What life is like for people using this service:

People living at Fairways told us they were happy with the service they received. Everyone we spoke with said they enjoyed living at Fairways and were supported to have a meaningful everyday life. Staff encouraged people to be independent and promoted them to develop and maintain relationships with family and friends.

Care and support was tailored to each person needs and preferences and people were involved in developing their support plans. People had good access to support from health care professionals and the service was pro-active in recognising when interventions were required to ensure a person’s wellbeing.

People who lacked capacity were supported to have maximum choice and control of their lives. Policies and systems supported them in the least restrictive way possible.

People were supported to take positive risks and detailed risk assessments supported them to remain safe. Staff understood how to safeguard people from harm and abuse. The staff team empowered people to make choices about what they wanted to do, when they wanted to do it.

Appropriate recruitment checks were carried out. Checks included staff's previous employment, references and Disclosure and Barring Service checks (DBS). These checks helped to ensure people were supported by staff who were suitable to work in a care service.

Medicines were managed and administered safely. Records confirmed people had received their medicines as prescribed. Training records showed medication training was completed annually and regular competency checks were completed by the registered manager

The registered manager demonstrated a commitment to providing person centred care for all people. People knew the registered manager and told us they trusted them. Staff felt the registered manger was supportive and approachable. Relatives we spoke with only had positive comments to say about the service.

Rating at last inspection: Good (Report published March 2016)

About the service: Fairways is a residential care home that was providing personal care to ten people with learning disability, aged 25 and over at the time of the inspection. The service is a care home for up to 12 adults with a learning disability and/or autism.

The service had been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with a learning disability were supported to live as ordinary a life as any citizen.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service improved their rating to good overall at this inspection.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

The inspection of Fairways took place on 10 March 2016 and was unannounced. At the last inspection on 02 October 2014 the service was rated as Requires Improvement in all five of the key question areas, under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. These regulations were superseded on 1 April 2015 by the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and on 13 May 2015 we checked on the progress being made by the provider. We found that improvements had been made.

Fairways provide care and support for twelve people with a learning disability, some of whom have complex needs. It is situated on the outskirts of Bridlington and consists of a large house with accommodation provided over two floors. There are two lounge areas on the ground floor, one of which also serves as a dining room. People living in the property have access to a large garden area. Parking is available on the street outside the property. At the time of our inspection there were ten people using the service.

The registered provider is required to have a registered manager in post. On the day of the inspection there was a manager that had been registered and in post for the last ten months. 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 2008 and associated Regulations about how the service is run.

At the inspection on 10 March 2016 we found that the service had improved sufficiently to ensure people received a better service of care. There was still room for more improvement and in particular with the design and layout of the premises. We saw this had not been upgraded for some years (with the exception of the kitchen units and floor covering replaced two years ago) and that there was inefficient use of space within the utility and kitchen areas. We have made a recommendation regarding this.

People were protected from the risk of harm because the registered provider had systems in place to detect, monitor and report potential or actual safeguarding concerns. Staff were appropriately trained in safeguarding adults from abuse and understood their responsibilities in respect of managing potential and actual safeguarding concerns. Risks were also managed and reduced on an individual and group basis so that people avoided injury of harm whenever possible.

The premises were safely maintained and there was evidence in the form of maintenance certificates, contracts and records to show this. Staffing numbers were sufficient to meet people’s need and we saw that rosters accurately cross referenced with the people that were on duty. We saw that recruitment policies, procedures and practices were carefully followed to ensure staff were ‘fit’ to care for and support vulnerable people. We found that the management of medication was safely carried out.

People were supported by qualified and competent staff that were regularly supervised and appraised regarding their personal performance. Communication was effective, people’s mental capacity was appropriately assessed and their rights were protected.

People received adequate nutrition and hydration to maintain their levels of health and wellbeing. The premises were suitable for providing support to people with a learning difficulty and were undergoing refurbishment. The utility area, accessible only to staff, was poorly organised and utilised, and while it was not unsafe it did not allow for good practice with regard to storage of foodstuff, cleaning materials, cleaning equipment and laundry.

People received helpful and considerate support from staff that knew about their needs and preferences. People were supplied with the information they needed at the right time, were involved in all aspects of their care

We carried out an unannounced comprehensive inspection of this service on 21 October 2014 and two breaches of legal requirements were found. These were regarding staffing levels and quality assurance systems. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches.

We undertook this focused inspection on 13 May 2015, to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Fairways on our website at www.cqc.org.uk

Fairways provide care and support for twelve people with a learning disability, some of whom have complex needs. It is situated on the outskirts of Bridlington and consists of a large house with accommodation provided on two floors. There are two lounge areas on the ground floor, one of which also serves as a dining room. People living in the service have access to a large garden area.

