You are here

Archived: The Firs Residential Care Home Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 12 January 2017

During a routine inspection

The Firs Residential Care Home is registered to provide accommodation and non-nursing care for up to 29 people. At the time of our inspection there were 23 older people living in the home. Each person had their own bedroom and en -suite facilities were provided. There was a dining room, conservatory and lounge for people and their visitors to use.

This unannounced inspection took place on 12 January 2017.

At the time of the inspection there was a registered manager in place. 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 the last inspection on 17 March 2016 we asked the provider to take action to make improvements to the staffing levels, fire safety and complying with the requirements of the Mental Capacity Act, and these actions had been completed.

The Care Quality Commission (CQC) is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was not acting in accordance with the requirements of the MCA including the DoLS. The provider was able to demonstrate how they supported people to make decisions about their care. Where people were unable to do so, there were records showing that decisions were being taken in their best interests. DoLS applications had been submitted to the appropriate authority. This meant that people did not have restrictions placed on them without the correct procedures being followed.

Staff knew what actions to take if they thought that anyone had been harmed in any way. Local safeguarding procedures had been followed when necessary. Risk assessments reduced risks to people without restricting them from doing the things they enjoyed.

There were enough staff available to meet people’s needs. The recruitment process was followed to ensure that people were only employed after satisfactory checks had been carried out. Staff received the training they required to meet people’s needs and confirmed that they felt supported in their roles.

Staff were kind and compassionate when working with people. They knew people well and were aware of their history, preferences, likes and dislikes. People’s privacy and dignity were upheld. Visitors were made to feel welcome to the home and staff supported people to visit their family members when needed.

Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed. People received their medication as prescribed. Medication was stored securely.

People were provided with a choice of food and drink that they enjoyed. When needed people received the support they needed to eat and drink. This was carried out in a respectful manner.

Staff supported people to maintain their interests and their links with the local community to promote social inclusion. Measures were taken to promote people’s safety if they wanted to access the community on their own.

Care plans and risk assessments gave staff the information they required to meet people’s individual care and support needs. The care provided was based on people’s preferences.

There was a complaints procedure in place and people felt confident to raise any concerns either with the staff or the registered manager.

There was an effective quality assurance process in place to identify when any improvements were needed. The registered provider obtained the views from the people, their relatives and staff about the quality of the service and took action when improvements were suggested.

Inspection carried out on 17 March 2016

During a routine inspection

The Firs Residential Care Home is registered to provide accommodation and non-nursing care for up to 29 people. At the time of this inspection there were 26 people living in the home. Each person had their own bedroom and en suite facilities were provided. There was a dining room, conservatory and lounge for people and their visitors to use.

This unannounced inspection took place on 17 March 2016.

At the time of the inspection the manager was in the process of applying to the Care Quality Commission [CQC] to become the registered manager. 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 CQC is required by law to monitor the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The provider was not acting in accordance with the requirements of the MCA including the DoLS. The provider could demonstrate how they supported people to make decisions about their care but not how the requirements of the MCA were being followed. Where people were unable to do so, there were no records showing that decisions were being taken in their best interests. This also meant that people were potentially being deprived of their liberty without the protection of the law.

There were not always enough staff on shift to ensure that people were kept safe. In addition, staff told us and our observation confirmed that care was sometimes task lead. This meant that people were at risk of receiving care and support that did not meet all of their needs.

Action had not been taken to ensure that the risks to people from a fire had been adequately reduced. An action plan had been written in 2014 about how to reduce fire risks: however,this had not been completed. This placed people at risk of avoidable harm in the event of a fire.

Staff knew what actions to take if they thought that anyone had been harmed in any way.

The recruitment process was followed to ensure that staff were only employed after satisfactory checks had been carried out. Staff received the training they required to meet people’s needs and confirmed that they felt supported in their roles.

Staff were kind and caring when working with people. They knew people well and were aware of their history, preferences, likes and dislikes. People’s privacy and dignity were upheld.

Staff monitored people’s health and welfare needs and acted on issues identified. People had been referred to healthcare professionals when needed. People received their medication as prescribed.

People were provided with a choice of food and drink that they enjoyed. Staff supported people to maintain their interests and their links with the local community to promote social inclusion.

Care plans and risk assessments gave staff the information they required to meet people’s care and support needs.

