This inspection took place on 12 April 2018 and was unannounced.

At our last inspection in February 2017 we found breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was because care plans and risk assessments were not always completed or updated and did not always provide clear information and guidance for staff on how to safely manage risks identified. Personal evacuation plans were not always completed to ensure people would be safely evacuated in the event of an emergency. People's food and fluid charts and Malnutrition Universal Screening Tool (MUST) were not always adequately completed or monitored. Not all staff had DBS checks carried out before they started work. Best interests meetings were not always carried and decisions documented. Following that inspection, the provider wrote to us to tell us the action they would take to address our concerns.

At this inspection, we found that the provider had addressed the individual concerns identified at our last inspection. However, we found further breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There were not enough staff deployed to meet people's needs. There were not enough hoists to meet people’s needs in a timely manner. Risks to people had been assessed and minimised, but risk management plans did not list the equipment required and used to mobilise people. People were not always protected from the risk of infection as individual hoist slings were not used when mobilising people. Processes were in place to monitor the quality of the service but these were not always effective as they did not identify the issues we found at this inspection.

Fairmount provides accommodation and personal care for up to 38 older people and specialises in caring for people living with dementia. There were 29 people using the service at the time of the inspection. 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 place, who was on leave at that the time of this inspection. The deputy manager and area manager were available on the day. 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 told us they felt safe. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse. Staff understood the types of abuse that could occur and were aware of the action to take if they had any concerns. Staff knew about the home’s whistleblowing procedure and told us they would use it if required. The home recorded accidents and incidents acted on them in a timely manner. Medicines were stored, administered and managed safely. Appropriate recruitment checks were carried out before staff started work to ensure that they were suitable.

Staff received appropriate training and were supported through supervisions and appraisals so that they were effectively able to carry out their roles. The registered manager and staff understood the requirements of the Mental Capacity Act 2005 (MCA). 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. Staff told us they asked for people’s consent before they provided care. People were supported to have enough to eat and drink and had access to healthcare professionals when required to maintain good health.

People told us staff were kind, caring and respected their

We carried out an unannounced comprehensive inspection on 08, 09 and 10 February 2017 due to concerns raised about the number of falls and staffing levels and to provide the service with a rating.. This was the first inspection of the service since it changed provider in October 2016. We found that people were risk assessed with regards to falls and the service managed this by making appropriate referrals to healthcare professionals. We also saw that there were enough staff to meet people’s needs.

Fairmount Residential Care Home provides accommodation and personal care for up to 38 people older people and is situated in the London Borough of Bromley. At the time of our inspection there were 31 people living at the home.

Fairmount Residential Care Home was taken over by a new provider in October 2016. There was a registered manager who had been in post since December 2016. 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 this inspection we found two breaches of legal requirements of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Care plans and risk assessments were not always completed or updated and did not always provide clear information and guidance for staff. Personal evacuation plans were not always completed to ensure people would be safely evacuated in the event of an emergency. People’s food and fluid charts and Malnutrition Universal Screening Tool (MUST) were not always adequately completed or monitored. Best interests meetings were not always carried and decisions documented. Not all staff had DBS checks carried out before they started work. Although the provider had introduced and carried out a number of internal audits since taking over the service, not all shortfalls identified had been followed up and addressed at the time of the inspection. The provider only took over the service five months will ago and has assured us that all actions identified would be followed up as soon as possible. You can see the action we have asked the provider to take in respect of this breach at the back of the full version of the report.

Safeguarding adult’s procedures were robust and staff understood how to safeguard people they supported. There was a whistle-blowing procedure available and staff said they would use it if they needed to.

We saw staff training except for MUST training was up to date. Staff received supervision, appraisals and training appropriate to their needs and the needs of people who they supported to enable them to carry out their roles effectively. There were processes in place to ensure new staff were inducted into the service appropriately.

The registered manager and staff demonstrated a clear understanding of the Mental Capacity Act 2005(MCA) and Deprivation of Liberty safeguards (DoLS). Staff asked people for their consent before they provided care.

People had access to a range of healthcare professionals in order to maintain good health. People were treated with kindness and compassion and people's privacy and dignity and confidentiality was respected. People were supported to be independent where possible such as attending to some aspects of their own personal care.

Staff were knowledgeable about people's individual needs. People's religious beliefs were recorded to ensure that staff took account of people's needs and wishes.

People were involved in their care planning and the care and support they received was personalised and staff respected their wishes and met their needs. People knew about the service's complaints procedure and said they believed their complaints would be investigated and action taken if necessary.

Regular resident and staff meetings took place and people