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Fairhaven

Provider North West Boroughs Healthcare NHS Foundation Trust Type NHS Healthcare Organisation Region North West Last inspected 25 Jun 2018

Overall rating: Good  View full CQC report

Domain ratings

Five CQC key questions
Safe
Not Yet Rated
Effective
Not Yet Rated
Caring
Not Yet Rated
Responsive
Not Yet Rated
Well-led
Not Yet Rated

Earlier inspection findings

pre-2024 framework · 3 must-do 7 should-do

Must-do actions (3)

Legal requirements based on regulation breaches identified during inspection.

Must-do action 1 of 3
Must do
Safe
The trust must ensure all aspects regarding care and any associated risks are documented in the main casenotes and not just supplementary documentation.
Regulation: Regulation 12 HSCA (RA) Regulations 2014 Safe care and treatment
⚠ Staff did not always document all risks associated with each patient withinthe appropriate section of the care record.
Must-do action 2 of 3
Must do
Well-led
The trust must ensure staff complete all mandatory training in the intended time frame.
Regulation: Regulation 18 HSCA (RA) Regulations 2014 Staffing
⚠ Staff did not complete all mandatory training withinthe intended time frame.
Must-do action 3 of 3
Must do
Caring
The trust must ensure care planning records including the language used within them, are consistent in terms of the detail given and follow current guidance.
Regulation: Regulation 9 HSCA (RA) Regulations 2014 Person-centred care
⚠ The language used in records was not consistently person centred. Care plans did not in all instances demonstrate the individualised care required by each patient and were not always written to the highest of professional standards.

Should-do actions (7)

Recommended improvements to enhance service quality.

Should-do action 1 of 7
Should do
Safe
The trust should ensure care plans document the rationale for the decision to prescribe as required medication and the circumstances when they should be administered.
Should-do action 2 of 7
Should do
Safe
The trust should regularly review the environment to ensure it is clean and well maintained.
Should-do action 3 of 7
Should do
Safe
The trust should ensure seclusion records detail non-restrictive practices which have been attempted in the first instance before resorting to the need for seclusion.
Should-do action 4 of 7
Should do
Responsive
The trust should ensure movements around the environment are less restrictive and ensures service users have access to the garden and other regularly used rooms when they need it.
Should-do action 5 of 7
Should do
Caring
The trust should work with patients to capture their decisions and wishes in safety plans and advanced statements and have these clearly documented in the care records.
Should-do action 6 of 7
Should do
Caring
The trust should ensure patients have access to individual snack boxes without restriction.
Should-do action 7 of 7
Should do
Responsive
The trust should ensure there is a separate female lounge available for female patients if they require one.

Location details

CQC ID: RTVL5
Local authority: Warrington
Region: North West

Inspection report

Type: Focused inspection
Date: 25 June 2018
Actions: 3 must-do 7 should-do
AI-extracted 2 Jun 2026