Fairways

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Requires Improvement. This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

The service was in breach of legal regulation related to safe care and treatment in relation to recognising and responding to risks.

This service scored 59 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives were positive about their experiences.

The provider did not always have a proactive and positive culture of safety based on openness and honesty. Lessons were not always learnt to continually identify and embed good practice. The provider had procedures in place to investigate incidents and accidents. Investigations did not include enough detail about what had happened. It was also unclear how events had been investigated. This meant opportunities to learn from events and avoid them happening again could have been missed.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had systems in place to consider new referrals. Pre-admission assessments were thorough and helped the provider decide if they were able to meet people’s needs.

Communication with staff was regular, senior staff had their own communication book, and there were both written and verbal handovers. Staff we spoke with said they could see enough information about people to know how to support them.

People had hospital ‘passports’. These are short descriptions of people’s needs, medical conditions and medicines which can go with them to hospital appointments and in an emergency.

Oversight and referrals to other professionals needed to improve in relation to some aspects of personal care, we have discussed this below.

The provider did not always work well with people and healthcare partners to understand what being safe meant to them and how to achieve that. The provider did not always share concerns quickly and appropriately.

We found not all incidents and accidents had been reported in a timely way. The provider referred to the local authority safeguarding criteria, we found they had not notified the local authority or CQC if they found no evidence of abuse or neglect. Though this is appropriate, we found their own investigations needed to be more thorough to evidence their findings. We were not confident a safeguarding would be recognised and raised when required.

Safeguarding procedures were in place. Staff had received training, and those we asked, felt confident they would recognise concerns and raise them with senior staff.

The provider did not always work well with people to understand and manage risks.

The provider had policies and procedures in place to assess risks but did not always act on changes to people’s condition. Two people had significant, unintentional weight loss but had not been referred to health professionals for a review. Potential swallowing difficulties had been identified for two people and referrals made for assessment. However, though their diet had been modified, pending input from health professionals, there was no guidance in place for staff. Not all the staff we spoke with understood the support people on a modified diet needed.

Pressure relieving mattresses for two of three people we reviewed were set too high to be effective. This had not been noticed by staff or referred to the relevant health professionals responsible for this.

People had been encouraged and supported to be safe when they engaged in activities independently. We saw staff had responded quickly and kindly when people who needed support to mobilise attempted to move alone. Some people were able to walk around the grounds and on the decking because the provider had ensured the area was safe and secure.

People lived in a safe environment. The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The premises were well maintained, safety certificates were in place for, fire safety equipment, gas, electric safety, lift and hoist maintenance. Some refurbishments and decoration were ongoing.

At our last inspection we found the building had not always been secure, this had now improved and there were daily security checklists in place which had been completed regularly.

People were supported by enough qualified, skilled and experienced staff, who received effective support, supervision and development.

The provider assessed the staffing levels needed based on people’s needs. Staffing levels had recently been amended in response to an increase in occupancy.

The providers recruitment procedures were robust. Though we identified some shortfalls in how these procedures had been followed, we were satisfied with the providers response during the assessment.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean and tidy home, without any malodours.

Housekeeping staff had effective schedules in place and followed these well.

Staff and visitors had access to personal protective equipment, (PPE) at various points throughout the home. We saw staff using PPE when necessary.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were being managed and administered safely.

Policies and procedures were in place to guide staff, and these were being followed.

People had access to homely remedies, including pain relief. Night staff were able to administer homely remedies when required.

People who had time specific medicines received them at the correct time.

Medicine audits were in place, when medicine errors were identified staff practice had been addressed in a timely way.