The inspection took place on the 12, 13 and 16 March 2018 and was announced.

The service is registered to provide personal care to people living in their own homes. At the time of our inspection the service was providing personal care to 24 people.

This service is a domiciliary care agency. It provides personal care to people living in their own apartments in the community. It provides a service to older adults, younger adults, people with dementia, physical disability or sensory impairment. Not everyone using Fairhope receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

Fairhope office is situated in Wimborne. It provides support to people living in Bournemouth, Poole and surrounding areas.

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.

People were protected from the risk of harm by staff who understood the possible signs of abuse and how to recognise these and report any concerns. Staff were also aware of the risks that people faced and understood their role in managing these to ensure people received safe care.

People were supported by enough staff to provide effective, person centred support. Staff were recruited safely with appropriate pre-employment checks and received training and support to ensure that they had the necessary skills and knowledge to meet people’s needs.

People received their medicines as prescribed and staff worked with healthcare professionals to ensure that people received joined up, consistent care.

People were supported from the spread of infection by staff who understood their role in infection control and used appropriate Personal Protective Equipment (PPE).

People were supported to make choices about all areas of their support and staff understood the principles of mental capacity.

People were supported to have enough to eat and drink. People’s preferences for meals were well known and staff offered people choices about what they ate and drank.

Where people had medical decisions in place around their end of life care, these were recorded. Some care plans reflected that end of life wishes and preferences had been discussed. The registered manager told us that they would ensure that people’s choices and preferences were consistently discussed and reflected in people’s care plans.

People and those important to them were involved in planning the support they would receive and were asked for their views about the support and any changes to people’s needs. Reviews identified where people’s needs had changed and reflected changes to the support provided in response to this.

People were supported by staff who respected their individuality and protected their privacy. Staff understood how to advocate and support people to ensure that their views were heard and told us that they would ensure that people’s religious or other beliefs were supported and protected. Staff had undertaken training in equality and diversity and understood how to use this learning in practice.

Interactions with people were kind and caring and relatives told us that they had peace of mind that their loved ones were receiving safe, compassionate care.

People were supported to access healthcare professionals when required and the service worked with a number of external agencies to ensure that people received joined up, consistent care.

Staff were confident in their roles and felt supported by the registered manager and office team. Feedback from people and relatives indicated that the manager was ap

The inspection took place on 30 January and was announced. The inspection continued on 2 and 8 February 2017.

Fairhope is registered to provide personal care to people living in their own homes. The agency provides care and support to a wide range of people including older adults, people living with dementia and or with a sensory impairment or physical disabilities. At the time of our inspection there were 39 people receiving personal care from the service. There was a central office base which had two rooms. One was shared by the registered manager, risk assessor and care coordinator and the other room was used for staff training and meetings.

The service had a registered manager in place. 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.

Fairhope was not effective. Consent to care and support was not always sought in line with legislation and current guidance. It was not clear how staff were assessing people’s capacity and inconsistent approaches were being used by staff due to a lack of guidance and no best interest decisions being in place.

This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulation 2014 (Part 3). You can see what action we told the provider to take at the back of the full version of the report.

Management meetings were not recorded and it was unclear how incidents were being recorded and data analysed for trends, improvements and learning.

People and staff told us that the service was safe. Staff were able to tell us how they would report and recognise signs of abuse and had received safeguarding training.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about how they lived their life. Each person had a care file which also included guidelines to make sure staff supported people in a way they preferred. Risk summaries were completed, regularly reviewed and up to date.

Medicines were managed safely, securely stored in people’s homes, correctly recorded and only administered by staff that were trained to give medicines.

Staff had a good knowledge of people’s support needs and received regular mandatory training as well as training specific to their roles for example, nutrition and dementia.

Most staff received regular supervisions and annual appraisals which were carried out by the registered manager. Records showed that at the time of inspection that eight out of 25 staffs supervisions were between three and four months overdue.

People were supported to eat and drink enough whilst maintaining a healthy diet. Food and fluid intake was recorded for those who were under monitoring for this.

People were supported to access healthcare services as and when required and staff followed professional’s advice when supporting people with ongoing care needs.

People told us that staff were caring. During a home visit we observed positive interactions between the staff member and person. People said they felt comfortable with staff supporting them. Staff treated people in a dignified manner and had a good understanding of people’s likes, dislikes, interests and needs.

People had their care and support needs assessed before using the service and care packages reflected people’s needs. We saw these were regularly reviewed by the risk assessor with people, families and other health and social care professionals.

The service had systems in place to capture and respond to people’s feedback. People were asked if they were happy with the support they received and if they would like any changes made during people’s regular review meetings. General feedback from the 2016 survey was positive