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The Firs Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 8 January 2020

About the service

The Firs Nursing Home can accommodate 31 older people and people living with dementia and nursing needs in one adapted building. Accommodation is provided on three floors; a passenger lift is available. At the time of our inspection 26 people were living at the service.

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

People did not receive consistent safe care. People’s dependency needs had not been consistently reviewed, to ensure staffing levels were sufficient in meeting people’s individual care needs and safety. Risks associated with people’s care needs and health conditions had been assessed. However, documentation to confirm care needs had been provided at the frequency required showed gaps. Pressure relieving mattresses to assist in the prevention of pressure ulcers developing, were not set correctly. Best practice guidance in the administration and management of medicines were not followed. Equipment was not consistently clean.

Staff were aware of their responsibilities to protect people from abuse and avoidable harm. Safe staff recruitment checks were completed before staff commenced. Health and safety checks were completed on the environment. The provider had a process that analysed accidents and incidents, but this information was not available during the inspection.

People did not receive consistent effective care. Where people had been identified at risk of malnutrition and required additional snacks, this was not seen to be provided. People’s pre-admission assessment showed gaps in important information such as a person’s religion, social history, interests and hobbies. The environment required some refurbishment work, it was not clear of the plans in place to complete this. Best interest decisions completed for people who lacked mental capacity to consent to their care, did not consistently show who had been involved in the decision-making process.

Staff received an induction, ongoing training and opportunities to discuss their work. Staff worked with external health care professionals in supporting people’s health care needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People did not receive care that consistently respected their dignity. Staff used good communication skills and understood people’s needs and involved them as fully as possible in their care. Advocacy information was available for people should they have required this support.

People did not receive care that was consistently responsive to their individual care needs. Staff were not always responsive to requests for assistance, resulting in a delay of care and support. Social activities and opportunities for people to pursue interests and hobbies were very limited. Complaints had not always been responded to in a timely manner.

People received good end of life care.

The leadership of the service had been poor, and this had resulted in staff not being sufficiently supported and guided. Staff were task focused and there was a lack of direction. Whilst audits and checks monitored quality and safety these had not been fully effective in driving forward improvements.

People received opportunities to feedback their experience of the service. The provider had met their registration regulatory requirements.

Rating at last inspection

The last rating for this service was Requires Improvement (published 4 December 2018). The service remains rated Requires Improvement. This is the provider's third consecutive rating of Requires Improvement.

Why we inspected

This was a planned inspection based on the previous rating.

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

Enforcement

During this inspection, we identified three breaches of the Health and Social Care (Regulated Activities) 2014. This was in relation to pe

Inspection areas

Safe

Requires improvement

Updated 8 January 2020

The service was not always safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 8 January 2020

The service was not always effective.

Details are in our Safe findings below.

Caring

Requires improvement

Updated 8 January 2020

The service was not always caring.

Details are in our Safe findings below.

Responsive

Requires improvement

Updated 8 January 2020

The service was not always responsive.

Details are in our Safe findings below.

Well-led

Inadequate

Updated 8 January 2020

The service was not well-led.

Details are in our Safe findings below.