Fairfield Nursing Home

Fairfield Nursing Home is a residential care home providing personal and nursing care to up to 30 people. The home is a detached property set in its own grounds in a quiet residential area. The service provides support to people in need of nursing support, respite care, end of life care and general assistance with everyday living for people with dementia. At the time of our inspection there were 25 people using the service.

People’s experience of using this service and what we found

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Medicines were not managed safely and the monitoring information for people living in the home was not always completed fully. Risks in relation to people's care had not been properly assessed.

People’s dietary needs were identified, however there was no adequate system in place to ensure catering staff had accurate information about people’s dietary needs or risks.

The systems in place to monitor the quality and safety of the service were not always used effectively to identify and mitigate risks including allegations of abuse.

Information regarding some agency staff not always available and the information provided to agency staff for the safe care of people was not always up to date.

There were a range of audits completed by the provider and manager, however they were not always effective in identifying and bringing about improvements.

Permanent staff were recruited appropriately and they received training and support for their role. There were enough staff on duty on the day of inspection to meet people's needs.

Equipment had been serviced and maintained and accidents and incidents were recorded and reviewed in order to minimise the risk of reoccurrence. The environment seemed clean and welcoming however it had been recognised by the provider that refurbishment was needed.

Complaints were managed appropriately, and referrals were made to other professionals when people living in the home were in need.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 01 November 2017.)

Why we inspected

The inspection was prompted in part due to concerns received about the use of medicines, recruitment, and governance of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairfield Nursing Home on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the need for consent, fit and proper persons, medicines management, risk management and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Fairfield Nursing Home is a nursing home registered for up to 29 people. The home is a detached property set in its own grounds in a quiet residential area. At the last inspection in October 2015 we found that the home was providing a good service in all areas. At this inspection we found the service remained Good.

The home provided a comfortable, safe and well-maintained environment for people to live in. People’s medicines were managed safely.

There were enough staff to meet people’s needs. New staff were recruited safely and all staff received regular training relevant to their work.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service worked within the requirements of the Mental Capacity Act.

Everyone we spoke with was happy with the meals provided. The meals were presented well and people received the support they required with their meal. People we spoke with said how kind, considerate and polite all members of staff were.

People's care and support needs were assessed and plans put in place for how their needs should be met. These were individualised and covered all aspects of a person's needs including physical, mental health and social needs.

The home's complaints procedure was displayed in the entrance area and provided details about how, and to whom, complaints should be addressed. The manager maintained detailed complaints records.

The home had a manager who was registered with CQC. People told us that the manager was approachable and they considered her a good leader. We saw that people had completed satisfaction surveys. Auditing systems were used to monitor the quality and effectiveness of the service.

Further information is in the detailed findings below.

We found that people's needs were assessed before they moved to the home. Plans to support them were regularly reviewed to ensure their care needs were met. A relative described the staff as wonderful, kind and caring and their relative as being very settled living in the home. One person described the care as second to none.

Medicines were administered by qualified nurses so that people living in the home received medicines safely.

We found that the bathroom flooring identified at our last visit had been replaced and communal areas in the home were undergoing some decoration.

Staff told us that they receive support and training to enable them to do their job. We found that a training plan had been developed to ensure staff knowledge was current.

People told us their rooms were comfortable and regularly cleaned. Although the people receiving the services were happy with the home we found that there were failures in maintaining the bathrooms in the home. There was only one shower working in the home which was insufficient to meet the needs for up to 29 people.