Fir Villa Residential Home

Fir Villa Residential Home provides accommodation and personal care for up to 24 older people. Accommodation is provided in the main house and there is a one-bedroom cottage, known as The Owls Nest which is situated in the grounds of the home. The home is staffed 24 hours a day, at the time of the inspection there were 22 people living at the home.

People’s experience of using this service and what we found

People and their relatives told us the service was safe and people were well cared for. They told us the service was well run and staff helped them quickly when they needed it.

There were enough staff to meet people’s needs and medicines were well managed. The service had assessed the risks people faced and had plans in place about how to keep them safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People or their representatives were involved in decisions about their care. People were supported to have access to health care.

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

Rating at last inspection and update

The last rating for this service was good (published on 14 November 2018).

Why we inspected

We received concerns in relation to the management of medicines. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The rating for the safe key question has changed from requires improvement to good. The overall rating for the service remains good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Fir Villa nursing home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Fir Villa provides accommodation and personal care for up to 24 residents. Accommodation is provided in the main house and there is a one-bedroom cottage, known as The Owls Nest which is situated in the grounds of the home. The home is staffed 24 hours a day, at the time of the inspection there were 22 people living at the home.

There was a registered manager in post. 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.

At our last inspection we rated the service good. At this inspection, although there were some improvements needed to how the provider manages people’s medicines, the provider responded immediately and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns to people. We therefore kept the overall rating of good in place.

People being supported at Fir Villa told us they felt safe, although some areas of practice within the service were not safe, and placed people at risk. For example, one person’s medicines had not been administered for seven days. There were gaps in fridge temperature records and no records were kept of the room temperatures where back up stocks of medicines were stored. Discrepancies that the inspection team found had not been brought to the attention of the registered manger and appeared to occur when the staff member responsible for medicines management was on annual leave, which meant the oversight of people’s medicines was not robust.

Staff showed a good awareness of safeguarding procedures and knew who to inform if they saw or had an allegation of abuse reported to them. The registered manager was also aware of their responsibility to liaise with the local authority if safeguarding concerns were raised.

The provider had suitable processes to assess people’s needs. Care plans were detailed and contained risk assessments that documented areas of risk to people, such as nutrition and hydration or pressure areas. Staff sought consent to care.

The provider employed enough staff to cover the needs of the home and there was a robust recruitment and selection process in place where staff had been subject to criminal record checks before starting work at the service.

The provider had infection control arrangements in place and the home was clean, tidy, and free from any unpleasant odour. Accident and incident reporting was robust. Staff knew the reporting process. Records showed that staff had taken proper action where necessary and made changes to reduce the risk of a re-occurrence of an incident.

Staff and volunteers had the skills, knowledge, and experience to support people. Supervision and appraisals were completed regularly to develop and motivate staff to improve on the care and support being delivered.

Staff supported people to eat, drink and keep a balanced diet. People told us that they had choices of food and that the quality of the food was good. People told us they had access to healthcare services such as GPs, Dentists, and Chiropodists.

People were supported to take part in activities. The provider helped people celebrate special occasions such as birthdays and religious festivals such as Christmas.

People told us they were encouraged to give their views and raise concerns or complaints.

The leadership was visible and accessible. The registered manager understood the importance and responsibility of their role and had clear lines of responsibility and accountability. There was evidence that learning from incidents and accidents and investigations took place and appropriate changes were implemented

There were effective quality assurance arrangements at the service to raise standards and drive improvements and the service worked with other health and social care professionals in line with people's specific needs. Staff understood the importance of supporting people to have a good end of life as well as living life to full whilst they were fit and able to do so.

