The Firs

Updated 7 July 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

The inspection was carried out by one inspector and an 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.

Service and service type

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

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post, however, they were not in day to day management of the service. A new manager had been appointed and had been managing the home for three months with the support of the registered manager. The new manager had applied to CQC to register.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service. We sought feedback from three health and social care professionals that had regular contact with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service, three members of staff, the registered manager, the new manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We carried out observations in communal areas to see how staff interacted with people and checked the premises to ensure they were clean, hygienic and a safe place for people to live. We reviewed a range of records including audits and medicines administration records and three staff files in order to check that they had been recruited safely.

After the inspection we spoke with seven relatives to gain feedback about the service. We continued to review a range of records which included four people's care records and a variety of records relating to the management of the service including policies and procedures. We continued to seek clarification from the provider to validate evidence found.

Updated 7 July 2022

About the service

The Firs is a care home, without nursing, accommodating up to 22 people. At the time of our inspection there were 16 people using the service. The accommodation is arranged over two floors with a passenger lift, and stairs, available to access the upper floor. Some rooms are ensuite. There is an accessible, mature garden surrounding the home and a patio area with seating areas. Some of the people using the service were living with dementia.

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

The assessment of risks to people’s safety had improved which supported people to stay safe. Staff recruitment checks promoted safety. There were sufficient staff deployed to meet people’s needs. The manager was embedding best practice guidance in relation to the safe management of medicines. We have made two recommendations about this. Improvements had been made to ensure that appropriate records were maintained of the cleaning that took place. The home continued to looked visibly clean with high standards of cleanliness and hygiene throughout. The provider’s approach to visiting aligned with government guidance. People told us they felt secure living at The Firs and relatives were confident that their family members were safe from abuse.

The leadership team had been working effectively with a range of external organisations to drive improvements within the service. Feedback from these organisations about progress was positive. Overall, the audits that were in place were being used more effectively to monitor the quality of care that was being provided. Further work was needed to ensure that guidance and frameworks relating to assessing mental capacity were fully implemented. People and their relatives told us that staff provided person centred support and encouraged them to have freedom of choice and control over what they did. The leadership team had created a more positive work culture where staff felt valued. The manager was visible within the service, undertaking checks and audits but also supported with the delivery of care when needed. The manager actively sought the views of people, staff and relatives about the quality of care and how the service might improve. The manager had a clear vision for the direction of the service and understood the areas where the service still needed to make improvements.

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 this service was requires improvement (published 6 January 2022) and there were breaches of Regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on 16 November 2021. 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 the safety of recruitment procedures and the robustness of the governance arrangements.

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 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 changed from requires improvement to good. 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.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.