Fairholme House is registered to provide accommodation for up to 22 older people who require personal care. At the time of the inspection there were 22 people living at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. However at this inspection the service had improved their rating in responsive to outstanding.

The service was extremely responsive to people's individual needs and preferences and staff worked flexibly and often went the extra mile to ensure people lived as full a life as possible. People's care plans were centred on their wishes and needs and continuously kept under review.

The registered manager and staff went to exceptional lengths to deliver person centred care that recognised people as unique individuals. The involvement of relatives, other organisations and the local community was at the very heart of how activities at Fairholme House were planned to ensure people were stimulated and had their needs met.

The service continued to provide safe care to people. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place, these included completing checks to make sure new staff were safe to work with vulnerable adults.

Medicines were managed safely and people received the medicines as prescribed.

People's care plans contained risk assessments which included risks associated with peoples care. There were sufficient staff to meet people’s needs.

People continued to receive effective care from staff who had the skills and knowledge to support them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health.

People continued to benefit from caring relationships with staff. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity and respect. People were involved in decisions about their care needs and the support they required to meet those needs.

The service continued to be well led by a registered manager and care provider who were open, honest and transparent. The registered manager continually monitored the quality of the service.

On our last inspection visit in August 2013 we found non compliance with how the service maintained their records and obtained people's consent. The provider sent us an action plan of how they intended to address these issues. We looked at these areas and found them to now be compliant.

On the day of our visit 21 people were using the service. They were supported by four care workers, an activities co-ordinator and two kitchen workers.

People we spoke with told us they liked living at the home and that care workers always asked permission before helping them. One said "I think it is a very good home. They care for me and ask what I need. They always ask me before I get assistance". Another said "they ask for my permission every time".

We spoke with three care workers and talked to them about consent to care. One said "I knock on the door first then ask if it is ok to help them, we always offer choices". Another said "We treat people individually and I try to get to know them. I always ask, some need coaxing but I always check first".

We found that people were safe from abuse, or the risk of abuse because the provider had taken appropriate steps to protect people. People told us they felt safe and all the care workers we spoke with new what to do if they suspected abuse was occurring.

We looked at the provider's records and saw they were held securely, maintained and up to date. Care plans were person centred and fit for purpose including fluid and food records.

During our visit we met with the registered manager and spoke with four people who used the service. We spoke with three relatives and three members of staff.

People we spoke with said they were happy living at Fairholme House. One said “everybody is kind and cheerful”. A relative told us “the general atmosphere is quite happy. I’ve never heard anything other than pleasantries”. People told us they were enabled to maintain their independence. One said “I just do what I want to do”.

Before people received care, for example the use of bed rails, it was not clear that the service had sought their consent. Where people did not have capacity to consent the provider had not always acted in accordance with the legal requirements.

Staff told us they felt well supported in their role and enjoyed their jobs. One member of staff said the support was “Very good. You can approach (the registered manager) or senior staff at any time”.

We observed that people were cared for in a clean, hygienic environment. Staff were able to clearly describe their responsibilities for cleaning and infection control.

Risks were managed across the service through appropriate risk assessments and the views of people who used the service were regularly sought.

Peoples’ records were not always up to date. For example, food and fluid charts had not been consistently completed to evidence that people, identified as at risk from malnutrition, had consumed enough food and fluid.

We found people were involved in decisions about their care and made sure they could make choices about their daily life. One person told us “I have an interview with them and they discussed my care “. A relative told us “they explained the care and asked about preferences as my mother was not well enough at that time “.

We found people were treated with dignity and respect. People told us “this is home from home “and “I couldn’t be in a better place “.

We found care was delivered safely. People told us they “felt safe” in the home.

Staff were supported and trained to deliver good care. One person told us “the staff are good here, they definitely know what they are doing”.

People told us they had no complaints about the quality of care the service provided. One person told us “I would speak to the manager if I had any complaints but I don’t have any”. People knew how to complain if they had a concern, a relative we spoke with told us ”I know who to complain to but I have never had to”.

People told us they were happy living in the home. They described the care and the staff as ‘’wonderful’’. They said that staff were always available and they never had to wait for more than a few minutes for call bells to be answered. People told us that they felt safe and confident to talk to the manager if they had any concerns. They said that the food was good and the home was always clean and tidy.

Fairholme House is registered to provide accommodation for up to 22 older people who require personal care. At the time of the inspection there were 22 people living at the service.

At the last inspection, the service was rated Good.

At this inspection we found the service remained Good. However at this inspection the service had improved their rating in responsive to outstanding.

The service was extremely responsive to people's individual needs and preferences and staff worked flexibly and often went the extra mile to ensure people lived as full a life as possible. People's care plans were centred on their wishes and needs and continuously kept under review.

The registered manager and staff went to exceptional lengths to deliver person centred care that recognised people as unique individuals. The involvement of relatives, other organisations and the local community was at the very heart of how activities at Fairholme House were planned to ensure people were stimulated and had their needs met.

The service continued to provide safe care to people. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place, these included completing checks to make sure new staff were safe to work with vulnerable adults.

Medicines were managed safely and people received the medicines as prescribed.

People's care plans contained risk assessments which included risks associated with peoples care. There were sufficient staff to meet people’s needs.

People continued to receive effective care from staff who had the skills and knowledge to support them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health.

People continued to benefit from caring relationships with staff. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity and respect. People were involved in decisions about their care needs and the support they required to meet those needs.

The service continued to be well led by a registered manager and care provider who were open, honest and transparent. The registered manager continually monitored the quality of the service.