Fairview provides accommodation and personal care without nursing for up to five people. It is a service for people who have a learning disability and/or autistic spectrum disorder, physical disabilities and mental health needs.

There were five people living in the service when we inspected on 8 and 15 December 2016. This was an unannounced inspection.

Although there was a manager registered, they had left the service and an acting manager was 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 received support that was personalised to them and met their individual needs and wishes. They were encouraged to be as independent as possible but where additional support was needed this was provided respectfully.

Staff respected people’s privacy and dignity and interacted with people in a caring, compassionate and professional manner.

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.

There were sufficient numbers of staff who had been recruited safely and who had the skills and knowledge to support people in the way they preferred. Staff had developed good relationships with people who used the service and understood the need to obtain consent when providing support.

Systems were in place which safeguarded the people who used the service from the potential risk of abuse and staff understood the various types of abuse and knew who to report any concerns to.

Staff knew how to minimise risks and provide people with safe care and there were procedures and processes which guided staff on how to ensure the safety of the people who used the service. These included checks on the environment and risk assessments which identified how risks to people were minimised.

Appropriate arrangements were in place to ensure people’s medicines were obtained, stored and administered safely.

People were encouraged to attend appointments with other health care professionals to maintain their health and well-being and the service worked closely with other agencies to meet people’s needs.

There was an open and transparent culture in the service and staff understood their roles and were very motivated.

An effective quality assurance system was in place and as a result the service continued to develop and improve.

Most of the people who lived at Fairview were able to speak with us. We spoke with two people who used the service on the day of our inspection. We gathered evidence of people's experiences of the service by observing how they spent their time and we noted how they interacted with other people who lived in the service and with staff. We also spoke with two staff members. We looked at two people's care records. Other records viewed included staff rotas, cleaning schedules and policies, training and supervision records, health and safety checks and records which related to the quality assurance of the service.

We considered our inspection findings to answer questions we always ask; Is the service safe? Is the service effective? Is the service caring? Is the service responsive?

Is the service well-led?

This is a summary of what we found;

Is the service safe?

When we arrived at the service we were asked for our identification and asked to sign in the visitor's book. This meant that the appropriate actions were taken to ensure that the people who used the service were protected from others who did not have the right to access their home.

The Care Quality Commission monitors the operation of the Deprivation of Liberty

Safeguards (DoLS) which applies to care homes. The service was aware of new changes in the law with regard to DoLS. Whilst no applications had needed to be submitted, appropriate policies and procedures were in place and had been followed. Relevant staff had been trained to understand when an application should be made and how to submit one.

People told us they felt safe living in the service and that they would speak with the staff if they had concerns. We saw the service had processes in place which ensured that staff had the skills and knowledge to support people safely.

We saw that people's personal records including medical records were accurate and that staff records and other records relevant to the management of the service were accurate and fit for purpose.

Is the service effective?

People told us that they felt that they were provided with a service that met their needs.

People's care records showed that care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. The records were regularly reviewed and updated which meant that staff were provided with up to date information.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service and how those needs were to be met.

Is the service caring?

We saw that the staff interacted with people who lived in the service in a caring, and

respectful manner. We saw that staff treated people with respect.

Staff had a good knowledge and understanding of people's care and support needs,

including recognising and supporting them as an individual. Where people required

assistance, staff provided this in a timely manner and at a relaxed pace. This ensured

people received care and support consistently and in ways that they preferred.

People's preferences, interests, aspirations and diverse needs had been recorded and

care and support had been provided in accordance with people's wishes.

Is the service responsive?

People who used the service were provided with the opportunity to participate in activities which interested them. People's choices were taken into account and listened to.

People told us that they knew how to make a complaint if they were unhappy. We saw that where people had raised concerns appropriate action had been taken to address them. People could therefore be assured that complaints were investigated and action was taken as necessary.

People's care records showed that where concerns about their wellbeing had been

identified the staff had taken appropriate action to ensure that people were provided with the support they needed. This included seeking support and guidance from healthcare professionals.

Is the service well-led?

The service worked well with other agencies and services to make sure people received

their care in a joined up way.

Staff told us they were clear about their roles and responsibilities. Staff had a good

understanding of the ethos of the service and quality assurance processes were in place. This helped to ensure that people received a good service at all times.

People who used the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

The service had a quality assurance system in place and records seen by us showed that identified shortfalls were addressed promptly. The service had processes in place to collate the information they had gathered, identify the service's strengths and weaknesses, and plan the actions required to improve the experiences of people who used the service. This ensured continued improvement in the areas identified.

We observed that staff members were polite and attentive towards people who used the service, in particular those people with no or limited verbal communication. We saw that staff made good eye contact with people.

People told us they were satisfied with the level of care and support they received at Fairview. One person told us: "I like it here, I am having my ceiling painted, I like my room and staff help me a lot."

Feedback about the service from the people we spoke with was positive and the comments they made to us during the inspection were relayed back to the manager. They told us that staff were kind, approachable, listened to their views, provided good care and were always available.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people living at the home had complex needs which meant that they were not all able to tell us their experiences. We spoke to people living at the home and were able to observe staff supporting people.

We saw that the people living at the home were supported and encouraged to exercise choice in their day to day lives. Independence was also promoted and staff worked with people to achieve this. People received the care, support and treatment they needed and this was provided in an individualised way.

During the course of our inspection we saw that people were supported to express their views and choices by whatever means they were able to and staff clearly understood each person’s behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.

The staff team were well trained and supported to carry out their role.

The provider had effective systems in place to monitor the quality and safety of service that people received.

Where people were unable to provide a verbal response or tell us verbally their experiences, for example as a result of their limited verbal communication or poor cognitive ability, we noted their non verbal cues and these indicated that people were generally relaxed and comfortable and found their experience at Fairview to be positive.

People with whom we spoke told us that generally they were able to make choices about some aspects of their care. For example, we spoke with two people about how they are supported to choose what to eat each day. They told us that staff offer them a choice of meals each day and that they can also choose where they have these, for example in the comfort of their own room or in the dining room. Another person who uses this service told us they are able to make decisions about going out and what time they go to bed.

People spoken with indicated that they were satisfied with the level of care and support they received at Fairview. Those people with whom we spoke indicated they could choose whether or not to join in activities and could spend time alone in their room pursuing their own interests if they preferred.

The people with whom we spoke made the following comments “It's good here.” and “I like living here and the staff are nice.”

People told us that they feel well looked after by the staff at Fairview. One person with

whom we spoke said "I like the staff here they are very kind"