Fairholme Nursing Home

Updated 12 November 2021

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Fairholme is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We also reviewed information that we held about the service such as notifications. These are events that happen in the service that the provider is required to tell us about.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does 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 seven people living at Fairholme. We looked around the premises and observed staff interacting with people. We spoke with the registered manager, the clinical lead, two nurses, five care staff and one housekeeper. We also spoke with a relative and a healthcare professional who were both visiting the service.

We reviewed a range of records. This included four people’s care records, multiple medication records and two staff recruitment files. We also looked at a variety of records relating to the management oversight of the service. These were audits of the care provided and maintenance and safety checks of the premises.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We reviewed the staff training records we had requested from the registered manager and spoke with three relatives.

Updated 12 November 2021

About the service

Fairholme is a care home registered to provide nursing and personal care for up to 60 people. At the time of our visit there were 48 people living at the service. Fairholme is situated in the town of Cambourne. It is a two-storey building with a range of aids and adaptations in place to meet the needs of people living there.

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

Before this inspection we received concerns about low staffing levels, staff absences not being covered and a lack of appropriate and person-centred care.

At this inspection we found no evidence that staffing levels were or had been unsafe and there were enough staff on duty to meet people’s needs. The management team had the authority to cover for staff absences, and apart from the occasional short notice absence, shifts were always covered. The service had some staff vacancies and recruitment to these posts was on-going.

People’s health conditions were well managed and where people needed specific care, to manage on-going conditions, there were treatment plans in place that provided clear instructions for staff. Treatment plans were followed, and daily records of the care provided were completed, after each intervention, helping to ensure people received consistent care.

People’s care plans were person-centred and reflected each person’s needs and preferences. People told us, and we observed, that staff were attentive to people’s needs and provided care in a personalised and individual way. People were relaxed and comfortable with staff and had no hesitation in asking for help from them. Comments from people and relatives included, "It's nice living here", "They are all friendly and approachable" and "It's alright here, staff are really good."

People were offered a range of healthy meal choices. In response to a recent COVID-19 outbreak, fewer people were using the dining room and more people were eating meals in their rooms, to help reduce the risk of the spread of the virus. As a result of this people were currently being served a hot dessert at the same time as their main course. People we spoke with and observed were happy with this arrangement and we saw that desserts were covered in cling film to keep them warm. We were assured this practice was being kept under review.

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 informed about people’s changing needs through effective shift handovers and informative records of the daily care provided for people. Risks were identified and staff had guidance to help them support people to reduce the risk of avoidable harm.

There was time for people to have social interaction and activity with staff. Individual and group activities were provided for people. Some people spent their time in their room or in bed because of their health needs or personal preferences. The activities co-ordinator spent one-to-one time, with people who stayed in their rooms, engaging in conversations or individual activities. This helped to prevent people from being socially isolated.

Staff knew how to keep people safe from harm. Staff had received appropriate training and support to enable them to carry out their role safely, including the management of medicines.

The premises were clean and well maintained. Where faults or repairs were needed these were rectified in a timely manner. People had access to equipment where needed.

Cleaning and infection control procedures had been updated in line with COVID-19 guidance to help protect people, visitors and staff from the risk of infection. Government guidance about COVID-19 testing for people, staff and visitors was being followed.

People and their families were given information about how to complain and told us they would feel comfortable raising a concern. People, their relatives and staff told us they thought the service was well managed and communication with the management was good. People were regularly asked for their views on the service provided and feedback was used to make continuous improvements.

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

This service was re-registered with us on 21/05/2021 and this is the first inspection under the new registration. The last rating for the service, under the previous legal entity, was good, published on 6 February 2018.

Why we inspected

The inspection was prompted in part due to concerns received about staffing levels and the quality of the care provided for people. A decision was made for us to inspect and examine those risks as well as carrying out the first comprehensive inspection for a newly registered service.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective, Responsive and Well-led sections of this full report.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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