Fairholme House

Updated 5 July 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fairholme House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fairholme House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We reviewed the provider’s last inspection report and action plan. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and two relatives. Some people living in the home could not verbally give us feedback. As such we looked around the home and observed the way staff interacted with people. We further received feedback from five relatives. We looked at six people's care records and medicine administration records (MAR). We spoke with 11 members of staff including the registered manager, carers, kitchen staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records relating to people's care and the way the service was managed. These included staff training records, five staff recruitment files, quality assurance audits, incidents and accidents reports, complaints records, and records relating to the management of the service.

Updated 5 July 2023

About the service

Fairholme House is a residential care home providing personal and nursing care for up to 22 people. The service provides support to older people, some of whom were living with dementia. At the time of our inspection there were 17 people living at the service.

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

There had been significant improvements made to improve people’s outcomes. People told us they felt safe living at Fairholme House. Staff knew how to identify and report any concerns. Staffing levels had improved, and the home was using no agency staff. There were sufficient staff deployed to meet people's needs. The provider had safe recruitment and selection processes in place.

Risks to people's safety and well-being were managed through a risk management process. Medicines were managed safely, and people received their medicines as prescribed.

People had a pleasant dining experience which offered a variety of appetising homemade food choices available at times that suited people's preferences. The menu was overseen, and food prepared by an enthusiastic catering team who knew people’s needs very well. Staff supported people to maintain food and fluid intakes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff had a particularly good understanding of when the principles of the Mental Capacity Act should be applied.

Provision of activities had improved, and people had opportunities to participate in meaningful activities and we saw evidence people were involved in choosing activities and following their hobbies.

The home was well-led by a new registered manager who was committed to improving people's quality of life. The registered manager had developed internally and knew the service well. The registered manager and the provider created a clear management structure and established a group of staff who worked well as a team. The provider’s oversight of the service had significantly improved. The provider had introduced effective quality assurance systems which were used to monitor the quality and safety of the service. Staff worked well with external social and health care professionals.

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

Rating at last inspection and update

The last rating for this service was requires improvement (Published 19 July 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

At our last inspection we recommended the provider consider current good practice guidance on staff training, induction and supervisions and take action to update their practice accordingly. At this inspection we found the provider had acted on the recommendations and had made improvements.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

We carried out an unannounced focused inspection of this service on 31 May 2022. Two breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment as well as good governance. We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

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 requires improvement to good. This is based on the findings at this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fairholme House on our website at www.cqc.org.uk

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.