There was a complaints procedure in place and people and their relatives felt confident to raise any concerns either with the staff or manager.

People’s views about the quality of the service had been obtained and action had been taken when improvements were identified.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 15 June 2015

During an inspection to make sure that the improvements required had been made

The Firs Residential Care Home provides accommodation and non- nursing care, for up to 29 people, some of whom live with dementia. Short and long stays were available. At the time of our inspection there were 27 people living at the care home.

The home is arranged on two floors with an enclosed landscaped garden to the rear of the building. Access to the first floor is by means of stairs or a passenger lift.

The inspection was unannounced and was carried out on 15 June 2015. It was carried out by one inspector.

A registered manager was in post at the time of the inspection and had been registered on14 May 2015. A registered manager is a person who has registered with the Care Quality Commission (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.

We carried out an unannounced comprehensive inspection of this service on 26 January 2015. A breach of three legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to management of people’s medicines, how people’s care records were to be accurately maintained and how people’s views about their experience of the home were to be obtained.

We undertook this focused inspection on 15 June 2015 to check that the provider had followed their plan and to confirm that they now met legal requirements.

This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Firs Residential Care Home on our website at www.cqc.org.uk

At our focused inspection on the 15 June 2015, we found that the provider had followed their plan which they had told us would be completed by May 2015 to show how the legal requirements were to be met.

People told us that they were satisfied with how they were supported to take their medicines. Records demonstrated that people were given their medicines as prescribed and action had been taken to improve the quality of the records for people’s prescribed medicines. This included the removal of stick-on-notes that were at risk of becoming loose or lost from the proper records of medicines. In addition, staff had clearer written guidance and an increased awareness of how and when people were to be safely supported with a certain type of medicine (Alendronic acid).

People’s care records were more detailed and provided staff with the information to support people with the care that they needed. This included information in relation to providing people with sufficient amounts of drink to meet their hydration needs. The standard of recording people’s fluid balance monitoring charts had also improved and this included the recording of the amount of drink people had taken throughout the day. Staff had taken the right action where people’s fluid balance charts demonstrated that people were at risk of not taking enough to drink. When people had experienced a fall, their care records were updated to reflect the change in the person’s needs. This included the provision of monitoring equipment for staff to ensure that people, who were at risk of falls, were kept safe.

People had an improved range of hobbies and interests to take part in with the provision of in-house and external recreational activities. A programme of recreational activities was developed and this was based on what people said that they liked to do.

Action was taken in relation to the improvement of the management of the service. The manager was now registered with the CQC. In addition, the provider had carried out audits which identified actions to be taken, by whom and by when, where improvements were required. Furthermore, people, including staff members and people’s relatives, were asked for their views about the home. Action was taken in response to these views, which included improving the range offered in relation to people’s hobbies and interests and the choice of food.

Inspection carried out on 26 January 2015

During a routine inspection

This unannounced inspection took place on 26 January 2015. The previous inspection was undertaken on 29 July 2014 and we found that the regulations which we assessed were being met.

The Firs Residential Care Home provides accommodation and care for up to 27 people. There were 25 people living at the home when we visited.

At the time of the inspection there was no registered manager in place however the manager was in the process of applying to become registered with the commission. 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.

Improvements needed to be made to the administration and recording of medicines to ensure that people always received their medicines in safe manner.

People and their relatives hadn’t been asked for their views about how involved in making improvements to the service could be made.

Quality assurance audits were conducted however there weren’t always clear action plans to show what improvements were being planned as a result of the findings of these and who was responsible for implementing them.

People had not been supported to engage in hobbies or interests. The provider was taking steps to ensure people’s hobbies and interests were more effectively supported.

Not all care plans contained sufficient detail to ensure that staff were clear about how they should support people. This meant that there was a risk that staff, (especially any new or agency staff), would not being fully aware of their responsibilities.

Staff were kind and compassionate when working with people. People enjoyed the food and always had enough to eat and drink. People were supported to see health care professionals such as GPs and district nurses when needed.

There were usually enough staff on duty to meet people’s needs but staff had limited time to sit and talk with them.

There was a complaints procedure in place and people felt confident to raise any concerns either with the care staff or the manager.

The requirements of the Mental Capacity Act 2005 were being followed to ensure that when needed decisions were made in people’s best interests and they weren’t having their liberty restricted unless the correct procedures were followed.

