Fairlight Manor provides accommodation and support for up to 19 older people living with a dementia type illness. Some people are independent and require little assistance, while others require assistance with personal care, daily living and moving around the home. There were 16 people living at the home during the inspection.

The home is a converted older building, bedrooms are on three floors, and there was a lift to enable people to access all parts of the home and a secure garden to the rear of the building. The registered manager is part owner of the home. The registered manager was not present during the

inspection, we were able to speak with them on the telephone during the inspection and after to discuss our findings and to clarify a few areas.

At the last inspection in July 2015, the service was rated Good. We found no breaches of the regulations. However we did make a recommendation to the provider to provide suitable training for staff to ensure they can meet the needs of people diagnosed with Parkinson’s disease. The provider had taken action and training had been delivered.

At this inspection we found the service remained Good.

Why the service is rated Good:

People, visitors and staff gave us positive feedback about the management team. They were happy to approach them if they had a concern and were confident actions would be taken if required. The registered manager and staff promoted person centred care and a family like atmosphere at the service where people were treated equally with any diverse requirements accepted and met.

There were sufficient numbers of suitable staff to keep people safe and meet their needs. The registered manager often stayed at the service to observe staff levels and staff practice.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. The staff demonstrated an understanding of their responsibilities in relation to the Mental Capacity Act (2005) (MCA). Where people lacked capacity, mental capacity assessments were completed and best interest decisions made in line with the MCA.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. DoLS provide legal protection for those vulnerable people who are, or may become, deprived of their liberty. They had made appropriate applications to the local authority DoLS team for people they had assessed as needing to be deprived of their liberty.

People were supported by staff who had the required recruitment checks in place and were trained and had the skills and knowledge to meet their needs. Staff had received training in understanding Parkinson’s. Staff had received a full induction and were knowledgeable about the signs of abuse and how to report concerns.

People were supported to maintain a balanced diet. People were asked about their preferred meal choice and were seen enjoying their lunchtime meal.

People received their prescribed medicines on time and in a safe way. Staff treated people with dignity and respect in a caring and compassionate way.

People were supported to undertake activities. There was a program of activities for staff to use as a prompt. People were seen enjoying the activities during our visit. Staff said where people were not able to take part in the group activities they sat with them on a one to one basis.

Risk assessments were undertaken for people to ensure their health needs were identified. Care plans reflected people’s needs and gave staff clear guidance about how to support them safely. Care plans were person centred and people where able, and their families had been involved in their development. People where able were involved in making decisions and planning their own care on a day to day basis. People were referred promptly to health care services when required and received on

There were 18 people who used the service at the time of our inspection. We used a number of different methods to help us understand their views and experiences, as not all of them were able to tell us.

We observed the care provided and looked at supporting documentation. We spoke to three members of staff, the manager, a relative of someone who used the service and a visiting health professional. We talked briefly with five people who used the service.

Records showed that people's care needs had been assessed, planned, reviewed and delivered in line with their individual care plan. People's medication was managed safely and they had access to healthcare support.

Staff were well trained, recruitment procedures were robust and staffing levels were sufficient for the needs of those who used the service. People who used the service said that staff provided them with all the support and assistance that they needed and wanted.

There were systems in place to identify, assess and manage risks to people who used the service.

At our last inspection on the 17 May 2012 we found shortfalls that the provider had to take action to address. At that time we found a lack of guidance within care plans for care workers to follow when supporting some people and that the local protocol for vulnerable adults had not always been followed. We also found that and not all care workers had received the training and training updates they needed to fulfil their role. At this inspection we found that improvements needed to reach compliance had been made.

The people we spoke with were happy with the care they were receiving. They were relaxed and comfortable with each other and in their surroundings.

Care workers told us that they had completed a lot of training over recent months. They told us that care planning training had helped them to complete the care plans adopted by the home and that they had a good understanding of the needs of the people living at the home.

The people who lived in the home, that could give us their views, told us that they were involved in the assesmsent process and that their preferences were taken into consideration. They told us that they were able to make their own decisions about their daily routines and that staff were kind and caring.

We observed staff supporting people appropriatly throughout our visit and speaking to people in a kind and respectful manner. We observed people being offered choice in respect of food, drink and activities throughout the day. People told us they enjoyed the food provided. One visitor told us the food was good and that they had no complaints.

