Littlefair

Updated 18 January 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector.

Service and service type

Littlefair is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service did not have a manager registered with the Care Quality Commission. This means that the provider is legally responsible for how the service is run and for the quality and safety of the care provided. The owner told us the post had recently been advertised.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with ten people who used the service and two relatives about their experience of the care provided. We spoke with two members of staff, a senior carer, the housekeeper, the owner, the chief operating officer, the business operations manager and the quality assurance manager who were acting together as the managers, the activities coordinator and the chef. We reviewed a range of records. This included five people's care records, and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service were reviewed.

After the inspection

We spoke with five people’s relatives, two health and social care professionals. The provider sent us information about what action they were doing to address issues identified in the inspection.

Updated 18 January 2020

About the service:

Littlefair is a residential care home. It is registered to provided accommodation and personal care for up to 41 people. At the time of our inspection 33 people were living at the home. Littlefair provides accommodation and personal care to older people some of whom are living with dementia. It is one purpose-built property spread over three floors and has a garden and accessible patio area.

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

People were supported to take their medicines safely; however the recording of people’s medicines held in stock did not match the actual stock levels in the medicine’s cabinet.

The provider’s policies and procedures for the frequency of supervision support for staff was not being followed and needed to be more regular. The acting managers told us improvements were being made to implement this immediately. We have made a recommendation regarding supervision.

People told us they felt safe and secure and well cared for.

The provider had good systems for monitoring risk and staff had a good understanding of people's needs and how to keep them safe.

People and relatives told us there were enough staff on duty to meet their needs.

Staff told us they worked well together as a team, and we noted there was a spirit of good morale amongst them.

Whistleblowing procedures were in place and displayed on notice boards. Staff told us they were confident any concerns they reported would be dealt with appropriately.

Appropriate infection control procedures were in place and staff received training with food hygiene. The home was seen to be clean. Some parts of the home were tired looking because some carpets needed replacing. The chief operating officer showed us the improvement plan for the home for 2019/20 which included a plan to replace these carpets and included other developments such as the installation of new kitchen equipment.

Feedback from people and relatives was positive. They were complimentary about the staff and commented on their caring and supportive attitude.

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 were knowledgeable of the Mental Capacity Act and how it may impact on people, however not all forms giving consent had been signed. We have made a recommendation about this.

People and their relatives told us they experienced a positive approach to care and were encouraged to give their feedback to help improve the home.

The staff worked with outside professionals to improve people's health and social wellbeing. They worked collaboratively with other agencies and organisations to meet people’s needs.

People received care that was tailored to their needs and wishes. This was provided by caring, attentive and compassionate staff. The atmosphere of the home was positive and welcoming, and people and relatives told us staff were friendly, providing care and support in a way people liked and enjoyed.

The concerns and complaints procedures meant that people were able to make complaints or raise concerns and have confidence they would be responded to in an appropriate way.

Quality assurance processes were in place that monitored practice and procedure by staff, however some improvements in developing the quality assurance systems were needed and the provider was in agreement with this.

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 good (published 20 June 2017).

Why we inspected

This was a planned inspection based on the previous rating. We have found evidence that the provider needs to make improvements.

Please see the Safe and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.