This unannounced comprehensive inspection took place on 3 and 9 May 2018. This was the first inspection of the service since it was registered in May 2017.

Fairlawn is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Fairlawn is registered to accommodate five adults with mental health care needs. At the time of the inspection the care home was providing personal care and accommodation for four people and there was one vacancy.

A registered manager is a person who has registered with 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. The registered manager is the director of the organisation that owns Fairlawn and was present on both days of the inspection.

We observed that people who used the service were at ease with the care staff and the management team. Staff told us that they enjoyed working at the service and felt supported by the provider.

Risks to people’s safety, health and wellbeing were not always identified and managed in an effective and positive manner. Staff did not consistently have appropriate written guidance within people’s care plans and accompanying risk assessments in order to demonstrate how they managed behaviours that challenged the service.

People stated that they felt safe using the service and thought that staff knew how to protect them from the risk of harm and abuse. The relatives we spoke with thought that staff were caring and committed to keeping their family members as safe as possible. However the provider had not appropriately informed us of events at the service that impacted on people’s safety, which meant we did not have accurate information in order to monitor the safety of people who used the service.

People received support from staff to receive their medicines. Staff had received applicable training and daily checks were carried out in order to minimise the risk of medicine errors occurring. The provider needed to ensure that potential risks were comprehensively assessed in circumstances where people progressed to managing aspects of their own medicine regime.

Staff were provided with training, support and supervision to enable them to meet the needs of people who used the service. The staff we spoke with told us that they had received induction training and opportunities to shadow experienced staff when they commenced employment with the provider, which was followed by a mandatory training programme. The training to meet the specific mental and physical health needs of people living at Fairlawn was limited in scope.

People who used the service were encouraged to make choices about their food and drink, however the provider did not demonstrate that people engaged in healthy grocery shopping and cooking.

Staff demonstrated an understanding of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS).

People were supported by staff to access health care services and attend health care appointments.

People and their relatives told us staff were compassionate and kind. We saw positive interactions between people who used the service and staff during the inspection. People told us that they were treated in a respectful way, and their privacy and independence were promoted. However we noted practices that did not protect people’s confidentiality and may have impacted on their wellbeing.

Systems were in place to support people to avail local leisure and social resources and take part in activities at home and in the wider community, although some people did not have their requested leisure and social wishes met.

People and their rel