We inspected Fairmount on 9 and 11 August 2016. Fairmount provides accommodation and support for up to six people. Accommodation is provided from a building which was purpose built as a care facility for people with learning disabilities. The building is located within a residential area.

The age range of people living at the service is 48 – 59. The service provides care and support to people living with a range of learning disabilities and mental health needs and longer term complex healthcare needs such as epilepsy. Most people living at Fairmount were unable to communicate verbally. People had been living at the service for between 11 to 20 years. There were six people living at the service on the day of our inspection.

We last inspected Fairmount on 3 September 2013 where we found it to be compliant with all areas inspected.

A registered manager was 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 and associated Regulations about how the service is run.

People appeared happy and relaxed with staff. There were sufficient staff to support them. Checks were undertaken to ensure staff were suitable to work within the care sector. Staff were knowledgeable and trained in safeguarding and knew what action they should take if they suspected abuse was taking place. A wide range of specialist training was provided to ensure staff were confident to meet people’s needs.

It was clear staff had spent considerable time with people, getting to know them, gaining an understanding of their personal history and building rapport with them. People were provided with a choice of healthy food and drink ensuring their nutritional needs were met.

People’s needs had been assessed and detailed care plans developed. Care plans contained risk assessments for a wide range of daily living needs. For example, seizures and falls. People consistently received the care they required, and staff members were clear on people’s individual needs. Care was provided with kindness and compassion. Staff members were responsive to people’s changing needs. People’s health and wellbeing was continually monitored and the provider regularly liaised with healthcare professionals for advice and guidance.

Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately.

The CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We found that the manager understood when an application should be made and how to submit one. Where people lacked the mental capacity to make specific decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

People were provided with opportunities to take part in a range of activities and hobbies and to regularly access the local and wider area. People were supported to take an active role in decision making regarding their own routines and the routines and flow of their home.

Staff had a clear understanding of the vision and philosophy of the home and they spoke enthusiastically about working at Fairmount and positively about senior staff. The registered manager and operations manager undertook regular quality assurance reviews to monitor the standard of the service and drive improvement.

There were six people living in the home at the time of our visit. People had complex needs and could not verbally tell us of their experiences. People indicated to us that they were happy living in the home. We determined this by our observation of their body language and their positive interaction with the staff supporting them.

There were processes in place to support people to make informed decisions about their care and support whenever possible.

Each person had a comprehensive person centred care plan in place that included their individual wishes and also recorded their physical and emotional healthcare needs.

The home’s staff worked with a variety of healthcare professionals including district nurses, speech and language therapists and the local learning disability team.

We spoke with staff and reviewed records which showed us that people were protected for risk of abuse and their care was delivered in a safe manner.

Staff were well supported and trained and had the skills they needed to safely support people.

There were processes in place to identify, address and record complaints and concerns.

Comments from a family member that spoke with us included. “I am very happy with the standard of care in the home. There is lots for people to do and I am kept informed if there are any concerns at all.”

We observed that staff were respectful in the way they supported people living at Fairmount. There were detailed support plans in place which identified people’s preferences, their health needs and the kind of activities they liked to participate in. We found that staff knew the people they looked after well and were able to help them make choices about their daily living.

We were not able to communicate with people directly as they had complex needs. People were very anxious about having unknown visitors in their home and when offered an opportunity to be involved in the inspection, they indicated their preference not to be.

We spoke with staff who told us the how they kept people safe from harm and the actions they would take if they had any concerns. They told us they attended training to keep their skills and knowledge up to date. This was confirmed by the staff records that we reviewed. Staff told us there was an open culture in the home. They told us that their managers were approachable and they felt able to raise anything with them at any time. They also had regular one to one meetings with their manager for personal and performance review.

We looked at the quality monitoring processes that were in place to evaluate the standards of care, safety and well being of people who used the service. The records we looked at showed regular assessments took place and action plans were completed to maintain standards.