We carried out a review of the data available to us about The Firs on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Firs, you can give feedback on this service.
About the service
The Firs is a supported living service providing personal care and support to people living in their own homes. At the time of the inspection the service was providing personal care to 17 people.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right Care, Right Culture. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Right Support
The model of care and setting maximised people’s choice and control. People lived the lives they wanted to live and had regular opportunities to pursue social interests and be part of their local community. Staff encouraged people to engage in meaningful activities and promoted people’s independence.
Right Care
Staff promoted people's dignity, privacy and human rights. People were involved in decisions about their care and empowered to make decisions about support they received. Staff used a variety of communication methods to support people to make everyday decisions.
Right Culture
The service had a person-centred culture which empowered people to achieve their goals and fulfil their aspirations. Systems were effective in identifying and ensuing people live the life they wanted. Leaders promoted a culture where staff promoted people’s best interests.
People were safeguarded from the risk of abuse and told us they felt safe. There were enough staff to provide safe, compassionate and person-centred care. Risks to people’s physical health and emotional wellbeing were identified, assessed and managed safely and medicines were managed safely. People told us they received good care from staff who cared about their wellbeing.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this location was requires improvement (published 09 April 2021).
Why we inspected
The inspection was prompted in part due to concerns received about care delivery. A decision was made for us to inspect and examine those risks.
We found no evidence during this inspection that people were at risk of harm from this concern.
We undertook a focused inspection to review the key questions of safe, caring and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.
The Firs is a supported living service. At the time of our inspection seven people with learning difficulties were using the service.
Not everyone who used the service received personal care, CQC only inspects where people receive personal care. Personal care is support related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The medicines of one person were not kept securely.
Staff spoke negatively about the management of the service and felt unsupported in their roles.
People and their relatives were not consistently involved in the review and development of care plans.
Relatives and professionals linked to the service told us that management were not consistently responding to issues in a timely manner.
Relatives and people told us they felt safe with the staff who supported them.
Staff had regular safeguarding training and knew about the different types of abuse.
Staff understood their responsibilities in relation to protecting people from the risk of harm.
People were supported by staff who were well trained and competent in their role.
People were assessed before they used the service to ensure their needs and preferences could be met.
Staff understood the importance of ensuring people's rights were understood and respected.
People and their relatives told us they felt well cared for by staff who treated them with respect and dignity and encouraged them to maintain relationships and keep their independence for as long as possible.
Where people lacked capacity, people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s communication needs were assessed and understood by staff. People were provided with information in a format which met their needs.
Staff liaised with other health care professionals to ensure people's safety and meet their health needs.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were working towards consistently meeting the underpinning principles of Right support, right care, right culture.
Right support:
People were supported to be independent and have choice and control. Systems in place were not consistently enabling people to have their voices heard. People were supported to make choices about where they go, what they do and to follow their own interests. People could access the local community and local health services.
Right care:
Care was delivered in a way which meant people's human rights were respected. People had unrestricted access to their home and their own rooms which promoted privacy and dignity. The service worked to ensure that people's human rights were met and supported people to understand they have the same rights and responsibilities as other citizens.
Right culture:
The Firs were working with management and staff at all levels to continually improve the culture of the service. Staff were aware of the organisations visions and values which were centred around supporting people to live meaningful lives. Staff had received specific training to meet the needs of people with a learning disability and spoke passionately about people and the care and support they provided.
The provider confirmed they would make amendments to the care plan review process to ensure people and their relatives were involved in the development of care provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this location was Good (published 27 December 2019).
Why we inspected
We received concerns in relation the management of safeguarding incidents. A decision was made for us to inspect and examine those risks. We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe, Effective and Well-Led sections of this full report.
We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.
We have identified a breach in relation to safe care and treatment at this inspection. The provider responded to the concerns on the day of the inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.