Archived: Fairways Care Home

Updated 21 April 2017

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 registered provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 6 and 8 March 2017 and was unannounced. The inspection was led by an adult social care inspector who was accompanied on the first day by a pharmacist inspector and an expert by experience who had experience of supporting older people living with dementia.

Before the inspection, the registered provider completed a Provider Information Return (PIR). This is a form that asks the registered provider to give some key information about the service, what the service does well and improvements they plan to make.

We also looked at notifications sent in to us by the registered provider, which gave us information about how incidents and accidents were managed. We spoke with the local authority safeguarding team, and contracts and commissioning team about their views of the service.

We spoke with ten people who used the service and eight of their relatives who were visiting during the inspection. We looked around all areas of the service and spent time observing care. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with the registered manager, administrator, two team leaders, three care workers, a housekeeper, laundry person, the cook and the activity co-ordinator. We spoke with two visiting health and social care professionals.

We looked at the care records of six people who used the service including assessments, risk assessments, care plans and daily recording of care. We looked at other records relating to people who used the service; these included accidents and incidents and medication records for 10 people.

We also looked at a selection of records used in the management of the service. These included staff rotas, training and supervision records, quality assurance audit checks, surveys and minutes of meetings with staff and people who used the service. We had a tour of the premises.

Updated 21 April 2017

Fairways Care Home is situated to the west of the town of Grimsby, on a main road with public transport facilities and local shops and other amenities within walking distance. The service is registered to provide accommodation and personal care for a maximum of 55 people some of whom may be living with dementia. Accommodation is single storey and all bedrooms have en- suite facilities. There is a good range of communal areas throughout the building. There is an accessible garden and car parking at the rear of the building. At the time of this inspection 39 people used the service.

The service did not have a registered manager at the time of the inspection. 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. The acting manager confirmed they had completed their interview with CQC two weeks previously, to support their application for registration and the certificate was issued on 13 March 2017, five days after the inspection.

We undertook this unannounced inspection on the 6 and 8 March 2017. The last inspection took place on 26 and 28 January 2016. At that inspection we found the service was in breach of one regulation around person centred care and was rated ‘Requires Improvement’ in all domains and overall. At this inspection we found improvements in relation to the previous breach and the rating in three domains had improved to ‘Good’. We found two new breaches of regulations in relation to medicines and notifications. The service rating overall remains ‘Requires Improvement.’

We found there were shortfalls in the administration and recording of some people’s medicines. This was a breach in regulations and you can see what action we have asked the registered provider to take at the back of the full version of the report.

The Care Quality Commission had not received all notifications for incidents which affected the safety and wellbeing of people who used the service, as required by registration regulations. This had been an error by the registered provider and acting manager and they told us they would forward all required notifications in future. We have written to the registered provider to remind them of their responsibilities in this area.

Improvements had been made with the standard of recording in the care files. A new recording format supported staff to provide more detailed and person centred information. Care plans had been reviewed and updated to reflect the person’s current care needs. We found risk assessments were completed, reviewed and updated when people’s needs changed. Supplementary records to monitor areas such as food and fluid intake, repositioning support and personal care were well completed and up to date.

We found some improvements had been made with the management of the service. Although aspects of the quality monitoring programme had been reviewed and strengthened, the registered provider considered the existing system remained limited and had provided a new monitoring programme, which was to be implemented by May 2017.

We found people who used the service were protected from the risk of harm and abuse. People told us they felt safe living in the service. We saw staff interacting with people and they did so in a kind, caring and sensitive manner. Staff had received safeguarding training and knew what to do if they witnessed abuse or if it was disclosed to them. Two staff were not clear about the reporting procedures to external agencies and the acting manager confirmed they would address this through training and supervision. Staff knew what to do in cases of emergencies and each person who used the service had a personal evacuation plan.

We saw there were enough skilled and experienced staff on duty to meet people’s needs. A new dependency tool assisted the acting manager to calculate the numbers of staff required. We found staff had been recruited using a robust system that made sure they were suitable to work with vulnerable people.

Staff told us they felt supported by the registered manager and confirmed they had received a range of training, formal supervisions and appraisals of their work. Gaps in the supervision programme were being addressed.

People enjoyed the meals provided to them. The menus enabled people to have choice and special diets when required. We saw people’s weight, their nutritional intake and their ability to eat and drink safely was monitored and referrals to dieticians and speech and language therapists took place when required for treatment and advice. During the day, we observed people were served drinks and snacks between meals.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff demonstrated good communication skills and distraction techniques when managing people who needed additional support to manage their behaviours.

People were cared for by a stable staff team who knew them well. We saw staff encouraged people to be as independent as they were able to be and spoke with them in a friendly and respectful way. Relatives told us the atmosphere at the service was calm, friendly and open and that staff were kind. The feedback provided by relatives and staff about the acting manager was also positive.

We saw arrangements were in place that made sure people's health needs were met. The service worked closely with community healthcare teams who gave us positive feedback.

A varied programme of entertainment and activities was available; we saw people enjoyed taking part in a music session with entertainers and playing games with staff and volunteers.

There were systems in place to manage complaints and people who used the service and their relatives told us they felt able to raise concerns and complaints.