This inspection took place on 28 November and 5 December 2017 and was unannounced. The home provides accommodation for up to 21 older people with personal care needs. There were 21 people living at the home when we visited. All areas of the home were accessible via stairs and a passenger lift. There were lounges/dining rooms on the ground floor of the home and accessible outdoor space from the ground floor.

There was a registered manager at the home. 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.

The registered manager had effective systems in place to monitor the quality and safety of the service, which identified where improvements were required. They had identified shortfalls in the service’s recruitment process when ensuring references from previous employment were obtained for every candidate. The registered manager had taken action to put a new more robust process in place.

The registered manager also sought feedback from people, relatives and staff about the quality and safety of the service in order to make changes and improvements. There was a complaints policy in place which the registered manager adhered to when people raised concerns.

People and staff told us the registered manager was approachable and ran the service effectively.

There was a calm and relaxed atmosphere at the service. Staff were caring and considerate of people’s needs and were aware of the steps needed in order to keep people safe, treat people with dignity and to ensure their rights and freedoms were respected.

People had risk assessments in place to assess, monitor and mitigate the risk of harm. Staff understood how to implement this guidance into their everyday practice. Staff were knowledgeable about people’s individual needs and were able to make adjustments to ensure these needs were met.

Staff had received a training programme which met the required standards relevant to their role. The registered manager monitored their work performance through ongoing training and supervision.

Staff had also received training in delivering compassionate end of life care. The service had many examples where they worked with people, families and other stakeholders in order to help people have dignity and comfort during their last days.

The service used an electronic care planning and monitoring system in order to record care notes, incidents and track trends and changes in people’s health and wellbeing. Staff had the most up to date guidance about people’s needs available including important information about people’s healthcare and medicines. The service had established positive working relationships with healthcare professionals, which meant that people had access to healthcare services when required.

People told us they enjoyed the food at the service and there was a chef employed who knew which people had specific dietary requirements or preferences.

During our visit we spoke with five people, five relatives, three staff and the manager. To help us to understand people's experiences of the service we observed the care people were receiving at different times of the day. A person said the care was “excellent” and told us the staff looked after them "very well”. People said they received help and support in a respectful manner. Another person said "the staff do a good job”. Relatives told us they were happy with the care and people were always well dressed and clean. Two relatives told us they came at different times of the day and there was “always staff around”. We saw the staff were courteous and respectful when providing care and support to people.

People said they were offered choices and "they (the staff) always ask before they do anything”. A person told us “I can get up when I want” and “there is help when you need it”. We observed staff supporting people with their meals and they preserved people’s dignity. A relative said “the staff keep me informed of how mum is getting on”. Another relative told us “they ring and let you know if there is any change in mum’s health”. This meant people or their relatives were involved in their care and treatment.

Arrangements were in place to ensure people received their prescribed medicines as needed. Medicines were stored safely and records were maintained. People who use the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. We saw records were maintained safely and securely and could be located promptly when we asked to see them at the time of the visit.

People told us that staff respected their dignity and gave them choices. A person told us how staff supported them to make choices about what to wear in the morning. Another person told us they went to bed when they wanted to. People felt they were listened to by staff and the manager. We spoke with staff and the manager who confirmed that they respected people’s privacy and dignity. People told us they were pleased with the level of care and support they received. We found that their needs were met in ways which met their individual preferences. We found that the manager consulted people on aspects of how the home was managed.

People told us the home was always clean. We found that systems were in place to reduce the risk of infection and records were kept which showed how often parts of the building were cleaned. Cleaning fluids, which could present a risk to people, were stored safely.

We spoke with one person who told us that the staff were lovely, very helpful, looked after them well and met their personal care needs.

This inspection took place on 07 and 14 July 2015. This visit was unannounced. At our last inspection on 31 December 2013 we found the provider was meeting all the expected standards of care.

Keychange Charity Fair Havens Christian Care Home (with Nursing) is a nursing and care home which provides accommodation and care for 23 older persons. Due to recent decisions by the provider, they were not providing nursing care within the home. This meant that at the time of our inspection there were 10 people living in the home.

The home had 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.

People told us they were safe living at Fair Havens. Staff received safeguarding training and knew how to recognise and report abuse to the appropriate person. Risks associated with the delivery of care were identified when people’s needs were first assessed. These were reviewed and updated when people’s needs changed.

The service had recently changed from nursing to residential care and new care staff had been appointed in senior positions. There were sufficient staff on duty to provide care to all people. Staff had been trained in the administration of medicines and had been assessed to be competent to do this. Medicines were safely administered and were stored in an appropriate secure location. Systems to order, audit and return medicines were safe and effective.

People received effective care as their needs were assessed prior to admission. Care plans were written to meet needs identified from the assessment. The care plans were personalised and people and their relatives were involved in reviewing their care plans. People were asked for their consent before care was delivered to them by staff.

People received sufficient and nutritious meals and were able to make their own drinks and snacks throughout the day if they wished. Where people were having their weight monitored, records were maintained of food and drink they consumed. People were supported to maintain good health and they were able to access the local GP surgery or receive home visits from the GP or other health care staff.

People spoke warmly about the staff who supported them and said they had a good relationship with staff. People said they would talk to the registered manager about any concerns they had about the service they received. People were able to give their views on their care to staff and this would be discussed with the registered manager. Changes had been made to people’s care plans in line with discussions they had with staff. People’s dignity and privacy was respected by staff and there were suitable areas in the home where they or their relatives could have private time.

People received personalised care that was based on information they or people who knew them well had supplied as part of the assessment of care. This was reflected in people’s individual care records where each person had a ‘this is me’ document outlining their personal history, likes, dislikes and preferences. People were able to talk to staff and the registered manager on a regular basis about their experiences in the home and changes they would like to make. They could make suggestions through regular satisfaction surveys the provider carried out.

The service was well led and there was an open culture where people and their relatives were kept up to date and involved in decisions about the future of the home. Staff told us the people were at the centre of what they did. Auditing systems were in place to ensure high quality care was delivered to people. The provider monitored this with their own audits of the care, environment and work practices of staff. The registered manager maintained their own skills and was aware of current trends and research in dementia and older person’s care. This had led to training being provided in dementia friendly services and staff developing a better understanding of the needs of people who lived in the home.