Archived: The Firs Residential Home

Updated 26 March 2015

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.

This inspection took place on 4 and 16 December 2014 and was unannounced.

The inspection team was one inspector. In preparation for the inspection we reviewed information we held about the home. This included the 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 had not been asked to submit a PIR in time for the inspection. We also reviewed notifications of incidents the provider had sent us since the last inspection.

During the inspection we met with 19 people who lived in the home; most of them were living with dementia and were unable to communicate their experience of living at the home in detail. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We spoke with four people using the service, and two of their relatives and friends to obtain their feedback.

We spoke with the registered manager, eight care staff and four support staff. We looked at the care records of four people and five people’s medicine records (MAR’s). We looked at four staff recruitment files and a variety of quality monitoring arrangements in the home. We obtained feedback from five health and social care professionals, which were a commissioner, two GP’S and two district nurses.

Updated 26 March 2015

This inspection took place on 4 and 16 December 2014 and was unannounced. The Firs Residential Home cares for up to 29 older people who are living with dementia. At the time of our visit the provider had built an extension to add an additional seven bedrooms. They were in the process of registering these additional bedrooms with the Care Quality Commission (CQC). Since this inspection the home has been granted registration to provider accommodation for seven additional people taking their registration up to 36 people.

At the time of our visit there were 27 people living at The Firs. Many of the people who were living at the home have dementia and lacked capacity, and were not able to communicate their experiences of the care they received.

We last inspected the home in December 2013. At that inspection we found the service was meeting all the regulations inspected.

The home had a registered manager who had registered with the Care Quality Commission (CQC) in September 2014 and had a degree qualification in dementia studies. A registered manager is a person who has registered with the CQC 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.

On the two days of our inspection there was a calm, friendly and homely atmosphere. People seemed happy and relaxed. We observed interactions between staff and people living in the home and found staff were kind and respectful to people when they were supporting them. Staff were aware of the values of the home and knew how to respect people’s privacy and dignity. Everyone spoke highly about the care and support at the home. One person said, “They look after me very well”. A health professional said “Staff were always kind and friendly to the people who live there” and they had no concerns about the care provided. A visitor said ““Nothing has been too much trouble; everyone has been very kind and thoughtful”.

Suitable arrangements were in place to ensure people’s nutritional needs were met. People were provided with a choice of healthy food and drink

Care records met people’s individual needs and gave staff the information and guidance they needed. They contained detailed person centred information about how people wished to be supported. People’s risks were well managed, monitored and regularly reviewed to help keep people safe. The home were transferring to a new care recording system that was more comprehensive and staff were positive about the new recording system.

People were supported to take part in a varied range of activities and were developing close links with the community. Activities were meaningful and reflected people’s interests and hobbies.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff understood their role with regards the Mental Capacity Act (2005) (MCA) and the associated Deprivation of Liberty Safeguards (DoLS). Applications were made and advice was sought to help safeguard people and respect their human rights. All staff had undertaken training on safeguarding adults from abuse; they described what action they would take to protect people against harm. Staff said they felt confident any incidents or allegations would be fully investigated. People told us they felt safe.

People knew how to raise concerns and make complaints. Records showed and people said concerns raised had been dealt with promptly and satisfactorily. Staff were supported by the registered manager and were able to raise any concerns with them. Lessons were learnt from incidents that occurred at the home and improvements were made when required. The registered manager and provider’s senior manager reviewed processes and practices to ensure people received a high quality service.

People were at the centre of the home and their opinions were sought. There was an effective quality assurance system in place that monitored people’s satisfaction with the service. Audits were carried out and were used to help make improvements and ensure good delivery of care and support provided by the home.