Archived: The Firs Nursing Home

Updated 5 October 2015

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

This unannounced inspection was undertaken by two inspectors.

We visited the home on the 9 July 2015 and spoke with six people who lived there, five members of staff, the manager and the nominated individual for the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us about their experience of living in the home. After the inspection we spoke with three relatives and one healthcare professional who supported people who used the service.

Before the inspection we looked at information we already had about the provider. Providers are required to notify the Care Quality Commission about specific events and incidents that occur including serious injuries to people receiving care and any incidences which put people at risk of harm. We refer to these as notifications. We reviewed the notifications that the provider had sent us and any other information we had about the service to plan the areas we wanted to focus our inspection on. We also contacted the local authority who commission services from the provider for their views of the service.

We looked at records including three peoples care plans and medication administration records. We looked at two staff files including their recruitment process. We also sampled records from training plans, resident meetings, staff meetings, incident and accident reports and looked at the providers quality assurance records to see how the service assessed and monitored the quality of the service.

Updated 5 October 2015

We inspected this home on the 9 July 2015. This was an unannounced inspection. The Firs Nursing Home provides accommodation for a maximum of 25 adults who require nursing or personal care and who have mental health needs. There were 24 people living at the home when we visited although one person was in hospital. The home is set out over three floors with a lift to provide access to all floors. There are eight shared bedrooms and nine single bedrooms. Shared shower-rooms and toilets were located on each floor of the home.

The home does not currently have a 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.

People living at the home and their relatives told us they felt safe and said the staff were very caring. Staff knew how to recognise and report potential abuse and told us they could speak to the manager if they had any concerns. People had access to regular healthcare checks in order to maintain their health needs.

The manager had conducted assessments to identify if people were at risk of harm. However, people were not always protected from harm as these risks were not acted on to reduce the risk of harm to people.

People living at the home and their relatives told us that there were enough staff to meet people’s needs. However, we saw that people were left for substantial periods of time with little or no interaction and that people who were at risk did not have enough staff available to support them.

The Mental Capacity Act 2005 (MCA) sets out what must be done to protect the rights of adults who may lack the capacity to make certain decisions for themselves. Whilst staff had received training about MCA we found that there was a lack of understanding from the provider and staff about what this meant for people living at the home.

People were supported to eat and drink sufficient amounts to meet their needs and maintain good health. People told us they liked the food and were given a choice of meals.

People were not always treated with respect because they were not always involved in planning or providing feedback about their care. We saw that care plans had been reviewed but not always with the person. We saw that, at times, staff acted responsively to peoples requests. People and relatives told us that if they had any concerns or complaints that they had been dealt with appropriately.

People knew who the manager was and said they felt he managed the service well. Staff said that they felt supported within their role.

The systems in place to monitor the safety and quality of the service were not robust and placed people at risk of reoccurring incidents or events. The current systems and checks did not measure the quality of the service and did not effectively identify areas of improvement.

The provider was not meeting the requirements of the law in respect of some regulations. You can see what action we told the provider to take at the back of the full version of this report.