We carried out an unannounced comprehensive inspection on 25 August 2018.

Fairglen residential Home provides care and accommodation for up to 12 people. On the day of our inspection there were 10 people living at the service. The home provides residential care for people with a learning disability.

People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

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. The registered manager is also the provider.

At the last inspection on the 12 February 2016, the service was rated Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

Why the service is rated good:

People were not all able to fully verbalise their views and staff used other methods of communication, for example pictures or visual choices. We met and spoke with all 10 people during our visit and observed the interaction between them and the staff.

People remained safe at the service. People were protected from abuse as staff understood what action they needed to take if they suspected anyone was being abused, mistreated or neglected. Staff were recruited safely and checks carried out with the disclosure and barring service (DBS) ensured they were suitable to work with vulnerable adults. There were adequate numbers of staff to meet people’s needs and help to keep them safe.

People’s risks were assessed, monitored and managed by staff to help ensure they remained safe. Staff assessed and understood risks associated with people’s care and lifestyle. Risks were managed effectively to keep people safe whilst maintaining people’s rights and independence.

People had their medicines managed safely, and received their medicines in a way they chose and preferred. Staff undertook regular training and competency checks to test their knowledge and to help ensure their skills in relation to medicines were up to date and in line with best practice.

People were supported by staff who had received training to meet their needs effectively. Staff meetings, one to one supervision of staff practice, and appraisals of performance were undertaken. Staff completed the Care Certificate (a nationally recognised training course for staff new to care). Staff confirmed the Care Certificate training looked at and discussed the Equality and Diversity and the Human Right needs of people.

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's health was monitored by the staff and they had access to a variety of healthcare professionals. The registered manager worked closely with external health and social care professionals, to help ensure a coordinate approach to people’s care. Some people’s end of life wishes were documented and included information on people’s wishes when needed.

People’s care and support was based on legislation and best practice guidelines; helping to ensure the best outcomes for people. People’s legal rights were up held and consent to care was sought as much as possible. Care records were person centred and held full detail

The inspection took place on 12 February 2016 and was unannounced. Fairglen Residential Care Home supports the needs of up to 12 people with a learning disability. When we inspected 11 people were living at the service.

The service had 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 and staff were relaxed throughout our inspection. There was a calm, friendly and homely atmosphere. People were supported to take part in a range of activities which reflected their interests. Staff were knowledgeable about the people they were supporting and had an in-depth appreciation of how to respect people’s individual needs around their privacy and dignity. People’s risks were managed well and monitored.

Staff responded quickly to people’s changing needs and relatives were involved in reviewing people's needs and how they would like to be supported.

People’s preferences were identified and respected. Staff put people at the heart of their work; they exhibited a kind and compassionate attitude towards people. Strong relationships had been developed and staff focused on people rather than on tasks.

People’s medicines were managed safely. People were supported to maintain good health through regular access to healthcare professionals, such as GPs, social workers, learning disability nurses and occupational therapists.

All staff had undertaken training on safeguarding vulnerable adults from abuse and demonstrated a good knowledge of how to identify and report any concerns. Staff described what action they would take to protect people from harm. Staff felt confident any incidents or allegations would be fully investigated.

People were protected by safe recruitment practices. Staff underwent the necessary checks which determined they were suitable to work with vulnerable adults, before they started their employment. Staff received a comprehensive induction programme and were trained to carry out their roles effectively.

People and those who mattered to them knew how to raise concerns and make complaints. Complaints had been recorded, investigated and the outcome fed back to the complainant. Where appropriate, regular checks were then made to ensure the complainant remained happy.

Staff understood their role with regards to the Mental Capacity Act (2005) and the associated Deprivation of Liberty Safeguards. Applications were made and advice was sought to help safeguard people and respect their human rights.

There were effective quality assurance systems in place which were used to enhance the service. People, their relatives and staff described the management as supportive and approachable.

We spoke to six people during our visit and met most of the people who lived at Fairglen. We spoke with the registered manager, deputy manager and one other member of staff on duty. We reviewed three care files and spoke to staff and management about the care people received.

We observed that people were treated respectfully and were encouraged to make choices and develop their skills when possible.

We found that people had the opportunity to partake in regular discussions about the service and the running of the home. Residents meetings took place on a regular basis, and covered issues such as decoration of the home, meals and holidays.

People told us that they had been involved in discussions about their care and support and that they had copies of their support plans.

Recording procedures and support plans had been developed and improved to ensure that staff had sufficient information to meet people’s needs.

The provider had worked closely with other agencies to improve systems within the home and to ensure that people’s individual care needs were being met.

Improvements had been made to the way the provider assessed and monitored the quality of the service. Formalised procedures were in place to monitor and check the quality of the environment, and people who lived in the home, relatives and other agencies had the opportunity to provide feedback on the quality of services provided.

We spoke to people about the food provided at Fairglen Residential Home and comments included “Good, really good” and “It’s really nice now”.

We spoke to the staff about how people make choices about their food. We were told that people came to the kitchen area at lunchtime to choose their meal. The staff also said people were asked about their food preferences and these were included into the home’s new menu. This information was recorded into each person’s care plan and people had recorded what they had eaten each day.

People were encouraged to use the dining area to eat their meals. We were told by people living in the home and the staff on duty that tea, coffee, drink and snacks were always available throughout the day.

The registered provider showed us an example of the new menus which, showed a choice of healthy food options with vegetables and a mixed salad provided each day.

During our visit we saw that staff spoke to people respectfully and encouraged people to make daily decisions such as, what they wanted to eat and which clothing they wanted to wear.

People we spoke to said that they liked living in the home and that the staff were nice to them.

People we spoke to said that they could decide what they wanted to do each day, however, the homes care planning process did not demonstrate that everyone using the service had the opportunity to participate in decisions about their care and lifestyle.

We were told that reviews took place on an annual basis. However, the service did not have a formal review process and it was not evident how people were involved in discussions about their care and lifestyle.

Most of the people using the service were able to access the community independently. People told us about a range of leisure opportunities they enjoyed. However, it was not evident how the home ensured that activities remained appropriate or met individual needs and preferences.

Staff had received appropriate training on how to recognise abuse and keep people safe.

Staff were not available in sufficient numbers to ensure that people’s individual care needs and choices of activities could be met.

People told us that they had opportunities to discuss issues concerning the home. However, the provider did not have a sufficient system in place to regularly review and monitor the quality of the service provided.

We had completed a previous inspection at Fairglen on the 20 November 2012. We found that the provider was non compliant in some areas that we looked at. Following the inspection the provider sent us an action plan to tell us how they would address these concerns and by when. We then looked at those areas of non compliance and the action that had been taken during this inspection of the service.

During our inspection we saw that staff spoke to people respectfully. Some people were able to make choices about their lifestyle, however, some of the systems in the home did not promote people's autonomy, choice and independence.

People we spoke to said they were happy living at Fairglen. People’s support plans had been updated and people had been involved in this process.

People were supported to access local health services and a record had been kept of health appointments. However, we found that when health needs had been identified some plans were not in place to show how these would be monitored and managed by the service. We saw that one person who had identified health needs in relation to their weight did not have the necessary information to make choices about their care or sufficient access to a healthy and well balanced diet.

People were supported by a consistent staff team.

Insufficient systems were in place to gather people's views about the quality of the service.