Further information is in the detailed findings below

Fir Villa provides accommodation and personal care for up to 24 residents. Accommodation is provided in the main house and a one bedroom cottage, known as The Owls Nest which is situated in the grounds of the home. The home is staffed 24 hours a day

At the time of our inspection there were 22 people living at the home. There was a registered manager in post. 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 atmosphere in the home was relaxed and welcoming. People and their visitors described Fir Villa as a home from home. One person told us “It’s a real home from home here and you would struggle to find anywhere better.” A visitor said “Nothing is too much trouble. The staff are so happy and friendly and they always have time for my [relative].”

There were sufficient staff to meet people’s needs and help keep them safe. Staff were available when people needed them and they responded quickly to any requests for assistance. One person said “If I need anything; the staff are always there.” Another person said “Sometimes I use my call bell and somebody comes before I know it.” A member of staff said “I love coming to work and what’s really good is that we can spend so much time with people.”

People told us they received care and support from kind and caring staff. Throughout this inspection we saw people were supported in a friendly and gentle way. Personal care was provided to people in a way that respected their privacy and dignity. One person told us “The staff have always got a smile on their face. They are all so very kind to me and so patient.” Another person told us “Everything is perfect. I couldn’t be happier. The staff are lovely and will do anything they can to help you.” A visitor said “The staff are so happy and friendly. It’s like you’re part of a big family. I know they adore my [relative].”

People's health needs were monitored and they had access to healthcare professionals according to their individual needs. Incidents and accidents were analysed to ensure people received the support they required to maintain their health and well-being. A visiting health care professional described the care people received as “Excellent.” They said “The staff here are so knowledgeable about people and they inform us and work with us if there are any concerns.”

People had their nutritional needs assessed and received meals in accordance with their needs. Where people required physical assistance to eat this was provided in a dignified manner. People were complimentary about the food served in the home. One person said “I am certainly well fed and the meals are excellent.” Another person told us “It’s good home cooking. Very good indeed and plenty of it.”

The arrangements for social activities were innovative and focused on meeting people’s individual needs. The home employed a very enthusiastic activity co-ordinator who developed a very varied and innovative programme of activities for people. Outside entertainers and visitors to the home included shows put on by a community theatre group, singers, musicians and visits from various animals. There was a strong emphasis on enabling people to continue with their individual hobbies and interests. There were strong links with the local community.

Staff knew how to recognise and report abuse. They had received training in safeguarding adults from abuse and they knew the procedures to follow if they had concerns. Risks to people were well managed and people were supported to be as independent as they could be.

The service made sure medicines were stored securely and there were sufficient supplies of medicines. People received their medicines when they needed them by staff who had been trained to carry out this task.

People were always asked for their consent before staff assisted them with any tasks and staff knew the procedures to follow to make sure peoples legal and human rights were protected.

There were effective systems in place to monitor and improve the quality of the service provided.

People's needs were assessed and care was planned and delivered to meet people's needs. A person's relative told us, "We received a home visit and pre-assessment." We found that people's care was regularly reviewed and their personal information was held securely. A visiting family member told us, "I am completely happy with what they have done."

We saw that people's needs were met by sufficient numbers of staff with the right knowledge, experience, qualifications, and skills. A relative told us, "There is always enough staff. They are always doing something, not just standing around chatting to each other.'

We found that people were protected from abuse, or the risk of abuse, and their human rights were respected and upheld.

We found that people benefitted from safe quality care, treatment, and support due to effective decision making and management of risks to their health and welfare.

People received the medicines they had been prescribed when they needed them. People told us they could have pain relief if they needed it. One person told us 'I get my medicines every day. One person gives the medicine out and the other person looks after the trolley.'

There were effective recruitment and selection processes in place for staff recruited to work in the home. We saw that the provider had checked whether people had any criminal convictions or cautions and had ensured that they were not on the list of people barred from working with vulnerable adults. Staff we spoke with confirmed that they had not started work at the home until all of the appropriate checks had been completed.

People's personal records including their medical records were accurate and fit for purpose. We checked other records relevant to the management of the services and saw that they were accurate and fit for purpose. All of these records were kept securely and could be found promptly.