Fairleigh House

Updated 7 February 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.

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

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Fairleigh House 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. Fairleigh House is a care home without 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 a registered manager in post.

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 sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

People were unable to communicate with us about the quality of the service, so we spent time observing staff interacting with people and people's experience of living at the home. We spoke to 2 people's relatives about the support people received. We spoke with 7 members of staff including the, registered manager, director of quality and compliance and found 5 care workers.

We reviewed a range of records. This included 2 people’s care records and multiple medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 7 February 2023

About the service

Fairleigh House is a care home providing personal and nursing care to up to 7 people. The service provides support to people with complex learning disabilities, autistic people and people with physical disabilities. At the time of our inspection there were 6 people living at Fairleigh House.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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

Right Support: Medicines were not always managed safely, and improvements were needed to ensure processes for storing people’s medicines were robust and effective. Environmental risks had not been fully mitigated. Staff provided kind, caring, person-centred care and support. Staff communicated with people in ways that met their needs. People living at the home each had unique and complex health needs and staff knew people and understood risks to people.

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.

Right Care: There were sufficient staff deployed to meet people's needs and wishes. A small number of agency staff were used to cover staff vacancies. Wherever possible the same agency staff were used which provided people with a consistent approach. People received person-centred care that promoted people's dignity, privacy and human rights. Staff recognised and responded to changes to individual's needs. We saw staff treated people with kindness and patience. People had access to meaningful activities and care plans were person centred.

Right Culture: The provider did not always operate effective systems to monitor the quality of the service they provide. Audits were not comprehensive and had failed to identify shortfalls in relation to risks to people's safety, medicines management and the use of PPE. People were at the heart of what the service did. Relatives and staff told us there was an open and positive culture at 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 16 August 2019).

Why we inspected

The inspection was prompted in part due to concerns received about the safety and quality of care provided to people. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

We have assurances that the issues identified are being acted upon by the management team and a pro-active response was taken during the inspection process to start addressing the areas of concern.

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.

Enforcement and Recommendations

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 monitor the service and will take further action if needed.

We have identified breaches in relation to medicines management, approach to health and safety, training of staff and the quality and assurance systems in place at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.