Fairhaven Care Home is located on the promenade at Fleetwood. The home accommodates 22 people. Individual bedroom accommodation and communal areas are comfortable. Appropriate aids are provided to promote independence and a passenger lift enables ease of access throughout the building. At the time of the inspection there were 21 people who lived at the home. The home is registered for 22 people.

There was a registered manager. 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 the last inspection in November 2015, the service was rated ‘Good’. At this inspection we found the service remained Good. However at the last inspection we recommended they improved recruitment procedures to ensure all checks were in place prior to staff starting their employment. In addition we recommended water temperatures were checked regularly so that people were not at risk of scalding themselves. Also suitable storage areas to be designated for equipment as they were kept in communal areas and could be a trip hazard and could put people at risk. During our inspection visit we found the management team had addressed these issues.

We found staff had been recruited safely and procedures improved since the previous inspection. They also received ongoing training relevant to their role and supported by the registered manager to undertake training that would enhance their skills. Discussion with staff and training records looked at confirmed this.

We observed during the inspection visit staff provided care and support for people in a sensitive, patient and respectful way. People who lived at the home confirmed staff were kind and caring. Comments we received confirmed this. One person who lived at the home said, “They have been and continue to be kind, thoughtful and respectful, I mean all the staff and the manager.”

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. Care records we looked at showed they were reviewed and any changes had been recorded.

Medication procedures we checked protected people from unsafe management of their medicines. People who lived at Fairhaven told us they received their medicines as prescribed and at the correct time.

We found staff were aware of treating people as individuals with importance placed on promoting dignity and respect. People who lived at the home confirmed to us staff treated them as individuals and delivered person centred care. Care plans we looked at confirmed staff and the management team promoted people’s independence and involved them in decision making about their care.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required.

The layout of the premises and facilities provided were appropriate for the care and support provided.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People had been 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 told us the standard of food at Fairhaven was good and there was plenty of choice. This was confirmed by comments we received that included, “Yes definitely if you did not like something the cook would always make something you liked.” And, “Good homely food.”

We found during the inspection visit and observing interactions between staff and people w

The inspection visit took place on 04 November 2015 and was unannounced.

The home is located on the sea front at Fleetwood and is registered to accommodate up to twenty-four people. Individual bedroom accommodation and communal areas are based on three floors. Appropriate aids are provided to promote independence and a passenger lift enables ease of access throughout the building. Access for people in wheelchairs is available at the front of the building. At the time of the inspection visit there were 22 people who lived at the home.

There was not a registered manager in place at the time of our visit. The provider had a manager currently applying to the Care Quality Commission (CQC) to be registered. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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 last inspection of the service in January 2014, we found the provider was meeting all the requirements of the regulations inspected.

During this inspection people told us they felt safe and secure at Fairhaven Care Home. There were sufficient numbers of staff deployed to meet people’s needs and provide a flexible service. However, not all new staff had been recruited in-line with national guidelines.

We have made a recommendation the provider seeks advice and guidance to ensure all employment checks for potential staff are in place, prior to employment in line with national guidance.

Water temperatures checked were delivering water at above safe temperatures and could put people at risk of scalding or burning themselves.

We have made a recommendation about hot water temperatures.

Some areas of the building were cluttered with equipment for example wheelchairs and hoists.This could be a health and safety hazard and put people at risk of trips and falls.

We have made a recommendation the owner explores relevant health and safety guidance for the safe storage of equipment.

Medication was being administered in a safe manner. We observed a staff member administered medication at lunch and breakfast time safely. They gave out medicines to one person at a time and stayed with the person until they had their medication.

The management team had completed an assessment of people’s support needs. This was before they moved into the home. We saw people or a family member had been consulted and involved in the assessment and support plan. People we spoke with said they were happy with their care and felt staff supported and cared for them.

People who lived at the home were happy with the variety and choice of meals available to them. Regular snacks and drinks were available between meals to ensure they received adequate nutrition and hydration. Comments about the quality of meals included, “The food is really good.”

The owner and manager understood the requirements of the Mental Capacity Act (2005) (MCA and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who lacked capacity to make their own decisions.

Staff we spoke with had a good understanding of how people should be treated in terms of dignity, respect and caring for people. We observed good examples of staff being respectful and patient towards people.

The service had a complaints procedure which was made available to people on their admission to the home. People we spoke with told us they were comfortable with complaining to staff or management when necessary.

The manager and owner used a variety of methods to assess and monitor the quality of the service. These included staff and resident meetings and annual surveys sent out to people and their relatives. People who lived at the home, relatives and staff told us they thought the new management team operated the home well.

On the day of our visit we spoke with the provider by telephone, senior carer, (The manager was not available at the time) staff, relatives visiting the home and residents. They helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, staff supporting them, relatives and from looking at records. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Fairhaven Care Home

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Systems were in place to make sure management and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduces the risks to people and helps the service to continually improve

The home had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards. The manager had been trained to understand when an application should be made and how to submit one. This meant that people would be safeguarded as required. The provider said, “We are looking to extend the training to all staff.”

From our observations during the day, we found people were treated with respect and dignity by staff. People living at the home told us they felt safe. Comments from residents and relatives included, “A lovely homely environment, the staff are really caring and ensure my auntie is in safe hands.” Also, “I like living here I feel safe and secure, always plenty of people about.”

Is the service effective?

There was an advocacy service available if people needed it, this meant that when required people could access additional support.

Relatives we spoke with said they were able to see people in private and visiting times were flexible. “We come here quite a lot to see our relative and are always made welcome by the manager and staff.”

People’s health and care needs were assessed with them, and they were involved in developing their plans of care where possible. Relatives views were also sought to ensure people receive the right care to meet their needs. Specialist dietary, mobility and equipment needs had been identified in care plans where required.