At the time of the visit, 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.

At our focused inspection we found that the provider had followed their plan of actions. Although some work had been undertaken and the service now met legal requirements some improvement was still required.

We received mixed responses from staff about the staffing levels in the service, not everyone felt the service always had the correct number of staff on duty. Although staff told us there were no staff meetings they did feel consulted and supported.

The manager had taken actions to increase the staffing numbers in the service; this included the use of agency, temporary staff and the recruitment of new staff.

However, records regarding staffing levels in the service required improvement.

Changes had been made to people’s care files and there was evidence these were now reviewed. This meant staff had more up to date information available to them when supporting people with their care.

The quality assurance systems had been used to help develop and improve the service, although some of the record keeping for this continued to require improvement. People that used the service had been provided with questionnaires about the care delivery, but their responses had not been reviewed and used to help plan developments for the service. However, meetings were held with people who used the service to obtain their views.

The inspection took place on 2 October 2014 and was unannounced.

The last inspection of this service was on 11 July 2013 when the service was meeting all of the relevant requirements.

Fairways provide care and support for twelve people with a learning disability, some of whom have complex needs. It is situated on the outskirts of Bridlington and consists of a large house with accommodation provided on two floors. There are two lounge areas on the ground floor, one of which also serves as a dining room. People living in the home have access to a large garden area.

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 and associated Regulations about how the service is run.

We found there was not enough staff to support people. Staff were working extra hours to cover staffing shortfalls.

There was a quality assurance system in the home which recorded checks undertaken to help keep people safe. However, improvements were required in monitoring staffing numbers, paperwork and activities. Systems used by the management of the home had not ensured this was in place. Staff also told us how these were not effective as the environment had not been identified as requiring improvement. Meetings to consult people who lived in the home and staff took place. However, although staff felt there was a good culture in the home they did not feel consulted.

These are breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010 and you can see what action we told the provider to take at the back of the full version of this report.

Staff had been trained in supporting people with any allegations of harm. Risk assessments were in place. These identified risks to people and actions staff would take to help minimise those risks whilst helping people live their lives.

Systems were in place for the safe storage and handling of peoples medicines although some minor improvements were required in relation to the recording of when people had used medicines which were only occasional.

CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. DoLS are part of the Mental Capacity Act (MCA) 2005 legislation which is in place for people who are unable to make decisions for them. The legislation is designed to make sure any decisions are made in the person’s best interest. The registered manager told us that no-one in the home had been supported using a DoLS. However, we found there were some restrictions (locked doors) in the home. 

We found that staff had received training to be able to help support people live their lives. However, not all staff had completed all the training. The registered manager told us this was due to being short staffed.

People’s files included information which recorded their health needs and some of the support they received with them. In addition if people required support to maintain an adequate diet this had been recorded.

Some areas of the home were in need of refurbishment, were damp and were not personalised. This was discussed with the managers during the visit as an area which required addressing.

People living in the home told us staff were “Alright” and “Good”. However, we observed staff support was not always person centred and focused on giving instructions to people. Although staff did offer people appropriate support to maintain their privacy.

Staff were aware of people’s needs but the documentation to support people, for example, people’s care plans, required improving. These documents were comprehensive and offered information about the individual but were not organised or easy to use.

People were able to undertake activities and go out in their local community. However, staff shortages had prevented some of these activities from taking place.

All the people who used the service had lived at the home for at least two and a half years and had learning disabilities. Due to having a variety of complex needs and communication difficulties, most people were not able to tell us directly about their care and treatment. We spoke with two of the ten people who used the service.

We used a number of different methods to help us understand the experiences of people who used the service. During the day we sat with people who used the service and observed their daily activities including lunchtime and observed their interactions with staff. We spoke with staff and reviewed documentation including three care plans.

We saw that care needs were discussed with people and/or their relatives and before people received care their consent was asked for. One person said “I get to choose which drink I want and I can get my own drink when I want”. From what we observed and noted as part of the inspection staff cared for the people who used the service appropriately. Another person said “I love it here”.

People were protected from abuse and the risk of abuse. Staff could tell us what they would do if they saw abuse happening or someone reported abuse to them.

The provider had systems in place to assess and monitor the quality of service that people received. There were enough qualified, skilled and experienced staff to meet people's needs.

People who lived at Fairways had complex needs and we were unable to talk to them in detail about their experiences. However, we observed the interactions between care workers and the people they supported. Members of care staff were seen to be attentive, patient and caring. People who used the service were relaxed and staff clearly understood what people needed and how to engage them in a positive way.

However we found that the further action was needed to make sure that people were provided with a safe and well maintained environment.