Fairlie House

Fairlie House accommodates 45 people in one adapted building across three separate floors, each of which have adapted facilities.. There were 43 people using the service at the time of the inspection. The nursing home cares for people with complex neurological needs, sensory impairments and physical disabilities as a result of brain injury or neurological conditions.

There was a registered manager in place. They had been registered with the Commission as the registered manager for the home 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.'

We found there were very good aspects to the systems to monitor safety at the home. Robust fire safety processes were in place and there were effective premises and equipment checks. Risks to people from their individual health needs were carefully assessed, monitored and comprehensive guidance provided to staff to reduce risk. However, one care record did not clearly track the monitoring of skin integrity risk. We saw this was addressed immediately at the inspection.

People were protected from the risk of abuse or neglect. Staff were fully aware of the action they needed to take to ensure people's safety and well-being. Accidents and incidents were recorded, monitored and acted on appropriately with actions to minimise reoccurrence. There were excellent systems for identifying and sharing learning from adverse events.

There were systems in place to ensure people were protected from the risk of infection and the home was clean and well maintained. There were enough suitably trained staff to meet people's needs and safe staff recruitment practices were in place. Medicines were managed, administered and stored safely. Staff were trained to manage medicines and their competences assessed.

The home was distinctly effective, which improved outcomes for people. There was a dedicated comprehensive system of appropriate training, competency assessment and support for staff to provide the right knowledge and competence for them to carry out their roles effectively and safely. This was constantly

evaluated for improvements.

People's clinical physical, mental, social and therapeutic needs were holistically assessed using best practice and current guidance, before they moved to the home to ensure staff and the home environment could meet their needs safely.

People's nutritional needs were supported in a safe and highly personalised way.

People complex health needs were supported through positive working relationships amongst the home's staff and with external health professionals.

The home fulfilled its responsibilities under the Mental Capacity Act 2005 (MCA 2005). This provides protection for people who do not have capacity to make decisions for themselves.

The home environment was well maintained and adapted to meet people's needs.

People and their relatives told us the home was very caring and some relatives were exceptionally complimentary about the care at the home. We observed staff to know the people they supported well and to be respectful, caring and considerate.

There was a strong values framework that underpinned the provider's approach to person centred care. Staff had received training on this and support to put this into practice.

People's privacy and dignity was very much respected and maintained and staff supported people to develop and maintain their independence. People were proactively supported and encouraged to maintain relationships with people that were important to them.

People's communication needs were considered and where possible, they were able to express their views, and be involved in decisions about their day to day care. Assistive technology was promoted to improve people's ability to communicate.

The service was exceptionally responsive. People had individually developed person centred care and therapy plans that reflected their needs. The home was proactive in supporting equality and respecting diversity.

People were encouraged to choose manageable goals which improved their lives. The staff team worked collaboratively in partnership with a range of organisations to improve people's life experience. People's quality of life was enhanced by assistive technology, and the stimulation and activities provided in conjunction with the therapy team.

Most people and their relatives told us they had not needed to make a complaint and any issues were promptly dealt with. There was an effective complaints process in place.

The home had recently been recognised for its outstanding end of life care.

Aspects of the home were extremely well led. People, their relatives, staff and health professionals gave us very positive feedback about the way the home was run. The home's values framework was familiar to staff and underpinned its governance and quality control.

The home supported training and development in the community to improve care.

People were encouraged to give their views about the service and these were listened to.

The home had developed a comprehensive quality assurance framework which it was embedding at the time of the inspection.

The five questions we ask about services and what we found