Peoples’ needs had been assessed and care and treatment had been planned and delivered in line with their individual care plan. However people’s needs had not been reassessed when accidents and incidents had occurred.

One person commented “The staff are very good here, they look after us well.” They told us that they call the doctor for them when needed and that they had supported them well since they had moved there.

There were a few people living at the home who had on occasions had become distressed and aggressive. Whilst staff described to us how they supported these people, there were no guidelines in place for them to follow to minimise people’s distress or of harm to others occurring.

People told us that they felt safe and that they felt comfortable raising any concerns with the manager, care staff or provider. Care records detailed accidents and incidents that had occurred. However when incidents of aggression had occurred the provider had not, at the time, contacted the local authority to establish whether or not these incidents needed to be investigated under local safeguarding protocol.

The staff we spoke with told us the dementia care training and the pressure area care training had helped them understand the needs of the people living at the home and that as a result of the training, they had changed the way they worked with certain individuals.

Records showed that the majority of staff had not completed the training and training updates they needed to carry out their role. However the provider told us that there were plans in place for all staff to receive the training they needed within 2012 and this included training in abuse and the safeguarding of vulnerable adults.

People living in the home have varying degrees of dementia and people we spoke to were not all able to tell us about the care they receive. However, we observed people engaging with staff that were attentive, observed their wishes and treated them with dignity and respect.

People living in the home have varying degrees of dementia and people we spoke to were not able to tell us about the care they receive. However, we observed people engaging with staff that were attentive, observed their wishes and treated them with dignity and respect.

Fairlight Manor provides accommodation and support for up to 19 older people living with a dementia type illness. Some people are independent and require little assistance, while others require assistance with personal care, daily living and moving around the home. There were 17 people living at the home during the inspection.

The home is a converted older building, bedrooms are on three floors, there was a lift to enable people to access all parts of the home and a secure garden to the rear of the building. The registered manager is part owner of the home.

The registered manager was present during the inspection. 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.

This inspection took place on the 28 and 29 July and was unannounced. The last inspection was carried out on the 13 May 2013 and we found no concerns.

Relevant training to support people with Parkinson’s disease had not been provided and staff were not aware of how to meet these specific needs.

A safeguarding policy was in place and staff had attended safeguarding training. They had an understanding of recognising risks of abuse to people and how to raise concerns if they had any.

Risk assessments had been completed as part of the care planning process; these identified people’s specific needs and included guidance for staff to follow to ensure people received the support and care they needed.

There were enough staff working in the home to meet people’s needs, and recruitment procedures were in place to ensure only suitable people worked at the home. Staff said they were supported to deliver safe and effective care, and demonstrated they knew people well and felt they enabled people to maintain their independence.

There were systems in place to manage medicines. Staff were trained in the safe administration of medicines. Staff followed relevant policies, they administered medicines safely and completed the administration records appropriately.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager and staff had an understanding of their responsibilities and processes of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.

People told us the food was very good. Staff asked people what they wanted to eat, choices were available for each meal, and people enjoyed the food provided. People told us they decided what they wanted to do, some joined in activities while others chose to sit quietly in their room or communal areas.

People had access to health professionals as and when they required it. The visits were recorded in the care plans with details of any changes to support provided as guidance for staff to follow when planning care.

A complaints procedure was in place. This was displayed on the notice board near the entrance to the building, and given to people, and relatives, when they moved into the home. People said they did not have anything to complain about, and relatives said they were aware of the procedures and who to complain to, but had not needed to use them.

Care and support was personalised to meet each person’s individual needs. Care plans had been reviewed regularly; with the involvement of people living in the home and/or their relatives if appropriate, these reflected people’s needs and included guidance for staff to follow to meet them.

An activity programme suggested a number of activities people might like to participate in, but this was very flexible. One person said, “We decide what we want to do and when, and it usually changes depending on how we feel.”

People, relatives and staff said they management were very approachable, and they all felt involved in decisions about how the service developed with ongoing discussion through residents and staff meetings. In addition feedback was sought from people, their relatives and other visitors to the home through satisfaction questionnaires, and staff also completed a questionnaire.

The registered manager had quality assurance systems in place to audit the support provided at the home. These included audits of care plans, medicines, menus, accidents and complaints.

We recommend the provider seek advice with regard to providing suitable training for staff to ensure they can meet the needs of people diagnosed with Parkinson’s disease.