We found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Inspection carried out on 29 July 2014

During a routine inspection

At the time of this inspection there were 20 people living at The Firs.

Below is a summary of what we found. The summary describes what people using the service and staff told us, what we observed and the records we looked at.

If you want to see the evidence supporting our summary, please read the full report.

This was an unannounced inspection. We spoke with four people who lived at the home. We could not speak with some people due to their needs. We also spoke with the manager and three other members of staff. We looked at written records, which included copies of people's care records, medication systems, staff personnel files and quality assurance documentation.

Is the service safe?

We found the home to be warm and clean. The accommodation was adapted to meet the needs of people living there and was appropriately maintained. The provider had a suitable plan in place to enhance the facilities further.

The provider had systems in place that ensured the safe receipt, storage, administration and recording of medicines. People were protected by safe recruitment practices. There were proper processes in place in relation to the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS).

Is the service effective?

We saw that care plans and risk assessments were informative and up to date. Staff we spoke with were familiar with their contents, which enabled them to deliver appropriate and safe care. People were cared for by staff who were properly trained and supported to develop professionally.

People we spoke with were satisfied with the care and support they received.

Is the service caring?

We spoke with four people who used the service. One person said to us, "The staff are great here. I couldn't wish for any better." Another person said to us, "They always keep the home very clean. Also the food is very good, just like mum used to make it."

We observed a good rapport between staff and the people who lived at the home. We witnessed the care and attention people received from staff. Staff were friendly, were attentive to people's needs and people were treated with dignity and respect.

Is the service responsive?

People were consulted about and involved in their own care planning and the provider acted in accordance with their wishes. Care plans and risk assessments were regularly reviewed.

Three staff members told us that the manager was approachable and they would have no difficulty speaking to them if they had any concerns.

Is the service well led?

Two staff members said that they felt well supported by the management team and they were able do their jobs safely. The manager had a range of quality monitoring systems in place to ensure that care was being delivered appropriately by staff, that the service was continuously improving and that people were satisfied with the service they were receiving.

During a check to make sure that the improvements required had been made

We reviewed evidence that demonstrated the provider had taken action to ensure that there was enough members of staff to keep people safe and meet their health and welfare needs.

Inspection carried out on 22 October 2013

During an inspection in response to concerns

We carried out this inspection to assess if the staffing levels in the home were sufficient to meet the needs of the people living there.

We found that there was not always enough care staff on shift to meet people's needs in a timely and safe manner.

Inspection carried out on 13 June 2013

During a routine inspection

We found that staff treat people in a kind and caring manner. We saw that staff gave people the help they required and this was done in a way that respected their dignity and privacy. Before staff helped people they explained what they were going to do. For example when two members of staff were helping a person into their wheelchair they were heard saying " Ready, steady�arms on the side. Nearly there. Can you feel it (the wheelchair) behind your legs now?�. When there were conflicts between people these were managed sensitively and calmly by staff. All of the people we talked to told us that they felt safe living in the home.

People told us they enjoyed living at the home, one person who was just in the home for a period of respite told us, "There is nothing the staff could better, I shall miss them when I go back home".

The records show that staff respond to people's changing needs and when needed, other professionals are involved. One person told us, "We get all the doctors � they�re very good.�

The staff records showed that staff have to pass recruitment checks before they are employed.

There was a complaints procedure in the home. All of the people that we talked to said they would complain if there were not happy about anything in the home.

Inspection carried out on 12 July 2012

During a routine inspection

People we spoke with were satisfied and positive about the care and support that they received in the home. Relatives we spoke with were complimentary and positive about the care and support that their relatives were receiving and commented that, "The staff are friendly, respectful and caring".

People told us that any issues or concerns they raised were dealt with in a timely manner by the managers and staff in the home. Relatives that we spoke with felt that they were always kept up to date with any changes to care and support regarding their family member.

Inspection carried out on 6, 20 February 2011

During a routine inspection

People living in the home and their relatives with whom we spoke rated the home highly. We received many positive comments including: �the home is brilliant, mum is so happy there� and �every time the doctor comes, they ring and tell me, it makes me feel really involved in mum�s care�.

People commented that there had been a lot of changes recently, but that these had been for the better, and that the service had improved greatly under the new manager in recent months. However, some people raised their concerns about the access to the home and also the lack of available parking outside.

Reports under our old system of regulation (including those from before CQC was created)