Fairview Court Care Home

We found the following examples of good practice.

The home had arrangements in place to ensure visits could take place safely. There was a visiting pod available for use in the grounds of the home, which had separate entrances for both people and their relative. Lateral flow tests were carried out before people could enter the home. Hand sanitisers and personal protective equipment (PPE) was readily available throughout the building. We discussed with the registered manager how clearer signage at the entrance would be helpful to make sure visitors were aware of procedures to follow.

Staff wore PPE and there were good supplies of this in place. Clinical waste bins were used to dispose of used PPE. There were arrangements in place to reduce the risk of transmission between staff. This included ‘cohorting’ staff to floors and using separate entrances to access different areas of the home. Staff had received training in how to use PPE effectively.

Staff and people in the home were tested regularly in accordance with government guidance. This helped ensure any infection would be identified promptly and action taken accordingly to reduce the risk of transmission. The home had experienced an outbreak of Covid 19, during the pandemic and had taken the opportunity to learn from the experience.

The home was clean and well maintained. We discussed with the registered manager some minor improvements, such as having clear protocols for staff to follow when cleaning rooms and also better storage facilities for items such as urinals and commodes. Infection control audits were undertaken to monitor how well procedures were being followed.

People’s wellbeing had been supported during the course of the pandemic. This included group activities when possible and activities taking place with individuals in their rooms. The registered manager told us staff had worked incredibly hard to ensure people received the care they needed, during some very challenging times over the course of the pandemic. The registered manager had also worked a very high number of hours to cover nursing shifts when required.

Five of the beds (called pathway three beds) were funded by the NHS and provided a six week assessment service following discharge from hospital. The home is a purpose built care home with facilities spread over three floors. All floors were fully accessible and all bedrooms were for single occupancy. At the time of our inspection there were 49 people living in the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Why we have rated the service as Good?

There were effective safeguarding systems in place to ensure people were not harmed. All staff received safeguarding adults training and were aware of their responsibility to protect people from harm. The staff had reported appropriately when there were concerns regarding a person’s welfare. Safe recruitment procedures were followed to ensure that only suitable staff were employed.

Any risks to people’s health and welfare were assessed and appropriate management plans put in place to reduce or eliminate that risk. The procedures in place for the management of medicines followed best practice guidelines and were administered to people safely. The premises were well maintained and regular maintenance checks were completed.

People were looked after by sufficient numbers of staff so their care and support needs could be met. Staffing numbers were adjusted as and when necessary. All staff felt the staffing numbers were appropriate and they could meet people’s needs. The staff teams worked well together and although tended to work on designated floors, they helped their colleagues out whenever was required. People were safe because the staffing levels were sufficient.

People’s care and support needs were assessed before admission to Fairview Court to ensure the staff team had the appropriate skills and knowledge to meet their needs. In addition, they ensured that any specific equipment that was needed for the person was available. People’s assessed needs were kept under review throughout their stay.

There was a programme of essential training all staff had to complete. This enabled them to do their jobs well. New staff completed an induction training programme and then completed the Care Certificate. The Care Certificate covers a set of standards that social care and health workers must work to in their daily working life. Care staff were encouraged to complete nationally recognised qualifications in health and social care. All staff had a regular supervision meeting with a senior member of staff to support them to do their job.

People were provided with sufficient food and drink and had a choice in what they ate and drank. People’s individual dietary requirements were met. There were measures in place to reduce or eliminate the risk of malnutrition or dehydration. Body weights were checked at least monthly and fortified foods provided if people were losing weight. Arrangements were made for people to see their GP and other healthcare professionals when they needed to.

People were supported to make their own choices and decisions where possible. Where people lacked the capacity to make decisions, assessments were recorded of best interest decisions. We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards.

The service was exceptionally caring. The staff team demonstrated their passion for caring for people, including those people living with dementia. The staff team had good working relationships with each other and with the people they were looking after. There was a real commitment from all staff to provide the best possible care, to provide ‘family life’ in a homely environment. Families, friends and other visitors were also included in this. People were given the opportunity to take part in a range of different meaningful activities. There were group activities but also staff could spend one to one time with people who were confined to bed or their bedroom.

Each person had a plan of care based on their care and support needs. The person of their relatives was involved in drawing up the plans and this ensured they were provided with personalised care. Clear detailed care records were maintained which evidenced the support each person received. Communication between staff handing over to the next shift ensured the ongoing healthcare needs of people were met appropriately.

There was good management and leadership in place with the registered manager generating a positive caring culture within the staff team. The registered manager was supported by a deputy and qualified nurses, to ensure the service was well-led. Regular staff meetings were held to keep all staff up to date with changes and developments in the service. Staff were encouraged to make suggestions and were listened to.

The registered provider had a regular programme of audits in place which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

All staff received safeguarding adults training and the team were knowledgeable about safeguarding issues. When concerns had been raised regarding a person’s welfare, the appropriate actions had been taken to prevent further harm. The service and registered manager had worked well with the local authority safeguarding team. Safe recruitment procedures were followed to ensure that only suitable staff were employed. The appropriate steps were in place to protect people from being harmed.

A range of risk assessments were completed for each person and appropriate management plans were in place. Specific risk assessments were in place on an individual basis. Medicines were administered to people safely. The premises were well maintained and regular maintenance checks were completed.

Staffing numbers were adjusted and based upon the care and support needs of each person in residence. All staff felt that the staffing numbers were appropriate and they were able to meet people’s needs. The staff teams worked well together and although tended to work on designated floors, they helped their colleagues out whenever was required. People were safe because the staffing levels were sufficient.

