The Firs Residential Home

We found the following examples of good practice.

¿ A visiting pod was used for relatives to visit their family members. Visiting was operated on a pre-booked basis only. Relatives could access the pod from the outside so there was little risk of them spreading infection into the home.

¿ The service provides care to people with varying levels of dementia. The staff described the difficulty in getting people to social distance as some understanding was low. Zoning in relation to communal areas (lounges and dining areas) was practiced to help prevent infection transmission.

¿ Guidance had been followed to ensure safe admissions took place. This included the need for the person moving into the home to have a negative COVID-19 test result and a self-isolation period of 10 days.

¿Stocks of Personal Protective Equipment (PPE) were plentiful. Staff wore face coverings, disposable aprons and gloves when delivering people's personal care. In communal areas they also wore PPE.

¿Adequate stocks of COVID-19 test kits were available. Staff were tested three times a week and people every 28 days. Records were maintained of test results. Where a positive test was identified a period of self-isolation for staff and people was adhered to.

¿ All bedrooms were single occupancy. The majority of bedrooms were provided with en-suite facilities. These bedrooms and facilities enabled social distancing and meant self-isolation could be achieved if required.

¿ Large floor areas of the premises had laminate type flooring which was easier to clean. Staff frequently maintained touch point (for example, grab rails and door handles) cleaning throughout the day to prevent the transmission of infection.

¿Staff had received Infection Prevention and Control (IPC) training and the provider's IPC policy was current and regularly reviewed.

People told us that they were happy living at The Firs and that they received kind and compassionate care. People were encouraged to be as independent as possible and they had their dignity respected.

People received care that was personalised and responsive to their needs. People were involved in the planning of their care and were given choices about how they received their support.

Staff understood how to keep people safe and protect people from the risk of harm and there were enough suitably trained staff to meet people’s needs in a timely way. People received their medicines on time and risks were managed safely.

People had access to a range of meaningful activities and there were systems in place to ensure complaints were dealt with appropriately.

People and their relatives said that the provider and the registered manager were approachable and that they were consulted about the day-to-day running of the service. There was an open culture within the service and the registered manager had mechanisms in place to monitor the care and support people received in order to continually drive improvement through the service.

Rating at last inspection: Good (report published 13 July 2016).

About the service:

The Firs is a residential care home that provides personal care with accommodation for up to 57 older people and those who may have additional needs due to dementia. At the time of our inspection there were 55 people using the service.

Why we inspected:

This was a planned inspection based on the date and rating of the last inspection. The service continues to be rated Good overall.

Follow up:

We will continue to monitor the service through the information we receive.

More information is in the detailed findings below.

The service had 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.

People were safe and staff were able to recognise potential abuse Risks to people were also managed in a safe way. There were enough staff available and they had a training and induction which helped them to support people. Checks were completed by the provider to ensure their suitability to work within the home. People received their medicines safely and they were stored and recorded in a safe way to protect people from the risks associated to them.

Where people were unable to consent, mental capacity assessments had been completed and decisions were made in people’s best interests. The provider had considered when people had restrictions placed upon them and applications had been made to lawfully restrict people’s liberty. Staff knew their roles in relation to this and how to protect people.

People and families told us they were involved with reviewing their care and knew how to complain if they were concerned. When needed people were reviewed by healthcare professionals and when recommendations made these were followed by staff. People’s privacy and dignity was promoted and they were treated in a caring way. People were encouraged to be independent and make choices about their day. Families were free to visit as they chose and they felt welcomed by the home There were choices at mealtimes and people told us they enjoyed the food.

Quality monitoring was completed by the provider and was used to bring about changes to the home. Feedback was obtained from people who used the service and this information used to make changes. Staff felt supported and were given the opportunity to raise concerns. People told us the home was well manager and spoke positively about it. There was a registered manager in post and people knew who this was. The provider understood about their responsibilities of registration with us.

We saw that the care plans were person centred and individualised and that what was important to people had been recorded in their individual plans of care.

There was a four weekly seasonal menu in place in the reception area. The home had some refurbishments to the kitchen and dining room in progress at the time of inspection.

We found that the home was clean and tidy throughout and that the cleaning schedules enabled effective cleaning of the service. Relatives told us that the home was always clean and tidy.

Staff were well supported and supervised. Mandatory and development training was available and up to date. Staff told us that the induction procedure at the service was tailored to their individual needs and took account of their previous experience.

We saw that the service had an effective compliments and complaints service. The service had only received compliments over the preceding 12 months. The last complaint had been received in 2009.

We found that people's care plans were personalised and clearly showed what care and support each person required and had received. One relative told us, "They involve us a lot with the care plan and our family member is included as much as possible".

We saw that people who used the service were protected from the risk of abuse. We found that the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

We saw that there were effective processes in place for the safe and secure handling of medicines and that people's prescriptions were up to date.

We saw that there were effective recruitment procedures in place, and one relative told us, "They are very particular here; they choose the staff very carefully".

The manager showed us very detailed audits that were used to monitor the quality of the care provided by the home and of the way the home was run. We were shown the recent refurbishments and told about future improvements to be made to the refurbishment plan in 2013.