The Firs

Updated 17 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was completed by two inspectors.

Service and service type

The Firs is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. The Firs is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post, however they were not involved in the inspection process. There was a new manager in post who had applied to register as the new registered manager.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider completed a PIR prior to the inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with three people who used the service and four relatives about their experience of the care provided. As well as speaking with people we observed staff interactions and people's body language whilst in their home. We spoke with four staff which included the regional manager, the manager and support workers. We reviewed a range of records. This included two people's care records and medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 17 November 2022

We expect health and social care providers to guarantee people with a learning disability and autistic people

respect, equality, dignity, choices and 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 supporting people with a learning disability and autistic people

and providers must have regard to it.

About the service

The Firs is a residential care home providing personal to six people at the time of the inspection. The service can support up to seven people.

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

Right Support

The care plans did not always focus on people’s strengths and aspirations and did not highlight some key risks for people.

Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome, however there was further development needed with the, ‘as and when required’ medicine protocols. Following on from the inspection the management contacted the relevant health professionals to create the missing protocols.

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.

The service gave people care and support in a safe, clean, well equipped, well-furnished and well-maintained environment that met their sensory and physical needs.

Staff supported people to play an active role in maintaining their own health and wellbeing and enabled people to access specialist health and social care support in the community.

Right Care

The provider made sure that there was enough skilled staff to meet people’s needs and keep them safe, however there was further development needed for staff to have training specifically for learning disability and autism. This was something that the provider was actioning.

Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and they knew how to apply it.

The manager was very proactive in ensuring peoples had the care and treatment they needed; however, this did not always reflect in care plans.

Right Culture

Professionals spoke highly about the responsiveness of staff and the management team when supporting people.

The provider had recently developed a new quality assurance system. Actions were documented and improvements implemented. However there needed to be further development in capturing lessons learnt particularly where incidents and accidents occurred.

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

Rating at last inspection and update

The last rating for the service under the previous provider was requires improvement, published on 23 April 2021 and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 20 July 2021 with the previous provider. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve managing risks to people’s health and safety, ensuring staff were suitably qualified and skilled to support people.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Firs on our website at www.cqc.org.uk

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.