Fairfield House Residential Care Home

Updated 5 October 2023

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 Health and Social Care Act 2008.

This was a targeted inspection to check whether the provider had met the requirements of the Warning Notice’s in relation to Regulation 12 (Safe care and treatment) and Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We also looked at staffing levels and skill mix at the home because we had received some concerns about whether there was safe staffing.

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 was carried out by 4 inspectors.

Service and service type

Fairfield House Residential Care Home is a 'care home'. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fairfield House Residential Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager. The registered manager from the provider's other home was managing the service. They had put an application in to CQC to add Fairfield House Residential Care Home to their registration.

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 had feedback from the local authority quality monitoring team's visits. We used the information the provider sent us following our last inspection, this included a service improvement plan. We used all this information to plan our inspection.

During the inspection

We spoke with 11 people who used the service and 3 visiting relatives about their experience of the care provided. We spoke with 14 members of staff including the manager, deputy manager, care lead, senior care staff, care staff, the chef, activity person and the gardener. The provider and quality compliance co-ordinator were also present on the second day of our visit.

We observed support and interactions between people and staff in communal areas. We reviewed 6 peoples' care records. The provider had recently started to use a new electronic care plan system, so information was being transferred to the new system. Therefore, we reviewed people’s paper care files and records on the new system. We also looked at paper and electronic monitoring charts.

We reviewed a range of records. This included, staff schedules, staffing dependency tool, service improvement plan, agency information folder, job descriptions, policies and a range of oversight documentation including audits.

We received feedback from the community nurse team and frailty team.

Updated 5 October 2023

About the service

Fairfield House Residential Care Home is a residential care home providing accommodation for persons who require nursing or personal care for up to 36 people. The service provides support to older people, older people with physical disabilities and older people living with dementia. At the time of our inspection there were 24 people using the service. Fairfield House Residential Care Home has a main house split across two floors accessible by a lift or stairs. People also lived in 3 separate cottages in the grounds.

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

People told us they felt safe and well looked after at the home. Comments included, “This is a lovely home, the staff are great…” and “I am happy here, I can’t fault it…the staff ask whatever you want, they will sort it out.”

Some improvements had been made by the provider since our last inspection in May 2023 to implement changes. The provider’s area manager had stepped into the role as manager and was working with the provider and staff team to implement the changes. This included a new electronic care system and call bell system. On the first day of our visit we found staff were using 2 systems to record monitoring and care tasks they had undertaken, the electronic care system and paper monitoring charts. There was no oversight monitoring to ensure people received enough fluids and safe care which placed people at risk.

Action was taken by the management and staff were supported to use the new electronic system and improved management oversight was put in pace to ensure people received enough fluids and were regularly repositioned in line with their care plans.

Peoples’ paper care plans and risk assessments had been reviewed monthly and some information had been added to the new electronic care system. However, these had not been updated promptly when peoples’ needs changed. This meant staff might not always have up to date information to support people safely.

Over the past few years there had been several managers at the home which had caused inconsistency and upheaval for people and staff. Staff were unclear about their roles and responsibilities. This meant tasks were not always consistently completed. The manager showed us new job descriptions they were working on with staff to implement and ensure staff were clear about their job roles and expectations.

A new audit system was being used to identify areas which required improvement. Audits we looked at had identified areas for improvement and some had actions required. We discussed with the manager the need for a more robust process to ensure actions were completed.

Concerns had been raised with CQC regarding the high amount of agency staff being used at the home and that some shifts were covered only with agency staff. We found consistent agency worked at the home and they were always supported by staff who worked at Fairfield House.

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 requires improvement (published 27 May 2023).

Why we inspected

We undertook this targeted inspection to check whether the Warning Notices we had previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We had also received concerns about staffing levels and skill mix at the home which we reviewed. We did not find people were at risk of harm in relation to these concerns.

The overall rating for the service has not changed following this targeted inspection and remains requires improvement. We use targeted inspections to follow up on Warning Notices or to check concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about.

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 information we receive about the service, which will help inform when we next inspect.