Archived: Fairview

Fairview is a residential care home providing accommodation and personal care to people. The service specialises in providing care for people with learning disabilities. The service can support up to five people. At the time of this inspection there were five people using the service.

The service applied the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were involved in all aspects of the service and made suggestions on how it was run. They were encouraged to make decisions relating to their care and support; their independence was supported and promoted. 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.

Before people came to live at the service, careful thought was given in the planning process. People who already lived at the service were involved and asked for their feedback about any potential, new admissions.

Care plans were person-centred in design and provided staff with detailed information and guidance about people's care needs and how they wished to be supported. Staff completed a range of training to enable them to deliver personalised care to people.

People were involved in all aspects of the service, from choosing and planning menus to deciding how they wanted to spend their days. Most people were encouraged to participate in the community and were supported by staff with external activities. People had access to a range of healthcare professionals and services. Positive, caring and compassionate relationships had been developed between people and staff.

People were protected from harm by staff who understood what actions to take if they suspected any form of abuse. Risks to people were identified and assessed as needed, with guidance for staff which was followed. There were enough staff to support people and help them engage with activities. Medicines were managed safely.

A range of audits measured and monitored all aspects of the service. Staff felt supported by the management team and involved in developing the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 21 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

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

There were five people living in the service when we inspected on 8 and 15 December 2016. This was an unannounced inspection.

Although there was a manager registered, they had left the service and an acting manager was in post. 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.

People received support that was personalised to them and met their individual needs and wishes. They were encouraged to be as independent as possible but where additional support was needed this was provided respectfully.

Staff respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

There were sufficient numbers of staff who had been recruited safely and who had the skills and knowledge to support people in the way they preferred. Staff had developed good relationships with people who used the service and understood the need to obtain consent when providing support.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse and staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care and there were procedures and processes which guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely.

People were encouraged to attend appointments with other health care professionals to maintain their health and well-being and the service worked closely with other agencies to meet people’s needs.

There was an open and transparent culture in the service and staff understood their roles and were very motivated.

An effective quality assurance system was in place and as a result the service continued to develop and improve.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive?

Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty

Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Whilst no applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and

respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs,

including recognising and supporting them as an individual. Where people required

assistance, staff provided this in a timely manner and at a relaxed pace. This ensured

people received care and support consistently and in ways that they preferred.

People's preferences, interests, aspirations and diverse needs had been recorded and

care and support had been provided in accordance with people's wishes.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People could therefore be assured that complaints were investigated and action was taken as necessary.

People's care records showed that where concerns about their wellbeing had been

identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from healthcare professionals.

Is the service well-led?

The service worked well with other agencies and services to make sure people received

their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good

understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.

People told us they were satisfied with the level of care and support they received at Fairview. One person told us: "I like it here, I am having my ceiling painted, I like my room and staff help me a lot."

Feedback about the service from the people we spoke with was positive and the comments they made to us during the inspection were relayed back to the manager. They told us that staff were kind, approachable, listened to their views, provided good care and were always available.

We saw that the people living at the home were supported and encouraged to exercise choice in their day to day lives. Independence was also promoted and staff worked with people to achieve this. People received the care, support and treatment they needed and this was provided in an individualised way.

During the course of our inspection we saw that people were supported to express their views and choices by whatever means they were able to and staff clearly understood each person's behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.

The staff team were well trained and supported to carry out their role.

The provider had effective systems in place to monitor the quality and safety of service that people received.