Archived: Firbank Nursing Home

Updated 16 May 2018

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.

The inspection took place on 20 and 22 February 2018 and the first day was unannounced. The inspection team consisted of one adult social care inspector, one specialist advisor in health and safety and one expert by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Prior to the inspection, we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider completed this in line with requested timescales.

We also contacted the local authority, the local authority safeguarding team and Healthwatch to seek their views about the service. The local authority told us they had some concerns and were working with the service to help them improve. We also considered information we held about the service, such as notifications in relation to safeguarding and incidents which the provider had told us about.

As part of the inspection we spoke with seven people living in the home, two relatives, two members of care staff, the chef, the deputy manager and the operations director of the care management company in the home. 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.

We looked at the recruitment records of three care workers, the care records of three people and the medication records of three people. We also looked at records relating to the running of the service which included staff rotas, records of accidents and other incidents, training records, servicing and maintenance records and audits and checks carried out.

Updated 16 May 2018

This inspection took place on 20 and 22 February 2018 and was unannounced. We last inspected Firbank on 18 October 2016 at which time we rated the service requires improvement overall and identified breaches of four regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection we asked the provider to complete an action plan to show what they would do and by when to improve the key questions of is the service safe, is the service effective, is the service responsive and is the service well led to at least good.

At this inspection we found the provider had made improvements to some of these areas but was continuing to breach two regulations of the Health and Social Care Act 2014. You can see the action we have told the provider to take at the end of this report.

Firbank Nursing Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Firbank provides nursing care for up to 21 people. Firbank is located close to Bramhall and the local amenities. The accommodation is arranged over two floors accessed via stairs or a passenger lift. The home has a communal lounge that leads into the dining room area with doors that lead onto the enclosed rear garden. There is a large garden at the rear and patio areas.

At the time of our inspection the home did not have a registered manager, but interviews were taking place. Shortly after our inspection a manager was appointed. 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.

We found some hot water outlets in the home reached temperatures where people would have been at risk of scalding. We also found some hot water outlets where the temperature was not high enough to destroy bacteria and so minimise the risk of infection.

We made the provider aware of these issues and they immediately called a plumber to try and rectify the issues. By the second day of our inspection the plumber had fitted temperature control valves on most of the outlets, however one of the showers in the home wasn’t able to be restricted and so the management put the shower room out of use until an appropriate shower could be fitted.

Portable Appliance Testing (PAT) in the home had not been carried out since 2014 meaning potentially unsafe electrical items may have been in use in the home.

People we spoke with told us they felt safe. One person told us; “I do feel safe. I don’t know what makes me feel safe but I do.” A relative we spoke with told us; “[My relative] is being cared for well and they like it here.”

People’s medicines were managed safely in line with national guidelines. During the inspection we saw people being asked for their agreement to take medicines.

Rather than having fixed breakfast times, people were able to have breakfast whenever they got up. There was a choice of meals available and if people didn’t like either option the chef was happy to make them other meals. People were involved in planning the menus and enjoyed the food. One person we spoke to told us; “[My lunch] was delicious. It really was very, very nice.”

People and their relatives were involved in planning their care and people’s needs were kept under regular review.

Many staff working in the home had worked there for a long time. When people were recruited appropriate checks were done before the person was allowed to start work. New staff underwent training in a number of areas to enable them to deliver care safely and their competency was kept under review.

Care workers told us they felt valued and supported by management and were able to speak with them to discuss any concerns or suggestions they had. Staff worked well together and treated each other, as well as people living in the home with respect.

During the inspection we found the atmosphere in the home to be calm and relaxed. Staff knew the people living in the home well and made a point of engaging them in conversation whenever they passed through a communal area. Where people preferred to stay in their rooms we observed staff making regular checks to ensure they were ok and whether they needed anything.

People living in the home told us they were happy and we observed numerous caring interactions between care workers and people living in the home.