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Inspection Summary


Overall summary & rating

Requires improvement

Updated 26 September 2018

This inspection took place on 26 July and 1 and 9 August 2018. The first day of this inspection was unannounced.

Firth House is a residential care home. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Firth House can accommodate up to 41 people who may be living with dementia or a physical disability. At the time of our inspection, 37 people lived at the service.

The home is over two floors and separated into four smaller units each with their own distinct name. Each unit has a dining area with a small kitchenette for the use of people who live at the service and staff. There is a large lounge for everybody to use which opens out into the secure garden. Each person has their own room with en-suite facilities.

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.

Although the service was staffed in accordance with the provider’s dependency tool, there were insufficient staff to meet people’s needs in a timely manner due, in part, to the layout of the building. We discussed our concerns about staffing with the registered manager and provider who took immediate actions by increasing the staffing levels.

On the first day of our inspection, risk assessments were not consistently in place for areas of identified risk. These were completed by the second day of our inspection. When risk assessments were completed, they were thorough and provided clear instruction for staff to follow to safely support people and reduce the potential risks.

A series of health and safety checks of the environment were completed, however some essential checks, including of bed rails, had not been completed in the two weeks prior to our inspection.

The temperature of the medicines storage was too high due to an ineffective air conditioning unit. The registered manager arranged for a contractor to assess the unit. Overall, medicines were managed safely and people received their medicines as required. Staff received medicines training and their competency was assessed annually.

The registered manager and provider completed a series of checks to monitor the quality and safety of the service provided to people. There remained some outstanding actions from these audits at the time of our inspection and the checks had not highlighted some of the issues we found during our inspection. The registered manager and provider were responsive and immediately addressed the issues.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible. Mental capacity assessments and best interest decisions were completed when required and involved people’s family members and professionals, when required. Staff sought people’s consent before providing care.

People told us the food was of good quality and a variety of options available. People’s weight and nutritional and fluid intake were monitored and the staff responded to any concerns.

People had access to healthcare professionals and staff sought their advice and input into people’s care.

Staff received supervision and appraisals and told us they were well supported in their role. New staff completed an induction and had a probation period to ensure they had the necessary skills and knowledge for their new role. Staff undertook training the provider considered to be mandatory and completed refresher training to ensure their knowledge and practice was up to date.

People told us the staff were kind, caring and promoted their dignity. We obse

Inspection areas

Safe

Requires improvement

Updated 26 September 2018

The service was not consistently safe.

Staffing levels were insufficient to meet people's needs in a timely manner.

Risk assessments were not consistently in place for identified risks.

People received their medicines safely.

Staff understood how to protect people from abuse.

Effective

Good

Updated 26 September 2018

The service was effective.

Staff received training and supervision to support them in their role.

People told us they enjoyed the food.

People had access to healthcare professionals.

Caring

Good

Updated 26 September 2018

The service was caring.

Staff treated people with kindness and compassion.

People's dignity and privacy were promoted.

Relatives and visitors told us they felt welcomed to the home.

Responsive

Good

Updated 26 September 2018

The service was responsive to people's needs.

People received person-centred care.

A wide variety of activities were available.

There was information about people's end of life wishes.

Well-led

Requires improvement

Updated 26 September 2018

The service was not consistently well-led.

The issues we found during our inspection had not been highlighted through the quality assurance processes.

The registered manager was noted to be supportive.

Close links had been established with the local community.