Fairburn Vale

Updated 8 February 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 27 January 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 8 February 2022

About the service

Fairburn Vale is a purpose-built facility offering specialist nursing care for 20 adults with acquired brain injuries, and accommodation for people with complex physical and mental health or behavioural needs. Accommodation is provided over two floors accessible by a lift and there is a communal garden area. There

were 20 people living in Fairburn Vale on the day we inspected.

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

People felt safely supported and there were secure relationships with staff, who knew people very well. Individual risk assessments were documented well in care plans and guidance for staff was very clear so they could support people safely. For example, positioning regimes, triggers for seizures and information about non-verbal communication cues.

Staffing levels on the day of the visit were below the provider’s expectations, although they tried to minimise the impact on care delivery by utilising the support of the wider staff team. Feedback we received about staffing levels was mixed. Some people and staff said there weren’t enough staff to support the service properly, whilst others said staffing levels were good.

Infection prevention and control measures were securely in place and known by staff, people who used the service and relatives. Clear information for staff about COVID-19 has been continuously delivered, from both a practical and supportive perspective. PPE was worn appropriately, although there was the occasional touching of masks, which the management team agreed to address immediately. Feedback from relatives about COVID-19 safety was the service ‘went above and beyond’ to ensure people’s safety.

Safety related training was completed and the staff training champion ensured compliance. Some practical training, which had been difficult to source during the pandemic, was being arranged. Staff felt supervision and training was relevant to the individual needs of people being supported. Staff were confident in their roles and to approach the management team with any development or further training needs. Staff felt confident to identify safeguarding signs of concern and to speak up if they had any. Medicines were managed safely overall, with clear recording. Staff competence was checked to ensure safe practice with administering medicines.

People were supported with healthy lifestyles and encouraged to make their own choices and decisions. Information about people’s mental capacity was clearly recorded. Mealtime support was in place, with lovely interaction between people and the staff. Staff knew people’s dietary needs well, although there was no information readily available, such as in the kitchen, to show people’s dietary needs for staff less familiar, such as agency staff. We made a recommendation for the provider to improve the quality of information available.

The key values and vision of the service were known by staff and on display in the home. Positive feedback was received about the management team and their supportive approach. Relatives felt very well informed and described the service as being ‘like family’. The provider ensured continuous health and safety monitoring was in place, as well as thorough responses to concerns raised internally and externally.

There was a clearly set out governance model; quality checks were robustly carried out, with close management oversight of the service. Clinical governance meetings and staff meetings were used for information sharing and driving improvements. Audits were detailed and identified areas to improve, actions taken to address matters raised and continuous monitoring of actions taken. Adverse events, such as poor moving and handling, choking incidents and medication errors, were thoroughly investigated and reviewed, with root cause analysis and clear actions taken to prevent occurrence. Opportunities for lessons learned were maximised with all staff through reflections, memos and further training where needed. Complaints and compliments were recorded well and responses made. Relatives had confidence in the complaints process. One particular compliment made was ‘Fairburn stands out as a light in a very dark year’ and highlighted the support for people and relatives throughout the challenges of the COVID-19 pandemic.

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 (report published 10 October 2017). The rating for this inspection remains Good.

Why we inspected

This was a planned inspection.

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

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.