This was an unannounced inspection that took place on 7 and 8 October 2015. There were 19 people using the service at the time of the inspection.
Firbank House consisted of two buildings. One building known as the ‘old’ building and the other known as the ‘annex’. The ‘old’ building has bedroom and communal facilities for up to 22 people. The ‘annex’ has bedroom and communal facilities for up to 20 people and is the only building currently used to provide accommodation to people living in Firbank House.
Firbank House is owned by Partnership Caring Limited, which is a private company. The home provides residential care only and is registered to accommodate up to 42 persons. The service was previously inspected on 3 and 4 September 2014, when breaches of legal requirements were identified.
At our inspection in September 2014 we had some concerns about the safety and suitability of some parts of the premises, in the ‘old’ building. The building was found to be in a state of disrepair and the provider said that it was their intention to fully refurbish the building so that it could once again be used for residential purposes. Following that inspection, we produced a report and set the provider a compliance action to address the concerns raised. To ensure that service users and others having access to premises where a regulated activity is carried out are protected against the risks associated with unsafe or unsuitable premises. The provider sent us an action plan telling us how they intended to address the concerns we had raised and to ensure compliance with regulation was achieved.
We undertook a further follow up inspection on 4 August 2015 to check that the provider had completed all the work required to the ‘old’ building to meet legal requirements in relation to the outstanding breach. We found that although most of the work had been carried out, some further work still required finishing to make the building safe for residential use.
There was no registered manager at this location. A new manager had been in post since July 2015. They had yet to apply to be registered with the Care Quality 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 and associated Regulations about how the service is run.
This was a breach of section 33 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Failure to comply with conditions. You can see what action we told the provider to take at the back of the full version of this report.
In parts of the home known as the ‘annex’ we identified areas where improvements were needed to ensure the safety of people using the service, staff and visitors.
The boiler room on the upstairs corridor was found to be unlocked and being used by staff to store their bags and coats as well as other items being stored in there. This room was very warm and people using the service were at risk of entrapment should they enter the room and become disorientated to where they are.
Where people required the use of a hoist, it was confirmed that people did not have use of their own, individual sling(s). Using the same slings to transfer different people increases the risk of cross contamination and infections.
This was a breach of Regulation 15 (1) (b) (d) (e) (2) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Premises and equipment. You can see what action we told the provider to take at the back of the full version of this report.
We looked around all areas of the ‘old’ building including every bedroom and communal facilities. We found that all bedroom areas had been fitted with, new beds and bedroom furniture and we saw that soft furnishings had been installed and, where required, new nurse call points fitted.
All the rooms with en-suites had all new tiling, flooring and sanitary ware fitted.
Work that was outstanding for completion at our last inspection of the ‘old’ building was found to have been completed.
We were provided with a copy of the electrician’s report for these premises that confirmed all electrical work and electrics had been fully checked and was compliant with electrical safety regulations.
We were provided with a copy of the report supplied by the fire contractor for the service, Bridge Fire Protection. They had carried out a full risk assessment of the premises. on 24 August 2015. The report identified the following areas had been assessed in accordance with the Regulatory Reform (Fire Safety) Order 2005 – Fire Risk Assessment. A list of those areas assessed can be found in the main body of this report.
Staff spoken with were able to demonstrate their knowledge around safeguarding vulnerable people and also around the whistleblowing procedures.
Inspection of the staffing rosters and discussions with staff and people who used the service confirmed that sufficient numbers of suitable experienced and competent staff were available at all times.
Care records seen showed that people using the service had access to other health and social care professionals, such as social workers, district nurses, general practitioners (GP) and community practitioners such as speech and language therapist and community psychiatric nurses.
We saw that people looked well groomed, well cared for and wore clean and appropriate clothing.
People using the service told us that they felt their needs were being met. People’s diet and fluid intake were closely monitored and action taken where concerns had been raised.
To make sure people using the service were receiving safe and effective care; auditing systems had been put in place to monitor the quality of the service being provided.