Archived: The Firs Care Home with Nursing

Updated 30 June 2016

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 1 and 2 March 2016 and was unannounced. The inspection visit was conducted by two inspectors and a specialist nurse advisor.

Before our inspection visit we reviewed the information we held about the service including notifications the provider sent us. A notification is information about important events which the service is required to send us by law. For example, notifications of serious injuries or allegations of abuse. We spoke with the local authority and health commissioning teams and Healthwatch Derbyshire, who are an independent organisation that represents people using health and social care services. No concerns were raised by them about the care and support people received. Commissioners are people who work to find appropriate care and support services which are paid for by the local authority or by a health clinical commissioning group.

We asked the service to complete a provider information return (PIR). This is a form that asks the provider to give us information about the service, what they do well, and what improvements they are planning to make. This was returned to us by the service.

During the inspection we spoke with eight people who used the service and four relatives. We spoke with six care staff, one nurse, the cook, the activities coordinator, one housekeeping staff, the deputy manager, the manager and the area manager for the provider. We also received the views of one healthcare professional. We looked at a range of records related to how the service was managed. These included eight people’s care and medicine administration records, three staff recruitment and training files, and the provider’s quality auditing system.

Not all of the people living at the service were able to fully express their views about their care. 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.

Updated 30 June 2016

This inspection visit took place on 2 and 3 March 2016. The inspection was unannounced.

The Firs Care Home with Nursing provides accommodation, nursing and personal care for up to 42 people, including people who lived with dementia. There is an extra care unit within the location providing specialist dementia care for up to 12 people. At the time of our inspection, 33 people lived at the home.

The service had a new manager. They had not yet applied to be a registered manager with the Care Quality Commission. The provider assured us that the manager intended to register. 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.

People felt safe, and were supported by staff who understood how to keep them safe from the risk of abuse or preventable harm. Care and activities were risk assessed and people were supported to take part in activities whilst remaining safe.

People received care and support from a trained and motivated group of staff. There were enough staff to meet people’s needs, and staff supported people when they needed it. The provider ensured they recruited staff who were suitable to work in a caring environment, and provided new and existing staff with training to ensure they had the right skills and knowledge to meet people’s needs.

People received their medicines as prescribed. Staff were trained to manage medicines in a safe way and in accordance with professional guidance.

Staff obtained consent from people before providing support. Where they were not able to do this, staff understood the requirements of the Mental Capacity Act and Deprivation of Liberty Safeguards.

People were supported to maintain a balanced diet by staff who understood people’s individual needs and preferences.

People were supported by staff who demonstrated kindness and a positive caring attitude. We saw staff consistently support people in a patient and respectful way, and people’s dignity was promoted at all times.

People were supported to maintain relationships that were important to them, and relatives were welcomed to visit and participate in life at the home. People were supported to remain active and to take part in activities and hobbies they enjoyed both in the home and their local community.

People were involved in making decisions about their care as much as possible, and staff understood people’s specialist needs, particularly in the area of dementia care.

The provider had a clear complaints policy, and people and relatives felt able to make a complaint or raise concerns. The provider investigated complaints according to their policy, and created opportunities for people to provide regular feedback about the service, which was acted on.

There were systems to monitor and review all aspects of the service, and these were undertaken regularly. This meant the provider was able to identify areas of good practice and areas for improvement, and to make changes to improve the quality of the service.