Archived: Fairlea

People told us they were very happy living in the home and felt the staff delivered a good standard of care.

We found that people's consent was sought in relation to their care and treatment. We saw the care plans and records for each person reflected the needs and the care was delivered in line with this. People told us they felt in control of their care.

We saw that people received their medication as prescribed, pain killers when needed and people's records were well kept.

We found the provider operated a robust recruitment process. This meant people were protected from the employment of people unsuitable or unsafe to work with vulnerable people.

We found that the home had a clear and publicly available complaints procedure. People told us if they had a concern their issues were responded to in a timely manner.

Our inspection of 19 December 2012 and 3 January 2013 found that people's welfare and safety were not promoted and staff were struggling to provide individualised care to people. At this inspection we observed events at the home, we spoke to two people who used the service and three staff on duty. People using the service told us "Oh, I am fine here" and "The staff are good".

Staff were very happy with the changes at the home, giving examples of improved engagement with people, activities and being able to provide choice to people using the service. They said that they felt empowered and the atmosphere at the home was much improved. This was what we observed.

We found that staff engagement with people was unhurried and friendly. People could summon assistance as needed using a new call bell system. People's needs were assessed, planned with them, and carried out in a thorough and well organised way.

All the arrangements at the home which promote a safe and effective service had improved. This included listening to people's views and responding to them, communication, record keeping, care delivery, staffing numbers, training and supervision, monitoring events at the home and the home environment itself.

People told us, 'Cared for very well'. A district nurse said, "Everybody is well looked after'. Care workers showed skill providing care. However, the arrangements at the home did not ensure that people's care and welfare were fully promoted, one example being a visiting nurse helping a person who could not reach, or see, their drink when they were thirsty.

People were not protected through the staffing arrangements. People told us, 'I have to wait so long, such as for the toilet'. A district nurse said, 'I have previously waited 20 minutes for them to find another care assistant to use the hoist and the call bell has been ringing' and "It is usually about the same". The issue of staffing numbers was identified by the provider but not managed effectively.

Staff training had improved and all health and safety training was being delivered, except for first aid. However, staff supervision was not regular and staff support had been variable, with three managers for the service in a short period of time.

Management was disorganised; information could not be found. Equipment failure posed a daily risk. The acting managers were unable to provide evidence of audit and quality monitoring of the service.

People were treated with respect and dignity and they were offered regular choice and consulted about their care. One person told us a district nurse visited them regularly and staff were helpful. Another person's family told us 'The girls are lovely. Gran is happy and we have no complaints'. The registered manager was well known to people and there were arrangements in place to listen to people's views about the service.

Personal care needs were well met and community nurses had no concerns, but the arrangements for identifying health care concerns had not been effective for one person. Another person did not have a care plan for conditions which they considered important. Overall, care needs were assessed, planned and reviewed regularly.

There were effective systems for safeguarding people from abuse and legal safeguards, which protect people unable to make decisions about their own welfare, were understood by staff and used to protect people's rights.

Staff we observed were skilled in their work but training considered to be essential to reduce risk was, for some staff, out of date. Staff were supervised and supported in their work and there were systems within the home and organisation to monitor the service provided.