Firtree House Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question Good. At this assessment the rating has remained Good.

This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Management had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion. A professional told us, “There is a culture of openness and transparency, in sharing issues and asking for support when needed through clear communication and honest practices. They have always been responsiveness in their approach if we have a query when I have spoken to them.” A relative said, “I have always been given a warm welcome by the friendly staff. I know that I will not have taken more than a few steps into the lounge before I am greeted with a warm ‘hello’ and smiles from everyone I see on my way to [person]. Visiting can be hard when your loved one has become unresponsive so the warm greetings proffered mean a great deal and are helpful.”

It was clear that a positive and supportive culture existed within the service. Staff were seen communicating effectively and sharing information to ensure people received timely and appropriate care. Team members were respectful of each other’s roles and this teamwork helped to ensure that people’s needs were met without delay. One staff member said, “The team is friendly and the manager listens to our ideas.” Another told us, “I go to the management and I tell them in order to do this I need XYZ and then they provide whatever I need for the activities. If we need to then they will put on an extra carer.”

The registered manager’s told us, “Our clinical lead leads by example and sets the standards. We have embedded a culture of learning from our shortfalls and mistakes, which has had a positive impact on staff attitudes and morale. We do not use agency staff which ensures good continuity of care.”

Management had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support. Leaders had the skills, knowledge, experience and credibility to lead effectively. A professional told us, “One thing I would like to mention what stands out for me about this provider is the owners/management team are well embedded within the staff team; they know what is going on.”

Management had a very good knowledge of the people they supported and were actively involved in their care. They clearly understood what good care looked like and were experienced in all aspects of the service. One told us, “Staff never know when we are going to turn up. We do night spot checks. I came in about 2 months ago as I wanted to understand how incontinence pads were being used. The outcome was that we have purchased more for staff as this helps reduce the risk of moisture lesions for people.”

Staff were happy working at the service and felt supported by management. One told us, “I am happy here. They (management) do value you and they respect you. They say thank you when you leave this home.”

Management fostered a positive culture where people felt they could speak up and their voice would be heard. Staff said they would be comfortable speaking up with 1 telling us, “I feel safe at work because safeguarding is a big priority.” Other’s told us, “Management has an open-door policy. If I raise an issue they will deal with it straight away” and, “They listen when you speak up.”

A recent concern had been raised by a whistleblower and management met with staff to discuss this and obtain staff feedback. They told us they treated this as an incident and the outcome of discussions with staff were their lessons learnt.

People told us they would have no concerns speaking with staff or management if they had any concerns.

Management valued diversity in their workforce. Staff had been recruited from overseas and to assist with them settling into the role and the English culture, appropriate training had been provided.

Management told us, “Yesterday, we celebrated Diwali with our staff. We recognise and respect the different religious beliefs and festivals of our team by offering special breaks during these occasions. We also have a staff of the month scheme which recognises exceptional work.”

In the staff entrance area, a board was displayed featuring pictures of staff each with country flags or pictures of personal passions which reflected the ethnically diverse makeup of the staff team. Staff said, “We have different people from different backgrounds but everybody is treated equally. Everybody is allowed to share their opinion.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support.

Regular audits were carried out by the management team. This included infection prevention and control, medicines and the safety of the service. However, these audits had not identified the shortfalls we found on our visit, such as the medicines stores and air mattress setting and although management took immediate action to rectify these, more robust auditing processes needed to be embedded into the service to help ensure that practices were consistently safe.

Evidence of action taken from audits was clear, such as reminding housekeeping staff on making up fresh cleaning solutions at each shift, or observing staffs handwashing techniques. A recent pharmacy audit of medicine practices within the service identified no issues.

Management worked with external professional in relation to the governance within the service. They took advice and sought support and used this to develop the service.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Staff had a close relationship with the local GP practice and they supported each other to help ensure people received the best and most appropriate care. In addition, staff worked with the speech and language therapy team, psychiatry colleagues and mental health services. Management told us how they appreciated the involvement from the Homelife training scheme run by the Integrated Care Board (a scheme to improve the quality of life for people who live and work in care homes).

The service was a member of the NAPA Society which is a registered charity who focus on wellbeing for people through activity. A local church group ran services regularly within the service and outings were organised for people to local shops and the surrounding area.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. A staff member said, “We are always looking at better ways. Activities and also day-to-day things.”

Management said a consultant/trainer advised the service about ongoing improvement and management shared this learning with the staff team.

There was a lessons-learnt culture within the service where changes made were disseminated to the staff team.

We found management to be responsive to our findings during our visit. Where we discussed areas that required improvement they acted immediately and introduced and established new processes and systems to help ensure that the changes were embedded.