This was an unannounced inspection, carried out on 16 August 2017. The service was previously inspected in August 2015 when it was judged to be meeting the regulations and was rated as 'Good'.Fairfield House provides accommodation for up to four people with complex needs. The service uses a large detached house with extensive outside space. There were three people living at the service at the time of our inspection.
Due to people’s communication needs we were unable to gain some people’s views on the service, therefore we carried out observations of staff interactions with one person who lived there.
We saw that people were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. One person told us they were happy and felt safe living at Fairfield House. Comments included; “I’m happy.” Relatives of people who lived at Fairfield House told us, “It’s a wonderful place. They are doing great things with [person’s name]. We couldn’t wish for anything more for [person's name].”
We walked around the service and saw it was comfortable and personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff. One staff member said, “I love working here. The guys we support are great and I get a great sense of achievement by supporting them to get the most from their lives. It’s a good organisation to work for because the culture is all about empowering people to be as independent as they can be.” Staff were trained and competent to provide the support individuals required.
People had regular routine access to visiting health and social care professionals where necessary. People attended an annual health check with a GP and had access to specialist medical services to ensure their health needs were met. Professionals told us there was appropriate communication between the service and medical services. We saw clear guidance for staff about how they were to meet people’s needs so that they worked in collaboration.
Medicines were managed safely to ensure people received them in accordance with their health needs and the prescriber’s instructions.
Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people. Staffing levels met the present care needs of the people that lived at the service.
The service were meeting the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). 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.
People had a choice of how they spent their time and the activities they undertook. Meals, snacks and drinks were chosen by people, which they enjoyed. People had been included in planning their own menus and their feedback about the meals in the service had been listened to and acted upon. Some people were actively involved in meal preparation.
Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors privately if they wanted to. Relatives of people who used the service commented, “We are very happy with Fairfield. We think it is the best move we have ever made for [person’s name]. We are made welcome and can visit freely whenever we want to.”
The service had clear complaint systems and people had regular opportunities to discuss how they felt about the service. Each person had a key-worker who checked regularly if people were happy or wanted to raise any concerns. One relative told us, “I have always felt able to raise any concerns with staff and there are never any issues with communication.” Another relative said, “I have never had to actually raise a complaint because if there are ever any issues they are dealt with immediately.”
People had individual support plans, detailing the support they needed and how they wanted this to be provided. Staff reviewed plans at least monthly with input from the person who was supported. Relatives told us they were kept informed of changes to their relatives support plans and were regularly invited to review meetings.
Staff demonstrated they knew the people they were supporting, the choices they had made about their support and how they wished to live their lives. For example, we saw how well staff and management eased the anxiety of one person who exhibited challenging behaviours because of their anxiety levels. It was clear that staff understood the person very well and were able to calm them in a way that did not escalate their anxiety.
The service had comprehensive quality assurance processes which were regularly undertaken to ensure the service was aware of people’s views of the service and could monitor auditing processes at the service. This ensured an open service culture that is both open to challenge and is learning from any issues affecting the quality of the service as they arise.