Archived: Fairview House

Updated 17 February 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. 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 completed by two inspectors on 22 July 2020 and one inspector on 31 July 2020. The inspectors were accompanied by a Specialist Advisor on 22 July 2020, whose specialism related to the management of medicines.

Fairview House 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 in post, but they were not yet formally registered with the Care Quality Commission. This means the provider is 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

Prior to our inspection to the service we formally asked the provider and manager to provide us with a range of information. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We 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 six people who used the service about their experience of the care provided. We collated information relating to 11 people who used the service and this related to specific topics. We looked at the provider’s arrangements for managing medication and the prevention and control of infection.

After the inspection

We continued to seek clarification from the provider and manager to validate evidence found. We spoke with seven members of staff between 31 July and 3 August 2020. We spoke with the manager about their role and responsibilities on 7 August 2020. We also provided feedback of our inspection findings to the manager and a representative of the organisation on 7 August 2020. We looked at information relating to people’s care and support needs, including risk factors, staff training data, three staff personnel files and the provider’s quality assurance arrangements. We spoke with several professionals who have recently visited the service because of emerging concerns.

Updated 17 February 2021

About the service

Fairview House is a residential care home providing accommodation and personal care for up to 55 people aged 65 and over. This includes people living with dementia. At the time of the inspection there were 35 people living at the service.

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

Information relating to people’s individual risks were not always recorded or did not provide enough assurance that people were safe. Suitable arrangements were not in place to ensure the proper and safe use of medicines. Effective arrangements were not in place to protect and prevent people who used the service from abuse. The staffing levels and the deployment of staff were not suitable to meet people’s care and support needs. People were not protected by the prevention and control of infection. Lessons were not learned, and improvements made when things went wrong.

The leadership, management and governance arrangements did not provide assurance the service was well-led, that people were safe, and their care and support needs could be met. Quality assurance and governance arrangements at the service were not reliable or effective in identifying shortfalls in the service. There was a lack of understanding of the risks and issues and the potential impact on people using the service.

Rating at last inspection (and update)

The last rating for this service was inadequate (published 14 January 2020) and there were multiple breaches of regulation. This service was placed in ‘Special Measures’ following our last inspection to the service.

Why we inspected

The inspection was prompted in part due to concerns received about unwitnessed falls and the provider’s arrangements for falls management. Other concerns related to unexplained bruising, inadequate staffing levels and inappropriate moving and handling practices. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of ‘Safe’ and ‘Well-Led’ only.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has not changed and is based on the findings at this inspection.

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

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.