The Firs Residential Home

Updated 5 June 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

Two inspectors conducted the inspection over one day.

Service and service type:

The Firs is a ‘care home’. People in care homes receive accommodation and personal care. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The inspection was unannounced, which meant that the home's management, staff and people using the service did not know the inspection was going to take place. The inspection visit took place on the 8th May 2019.

What we did:

On this occasion we had not asked the service to complete a Provider Information Return, however, information was gathered during our inspection. This included key information about the service, what the service does well and any improvements they plan to make. We took this into account when making our judgements about this service. We reviewed the information we already held, including notifications sent by the service. Notifications are changes, events and incidents the service must inform us about.

We reviewed information we had received about the service since the last inspection, this included details about incidents the provider must tell us about, such as abuse. We sought feedback from the local authority, clinical commissioning group (CCG) and other health professionals who work with the service.

During the inspection we spoke with five people and four relatives, to ask about their experience of their care. Some people were unable to tell us about their experience of living at The Firs, so we observed how the staff interacted with people in communal areas. We reviewed a range of records. This included four people’s care and medicine records.

We spoke with three members of care staff, the activities co-ordinator, the cook and assistant cook, the maintenance manager and the deputy and registered manager. After our inspection we spoke with two external health professionals whose comments have been reflected in the report.

We also reviewed the staff recruitment process, training and supervision records and a variety of policies and procedures, including auditing tools developed by the provider.

Updated 5 June 2019

About the service:

The Firs is a residential care home that provides personal care for up to 28 people, some of whom are living with dementia. The accommodation is split over 3 floors, with a chair lift to the second floor. There are several communal areas with 3 lounges, a central foyer and a dining room. People’s bedrooms are on all three levels. There are several bathrooms and toilets throughout the building. At the time of inspection 24 people were using the service.

People’s experience of using this service:

People’s safety was not always recognised in relation to storage of COSHH (Control of Substances Hazardous to Health) products.

Systems of oversight were not sufficiently robust to have identified the issues we found in relation to storage of COSHH products and Medicines.

Medicines were not always being managed in line with current best practice. People received their medicines regularly; some systems were in place for administration of medication management.

People were given choice and staff supported them in the least restrictive way possible. Staff engaged well with people and responded to their individual needs promptly. People were positive about the staff and told us their privacy and dignity were respected.

People’s needs had been assessed, plans developed, and care delivered, in line with good practice. Care was delivered by staff who were well trained and knowledgeable about people’s support needs. People said they felt involved in their care, supported in decision making and were supported to have maximum choice and control of their lives. People were provided with a choice of varied diet and were complimentary about the food.

People were cared for by staff who knew how to keep them safe and protect them from avoidable harm. Sufficient staff were available to meet people’s needs and people told us staff responded promptly when they called them. Incidents and accidents were investigated, and actions taken to prevent re-occurrence. The premises were clean, and staff followed infection control and cleaning procedures.

There was a friendly, welcoming atmosphere for people using the service and they gave positive comments about the staff and care provided. People, relatives and staff spoke positively about the registered manager, felt able to raise concerns and were confident that they would be addressed.

Systems were in place to drive and improve the level of service. Staff had developed good positive working relationships with other services. Staff were safely recruited and received the training and support needed to undertake their role.

The previous rating had been displayed in the foyer of the home, however had been removed at the time of our inspection. The registered manager printed another copy and assured us, they would find a way to secure this for display. The manager understood their responsibility of registration with us and notified us of important events that occurred which meant we could check that appropriate actions had been taken.

Rating at last inspection: Good (report published 10/02/2017). The overall rating has remained the same.

Why we inspected: This was a planned inspection based on the rating at the last inspection.

Follow up: We will continue to monitor intelligence we receive about this service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk