Fairburn Vale is a purpose-built facility offering specialist nursing care for 20 adults with acquired brain injuries, and accommodation for people with complex physical, mental or behavioural needs. Accommodation is provided over two floors accessible by a lift and there is a communal garden area. There were 19 people living in Fairburn Vale on the day we inspected.

At the last inspection in March 2015, the service was rated Good. At this inspection we found the service remained Good.

People were safe as staffing levels were appropriate to meet people’s needs in a prompt and organised manner. Staff knew how to report any concerns and how to recognise signs of abuse. Medication was stored, administered and recorded correctly and risks were managed to minimise the likelihood of harm.

Staff had received regular supervision and training to ensure they were fully equipped to perform their roles competently. They supported people in line with their support needs in regards to nutrition and hydration, and also in accessing external health and social care support where required.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff displayed kindness, sensitivity and empathy in their interactions with people ensuring all their needs were met, both physical and emotional. People were involved as much as they were able in all decisions regarding their support needs and encouraged to participate in the life of the home.

Activities focused on individual needs and there was a programme to implement a wider range of pastimes and events. Complaints were handled with sensitivity and understanding, and all concerns addressed in depth.

The home was well managed with clear leadership and an organised staff team whose focus was ensuring all people living at Fairburn Vale had the best quality of life possible.

Further information is in the detailed findings below.

This was an unannounced inspection which took place on 17 March 2015.

Fairburn Vale provides nursing and social care to 20 people with an acquired brain injury, some people are supported to regain their independence and to move on from the service, and other people need longer term care. On the day of our inspection there were 20 people living at the home. The home is purpose built and all rooms have access to en suite facilities. There is level access to a secure garden and communal areas within the home.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.

Staff were aware of how to safeguard people who used the service. People’s needs were assessed and risks were identified and managed, we saw detailed risk assessments were in place. The service had systems and processes in place to protect people from harm and to ensure care was delivered safely.

We found people were cared for by sufficient numbers of suitably qualified and experienced staff. Robust recruitment and selection procedures were in place. Staff received the training and support required to meet people’s needs. Staff spoke positively about the amount and variety of training available to them.

Staff told us they were well supported, the service offered robust off site induction training. staff had access to regular supervision and everyone had received an annual appraisal. Staff told us the leadership team were supportive and they were confident any concerns raised would be investigated thoroughly.

We looked at the administration of medication and found people were being given their medication as prescribed. We found the recording of the medication administered was good. Staff told us they had received the training required to administer medication safely.We saw people had access to one to one activity, which was person centred. People were supported to maintain strong contact with their families and to develop links with the community.

Staff were trained in the principles of the Mental Capacity Act 2005. Deprivation of Liberty Safeguards (DoLS) were in place to protect the rights of people’s whose freedom was restricted. People were referred to advocacy services where appropriate.

Suitable arrangements were in place and people were supported and provided with a choice of suitable healthy food and drink ensuring their nutritional needs were met.

Health, care and support needs were monitored, assessed and met by contact with health professionals as needed. In addition to this the home had good links with the neuro rehabilitation consultant and people had on site access to therapy support.

People’s needs were assessed and care was planned and delivered in line with their individual care plans which described their needs, preferences and wishes well. We saw people and their loved ones had been involved in developing and reviewing these.

We saw positive relationships between staff and people who lived at the home, and staff communicated well with people who used non-verbal communication techniques. Staff knew how to respect people’s privacy and dignity.

There were effective systems in place to manage, monitor and improve the quality of the service provided. The home had an open and honest culture; staff told us they would be confident to report concerns, and the registered manager told us they were continually striving to develop and improve the service. Staff told us there was a strong focus by the provider about supporting people who lived at the home to have choice.

We observed the quality of care that was delivered, spoke with the manager, staff, relatives and people who lived in Fairburn Vale.

We found Fairburn Vale had a friendly, homely atmosphere. We saw people were well cared for and staff were welcoming and caring. We saw staff were particularly skilled in communicating with people and respected their privacy, dignity and independence.

We spoke with some of the people who lived at Fairburn Vale. One person we spoke said: “Staff are friendly, I like it here”. Where people could not verbally express their views, we observed their care and signs of how their well-being was supported.

We spoke with three relatives of people who lived at Fairburn Vale. One said us: “The care is absolutely excellent” and said “Staff are superb”. One relative said her family member "could not be in a better place" and said they were happy with the care.

We spoke with the manager and two staff who told us they involved people as much as possible in order to provide care that was person-centred. Staff demonstrated a good knowledge of people’s individual needs.

We saw most people enjoyed their food, although we noticed one person did not seem to enjoy the main course. We saw people had regular access to drinks and staff were aware of people's dietary needs.

We found staff were robustly recruited and vetted before they worked with people and there were systems in place to assess and monitor the quality of the service provision.

We used a number of different methods to help us understand the experiences of people using the service including talking to people and observing the care provided. We spent time with people and we observed staff being friendly and warm towards people. We observed that staff and service users had positive relationships and we saw some light hearted banter. People appeared relaxed and comfortable with their surroundings; with staff and the activities they were engaged in. We saw that staff supported people to make choices about their daily living.

We spoke to people who use the service and they told us that they had been included in decisions about what care and support they received and when this would be available.

We spoke with two members of staff who were able to demonstrate a good understanding of the needs of the people who lived at Fairburn Vale. They told us that they were well supported by managers of the home and there were good opportunities for training.

Because of the complexity of people’s needs we were unable to communicate effectively with the majority of people in the service. However we were able to talk to two people who spoke positively about the service they receive. They said that staff were very caring and helpful towards them. One person said ‘staff are perfect’ One person said that they attended their care plan reviews and were involved in decisions about their care.