Is the service caring?

We spent part of the day in the lounge and dining areas at lunchtime and breakfast observing staff interaction with residents. People were supported by kind and attentive staff. We saw staff showed patience and gave encouragement when supporting people. One resident we spoke with said, “I would not want to be anywhere else.”

People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with there wishes. Residents personal histories had been developed by staff. “Families and residents have really been helpful with this. It provides an individual picture of each person and helps us get to know them better.”

Is the service responsive?

People completed a range of activities in and outside the home regularly. We saw evidence of daily activities planned and advertised around the home. One resident said, “I organise outside events such as tea parties sometimes they go down well.”

We saw literature of the complaints procedure around the home for people to see. Relatives and residents we spoke with said they knew how to make a complaint if they were unhappy. One resident said, “I would definitely raise any concerns with T…. if I had any, she is easy to talk to.” Staff we spoke with and the provider said a recording system was in place to investigate record and reach outcomes for any complaints they received. People can therefore be assured complaints would be investigated and action taken as necessary

Is the service well-led?

We had responses from external agencies including social services .They told us they had a good working relationship with the manager and staff to make sure people received their care and support they required.

There were a range of audits and systems put in place in by the manager and provider to monitor the quality of the service being provided. However the manager might like to note more formal ways of seeking views of people who live and work at the home would ensure the continuing development for providing quality care and support for people. One resident we spoke with said, “I would like us to have residents meetings it may be beneficial to air our views together.”

We visited the home as part of a responsive follow up inspection. We spoke with the provider, manager and three staff.

During the inspection we looked at supervision and training records for staff. We also spoke with staff members individually. Comments were positive about the support the manager provides to residents and staff members. They included, “The manager is always available to talk to when you need here. “ Also, “We now have regular supervision sessions usually every three or four months.

Staff members we spoke with told us they were all being encouraged to undertake training, they felt access to any courses they would be interested in were supported by the manager. One staff member said, “We are encouraged all the time to attend more training to help us.”

During our inspection visit we spoke with a range of people. This included the registered manager, two members of the care staff team and four people who lived at Fairhaven Care Home. People spoke positively of the care and support provided. One person told us, “I like it here, all I need I get. They try and help me walk each day”.

Although three people spoken with could not really remember anything about their care plan, there was no concern about this. Two of these people said they were not really bothered about it and had complete confidence in the staff team. We were told, “They look after us very well”. However another person told us that she was fully aware of her care booklet that she had signed and dated when agreeing to the level of care to be provided.

Although we did not directly ask people about safeguarding people told us that they felt very safe living at the home. One person told us that if she did have any concerns, she would speak with the registered manager however she had never needed to.

We noted that medication practices had been improved. This helped to keep people safe.

Although staff provided an acceptable level of care and support, staff would have been better supported if formal, regular one to one supervision and an annual appraisal had taken place.

We spoke individually with three people living at the home and all staff on duty. As well as care staff this included speaking with the registered manager and the cook. More informal discussion with people also took place in communal areas at various times during the visit.

People using the service spoke positively of the staff team. One person said, “The staff are alright, very good in fact and kind, I have no complaints”. Another person told us, “A lovely sea front hotel, what more could I want. Everything is very good. I am quite happy and settled”.

People made positive comments regarding the meals provided. One person said, “I am quite satisfied, in fact I am happier eating here than outside. There is one set menu but I enjoy the food. The food is well cooked and there is always enough to eat. I am asked if I would like some more”.

While complementary about the meals served, people also told us that, “You just have what is given, it is not a problem”. However people were, in the main, also aware that if they did not like the set meal, an alternative would be provided.

People told us they were happy living at the home and that staff were always kind, polite and respectful. Staff spoke in a friendly way and there was a relaxed, comfortable and homely atmosphere.

People consistently stated that there always appeared to be a sufficient number of staff on duty. There was no concern that assessed needs were not being met in a timely manner.

One person spoken with who had very recently been admitted to Fairhaven Care Home told us that although he could not remember the actual detail, he had definitely being asked about his needs and requirements prior to admission and had later had explained to him, the proposed level of care. This person was pleased with the level of care and support provided saying, “Staff are quite excellent, nothing is too much trouble”.

Although two of the people spoken with could not really remember any discussion or detail about their care plan, both said that their needs and requirements were being met and that they were made aware of any proposed activity such as hospital visits prior to the event. The third person spoken with confirmed that discussion had taken place with a member of staff following admission regarding

how his needs were to be met.

During the course of the visit we spoke individually with three people living at the home. We also spoke very briefly with a number of other people living in the home in a communal area. One person told us, “I am quite satisfied with everything. The staff are very good, give all the help needed, very obliging”.

People living at Fairhaven Care Home stated that they enjoyed the meals served and the variety of the foods provided. One person said, “Meals are enjoyable, we don’t do bad at all, meals are very good”. Another person said, “I am quite satisfied with the meals and enjoy them. I would leave them otherwise and I never do”. A member of staff also commented about the meals served simply describing them as, “Lovely”.

People living at the home told us that the internal environment was always kept clean and tidy. One user of the service told us that the her bedroom was, “Comfortable”.

A person living at the home stated, “I quite like the staff, definitely kind and caring”. Two recently appointed members of staff confirmed that a thorough recruitment process had taken place prior to them being offered employment at the home.

A member of staff spoken with stated that in their experience, there was always a sufficient number of staff on duty to meet the assessed needs of people living at the home. A person living at the home said, “There seems to be enough staff, if I wanted anything I will ask for help”.

Staff spoke positively about the training provided.

People living at the home told us that if they had a concern or complaint they would speak with a member of staff or the registered manager. However none of the people we spoke with had felt the need to do this.