All staff completed a programme of essential training to enable them to carry out their roles and responsibilities. New staff completed an induction training programme and there was a programme of refresher training for the rest of the staff. Care staff were encouraged to complete nationally recognised qualifications in health and social care.

People were supported to make their own choices and decisions where possible. Where people lacked the capacity to make decisions, assessments were recorded of best interest decisions. We found the service to be meeting the requirements of the Deprivation of Liberty Safeguards.

People were provided with enough food and drink. People’s individual dietary requirements were met. Those people who did not eat well were monitored and were provided with fortified food. There were measures in place to reduce or eliminate the risk of malnutrition or dehydration. Arrangements were made for people to see their GP and other healthcare professionals when they needed to.

The staff team had good working relationships with the people they were looking after and also with their families and friends. People were given the opportunity to take part in a range of different meaningful activities. There were group activities and external entertainers visited the service, but also staff were able to spend one to one time with people who were bed bound.

Assessment and care planning arrangements ensured people were provided with personalised care that met their own individual needs. Accurate care records were maintained which evidenced the support each person received. Communication between staff handing over to the next shift ensured the on-going healthcare needs of people were met appropriately.

There was a staffing structure in place and all staff were provided with good leadership. Regular staff meetings were held in order to keep all staff up to date with changes and developments in the service.

The registered provider had a regular programme of audits in place which ensured that the quality and safety of the service was checked. These checks were completed on a daily, weekly or monthly basis.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Risk assessments were in place to keep people safe.

We saw that risk assessments were specific to people's needs and used to plan the care and support that people required. For example, we saw a risk assessment for moving and handling a person with mobility needs. This had been reviewed monthly and the level of risk had been increased over time from low risk to high risk, as the person's level of mobility deteriorated. This meant that risk to people's safety and wellbeing were effectively managed.

We saw the policies and procedures file which included procedures for maintenance. These also included routine repairs, portable appliance testing (PAT), temperature measuring and building maintenance.

People who used the service told us they were happy and that staff were always available when they needed assistance or support. We observed that staff attended to people in an unhurried manner.

One person told us 'staff are always there when I need them'. One relative told us 'we don't feel that there is shortage of staff in the home. There is continuity of care'. Another relative told us 'staff are always happy and we are happy'.

This meant that there were enough staff who knew the needs of the people who used the service and that people could expect same staff to always care for them.

Is the service effective?

We saw staff training records which set out what required training had been completed by staff as well as other training relevant to their roles. This included moving and handling, safeguarding, food hygiene, fire safety, first aid, dementia awareness and health and safety. The record also highlighted when refresher training was due. We saw that 33 staff had achieved National Vocational Qualification (NVQ) at different levels. For example six care staff had achieved NVQ level 3.This meant that staff were able to take part in learning and development that was relevant and appropriate to their role.

We saw that a plan was in place for each aspect of people's care. For instance one persons' plan described the difficulties they had due to their dementia. The care plan provided guidance for staff about the approach staff should take to engage the person, such as talking to them, reassuring them, before supporting them with personal care or other tasks. Staff we spoke with told us this made the person calmer and reduced agitation. This meant that care was provided in a safe manner to meet people's needs.

Is the service caring?

We saw staff assisted people with their care needs in a sensitive and supportive manner. For example, two staff members went quickly to support a person who needed help with personal care before they were assisted with their lunch. One person who used the service told us 'staff are kind and caring. I am happy with care here'.

We observed how people were supported at lunch time. We saw that staff were caring in their approach and were attentive to people's needs. For example we saw staff helped those who required assistance and promoted the independence of those who could eat and drink themselves. One relative told us 'mum is so content. I am happy with her care here. Staff are so caring and kind'.

Is the service responsive?

We saw that all people who used the service were registered with a local GP. Records of GP visits, opticians, chiropodist visits and other specialist professionals were recorded in care plans.

We observed staff supported people and followed the recommendations of health care practitioners such tissue viability nurse and or consultants. For example we saw that where people had fragile skin the recommendations of the tissue viability nurse had been included in their care plans. One relative told us, "since my relative's came here their health has improved'. This demonstrated that the home promoted the health and welfare of the people who used the service.

People and their relatives we spoke with confirmed that they were aware of the complaints procedure and knew who to go to if they were unhappy with any aspect of the service. One person who used the service told us 'I am happy here I have no complaints'. One relative told us' I have not made any complaint and I have no complaint'.

Is the service well-led?

There were systems in place for gathering and monitoring information about the quality and safety of care, treatment and support in the home. This included visits by the provider representative, surveys to gather people's views and relatives and residents meetings. Where shortfall were identified action was taken.

We saw evidence that the manager with the involvement of staff carried out a number of audits. These included pressure sores, infection control, medication, and catering and personnel files.

We spoke with the staff on duty who confirmed that staffing levels were 'good' and if they needed any extra help the senior staff and managers were always around to give extra advice and assistance if needed. Staff told us 'If I need help and support I feel my manager would listen' and 'We have a good staff team here and help to cover shifts amongst ourselves'.

We spoke with visitors during our visit that told us "The home seems to be staffed very well' and 'We always see plenty of staff and all of them are very hard working' and 'If my relative needs anything I can always find staff to ask them for assistance'. We asked visitors if staff were available to speak with when visiting. They told us they 'We are greeted with familiar friendly staff' and 'The staff are very polite and go out of their way to speak to us'.

All bedrooms offered en suite facilities that were found to be clean, tidy and odour free. We found that instant hot water was available. Laminate flooring, carpets, curtains and bedding throughout the home were suitable and were regularly cleaned and maintained by the staff.