Faithfull House

Faithfull House is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Faithfull House does not provide nursing care. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

The care home can accommodate 72 people in one adapted building. At the time of this inspection 68 people lived there. Eleven of these people lived in a separate dementia care unit called Bluebell.

People's private accommodation varied. People had varying size bedrooms of which some had a sitting room area. All had private washing facilities. People had access to additional communal lounges, dining areas, adapted toilets and bathrooms. Bluebell unit had its own lounge and dining space. At the time of the inspection the communal space for people on Bluebell unit was being increased to better accommodate people's needs. People had access to a large conservatory and well-tended garden with summer house. People who lived on Bluebell unit were supported to use other areas of the home, if doing so, supported their wellbeing.

The service was rated 'Good' overall following our first comprehensive inspection on 5 and 6 January 2017. We then carried out a focused inspection on 20 and 21 July 2017 in response to concerns shared with us about people's care. This focussed inspection looked at the key questions Is the service safe and Is the service well-led? We identified three breaches of regulation and the rating for the service was changed from 'Good' to 'Requires Improvement' following this inspection. This was the first time that the service had been rated 'Requires Improvement'.

At the July 2017 focused inspection we found risks to people had not been sufficiently identified and action had not always been taken to reduce or mitigate risk in order to keep people safe from harm. Incidents which had an impact on people's safety had not always been appropriately reported to the CQC or to other agencies as is required. Systems and processes used to monitor the service had not identified these shortfalls and had not led to improved outcomes for people

We asked the provider to complete an action plan to show what they would do and by when, to meet the necessary regulations and to keep people safe from potential harm. Also, how they were going to improve the key questions Is the service safe and Is the service well-led? to Good. The provider informed us on 22 September 2017 that they had completed their action plan.

During this full comprehensive inspection on 8 and 9 May 2018 we found all necessary regulations had been met. We also found all key questions Is the service safe, effective, caring, responsive and well-led? could be rated as Good. Following this inspection the overall rating for the service was 'Good'.

Faithfull House is required to have a registered manager of which one was in post. A registered manager is a person who has registered with the 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.

During this inspection we found the home to be operating in a safe way. Risks to people's health were identified and managed and either reduced or mitigated. The same had been done with environmental risks. The safety and care of people who lived with dementia had improved through the formation of a separate dementia care unit called Bluebell. People who were at particular risk of harm, due to behaviours sometimes associated with living with dementia, were protected from harm and distress. Staff who supported people on Bluebell unit were skilled and knowledgeable in identifying situations and behaviours which could lead to upset or harm. They took action to avoid these situations or to diffuse them before they fully developed. People in the main home also lived safely and staff supported their wellbeing.

People, both in the main home and on Bluebell, 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, and protected people from potential abuse and discrimination.

There were arrangements in place for people, their relatives and other visitors to the home to raise a complaint or area of dissatisfaction. All complaints had been taken seriously, investigated and responded to according to the provider's complaints policy and procedures. In managing complaints and relatives expectations staff had remained aware of other legislation which they had to adhere to.

People were cared for by staff who were caring and compassionate. At the end of people's lives this ensured that people had as dignified and comfortable death as possible. People's privacy and dignity was maintained.

People and relatives were provided with support to help them understand information which was important to them. Information could be provided in different formats to support this. Relatives were welcomed at any time, and where appropriate, supported to be involved with their relatives' care planning and review. Information about people was kept confidential and secure.

People's needs were assessed prior to admission to the home and care plans devised to meet these needs. These were well maintained, reviewed and updated when needed. They included information which enabled people's care to be personalised. People were supported to take part in activities of their choice and which they enjoyed. Several people in the home led independent lives and chose to arrange their own activities which staff supported and respected.

The registered manager provided strong leadership and had developed a strong senior management team. Improvements had been made to how the senior management team in Faithfull House monitored the quality of care and services provided. Robust quality assurance systems had resulted in improvements having been made to the service since our last inspection. This was reflected in full compliance with necessary regulations. The service's compliance improvement plans were monitored and were effective in driving and sustaining improvement and development of the service.

Staff felt more involved and better communicated with and were actively involved in finding solutions to problems. The registered manager had promoted a working environment where staff were confident to challenge poor practice. The views of people and their representatives were valued and acted on, where it was practicable to do so, to improve the lives of people who lived at Faithfull House.

The five questions we ask about services and what we found