This was an unannounced inspection, carried out on 16 August 2017. The service was previously inspected in August 2015 when it was judged to be meeting the regulations and was rated as 'Good'.

Fairfield House provides accommodation for up to four people with complex needs. The service uses a large detached house with extensive outside space. There were three people living at the service at the time of our inspection.

Due to people’s communication needs we were unable to gain some people’s views on the service, therefore we carried out observations of staff interactions with one person who lived there.

We saw that people were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. One person told us they were happy and felt safe living at Fairfield House. Comments included; “I’m happy.” Relatives of people who lived at Fairfield House told us, “It’s a wonderful place. They are doing great things with [person’s name]. We couldn’t wish for anything more for [person's name].”

We walked around the service and saw it was comfortable and personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff. One staff member said, “I love working here. The guys we support are great and I get a great sense of achievement by supporting them to get the most from their lives. It’s a good organisation to work for because the culture is all about empowering people to be as independent as they can be.” Staff were trained and competent to provide the support individuals required.

People had regular routine access to visiting health and social care professionals where necessary. People attended an annual health check with a GP and had access to specialist medical services to ensure their health needs were met. Professionals told us there was appropriate communication between the service and medical services. We saw clear guidance for staff about how they were to meet people’s needs so that they worked in collaboration.

Medicines were managed safely to ensure people received them in accordance with their health needs and the prescriber’s instructions.

Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people. Staffing levels met the present care needs of the people that lived at the service.

The service were meeting the requirements of the Mental Capacity Act 2005 (MCA) and associated Deprivation of Liberty Safeguards (DoLS). 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.

People had a choice of how they spent their time and the activities they undertook. Meals, snacks and drinks were chosen by people, which they enjoyed. People had been included in planning their own menus and their feedback about the meals in the service had been listened to and acted upon. Some people were actively involved in meal preparation.

Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors privately if they wanted to. Relatives of people who used the service commented, “We are very happy with Fairfield. We think it is the best move we have ever made for [person’s name]. We are made welcome and can visit freely whenever we want to.”

The service had clear complaint systems and people had regular opportunities to discuss how

This was an unannounced inspection, carried out on 14 August 2015. There was a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider. Fairfield House provides accommodation for up to four people with complex needs. The service uses a large detached house with extensive outside space. There was one person living at the service at the time of our inspection as well as an additional eight people who used the service for differing short periods of time for respite.

Due to people’s communication needs we were unable to gain some people’s views on the service and therefore we carried out observations of staff interactions with three people who lived there. We saw that people were relaxed, engaged in their own choice of activities and appeared to be happy and well supported by the service. One person told us they were happy and felt safe living at Fairfield House. Comments included; “I am happy here.

We walked around the service and saw it was comfortable and personalised to reflect people’s individual tastes. People were treated with kindness, compassion and respect. Staff demonstrated they had an excellent knowledge of the people they supported and were able to appropriately support people without limiting their independence. Staff consistently spent time speaking with the people they were supporting. We saw many positive interactions and people enjoyed talking to and interacting with staff. One staff member said, “I love working with [persons’ name]. I love supporting [person’s name] independence and getting out and doing what [person’s name] wants to do”. Staff were trained and competent to provide the support individuals required.

Staff were well supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively. The staff team were supportive of each other and worked together to support people. Staffing levels met the present care needs of the people that lived at the service.

Where people did not have the capacity to make certain decisions, the service acted in accordance with legal requirements under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People had a choice of meals, snacks and drinks chosen by themselves, which we saw they enjoyed. People had been included in planning their own menus and their feedback about the meals in the service had been listened to and acted on. Some people were actively involved in meal preparation.

Visitors told us they were always made welcome and were able to visit at any time. People were able to see their visitors privately if they wanted to. Relatives of people who used the service commented, “It’s an absolutely brilliant service. We can always ring and there is lots of email contact. We are always welcomed at Fairfield”.

People knew how to complain and we saw people had regular opportunities to discuss how they felt about the service. Each person had a key-worker who checked regularly if people were happy or wanted to raise any concerns. One relative told us, “We have no concerns. The most basic need is [person’s name] happiness and we’d know straightaway if they weren’t happy”. Another relative said, “We are happy with the service. Issues are resolved quickly”.

From discussions with relatives and documents we looked at, we saw that families were included in planning and agreeing to the care provided at the service. People had individual support plans, detailing the support they needed and how they wanted this to be provided. Staff reviewed plans at least monthly with input from the person who was supported.

Staff demonstrated they knew the people they were supporting, the choices they had made about their support and how they wished to live their lives. For example, staff told us about one person they supported who loved swimming and how the service had made specific arrangements to enable this person to do this activity in a low-stimulus environment.

We saw evidence that comprehensive quality assurance processes were regularly undertaken to ensure the service was aware of people’s views of the service and could monitor auditing processes at the service. This ensured an open service culture that is both open to challenge and is learning from any issues affecting the quality of the service as they arise.

We met with one person who received services from Fairfield House. We also spoke with the area manager, registered manager and two members of support staff and three family representatives of people who received services from the home. People spoke highly about the quality of care offered to people who lived at or received services from the home, and we observed people were happy and liked the staff that assisted them. One person’s relative told us, “I am very happy with Fairfield House”. Another relative told us, “ The staff are excellent. Very caring. We have no concerns”.

We saw the home was comfortable and clean. We observed the person who lived permanently at the home had individualised their room to suit their personal taste. People who received respite services from Fairfield House were encouraged to bring personal effects with them in order that they could personalise their room during the period they stayed at the home. People we spoke with told us their family members were encouraged to choose how they spent their time and had free choice about areas of their life such as when they went to bed and what choice of meals they had.

We found people experienced care, treatment and support that met their needs and protected their rights.

We saw Fairfield House had suitable arrangements in place that ensured that people were safeguarded against the risk of abuse by taking reasonable steps to identify the possibility of abuse and prevent it before it occurred and responding appropriately to any allegation of abuse.

People who lived at the home were safe and their health and welfare needs were met by staff that had been appropriately recruited and were appropriately qualified, skilled, experienced and of good character.

We saw Fairfield House kept accurate records in respect of each person who received a service. Records included appropriate information and documents in relation to the care and treatment provided to each person as well as records in relation to the employment of staff and the management of the home. Records were held in an accessible electronic format and were kept securely and retained for an appropriate period of time.

We met and spoke with two people who were staying at Fairfield House. One person was staying at Fairfield House for a respite break, whilst the other person stayed at Fairfield House on a permanent basis.

We spoke to two relatives; both relatives were complementary about the care and support provided at Fairfield House. Comments included, “I was so pleased to find this place”, and “I would recommend them to anyone they are brilliant, absolutely brilliant”. We were told that they were kept up to date and one person told us that they had “no complaints about the staff”.

We found, where people did not have the capacity to consent, the provider acted in accordance with legal requirements.

We found, people experienced care, treatment and support that met their needs and protected their rights. However, staff interaction observed did not always treat people with dignity or respect.

People were protected from the risk of infection because appropriate guidance had been followed and people were cared for in a clean, hygienic environment.

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard.

There was an effective complaints system available and comments and complaints people made were responded to appropriately.

People living in the home, who we were able to speak with, all said they were happy living in the home and they had no concerns about their care. From our observations people seemed happy living at Fairfield, and we observed positive interactions between staff and people using the service. People said they liked the food that was provided and they also thought the staff were nice.