Background to this inspection
Updated
3 August 2021
The inspection
This was a targeted inspection to check on actions the provider had taken to address concerns named in a Warning Notice served at the last inspection. We will assess all of the key questions at the next comprehensive inspection of the service.
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 two inspectors.
Service and service type
The Fairways 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.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
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.
We reviewed information we had received about the service since the last inspection, including information from the local authority. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
We spoke with four members of staff including the registered manager, deputy manager, care worker and maintenance worker. We reviewed a range of records. This included four people’s care records and eight medicines administration records. A variety of records relating to the management of the service, including policies and procedures were reviewed. We undertook a partial inspection of the premises.
After the inspection
We continued to seek clarification from the provider to validate evidence found.
Updated
3 August 2021
About the service
The Fairways is a care home that provides accommodation and personal care for up to 20 older people some of whom are living with dementia. At the time of the inspection 19 people were using this service. The Fairways is owned by Farrington Care Homes Limited who have a number of other care services in the UK.
People’s experience of using this service and what we found
At this inspection we found the provider had made some improvements, however some aspects of the service required further improvement.
The provider had addressed many of the environmental hazards identified at the last inspection. However, we found some areas unsecured that could put people at risk of harm and the garden had been made safer but was still ‘work in progress’.
Medicines were not always managed safely.
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 did not always support this practice. The provider did not always follow the principles of the Mental Capacity Act 2005 (MCA) regarding people consenting to their care plans and did not always undertake mental capacity assessments in line with best practice.
The provider had systems in place to monitor and manage the quality of the service provided and to improve the care and support provided to people. However, these were not always robust and accurate as they had not identified issues raised during the inspection.
People and relatives spoke positively about the service they received.
The provider had systems in place to safeguard people from the risk of abuse and staff knew how to respond to possible safeguarding concerns. Lessons learnt had been shared with staff and measures put in place to avoid a reoccurrence.
Staff had received an induction and further training to support them to develop the necessary skills to care for people using the service.
People were supported with dietary and health needs and to maintain hydrated. People were supported to access appropriate health care.
We observed, and people and relatives told us, staff were caring. People were supported to make day to day decisions.
The activities co-ordinator included both younger and older people in well thought out activities and care workers helped to make this an enjoyable experience.
There was a complaints procedure in place and the registered manager responded to complaints appropriately. People and relatives using the service told us the registered manager was approachable and listened to any concerns.
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
The last rating for this service was requires improvement on 7 February 2019 (published on 29 March 2019). At this inspection there were four breaches of the regulations in person-centred care, consent, safe care and treatment and good governance. The provider completed an action plan after the last inspection to show what they would do by July 2019 to improve.
At this inspection enough improvement had not been made and the provider was still in breach of three of the regulations. We have identified breaches in relation to safe care and treatment, consent and good governance. The service remains rated requires improvement in safe, effective and well-led. It is now good in caring and responsive but remains requires improvement overall. This service has been rated requires improvement for the last four consecutive inspections.
Please see the action we have told the provider to take at the end of this report.
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.