- 02How are liquid medicines recorded now, including the amount given and the remaining stock?
- 03How are accidents and incidents reviewed, analysed and followed up to prevent them happening again?
- 04Are all care records now together, up to date and easy for temporary or new staff to find?
- 05Has a registered manager been appointed and has the application been submitted to CQC?
This was an unannounced inspection of the overall service and all five quality areas; the inspector spoke with one person, reviewed one person's care records, and noted that not all requested information was provided. This explanation was written from the published report of 8 December 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 Fairlea
3 rated inspections over 2 years: the service has held its Good rating throughout.
- November 2018Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- June 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- July 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- July 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 31 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.
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