CQC report explained · a nursing home
What the CQC found at Firtree House Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Staff understood risks, medicines were managed safely, staffing levels were considered sufficient, and infection control arrangements were found to be effective. Some risk records were not completed accurately.
- Effective?
- Good
- People's needs were assessed before they moved in and staff had the skills and training needed. People received support with food, drink, healthcare and decision-making, and the inspection found no evidence of harm from the nursing-care concerns that had prompted it.
- Caring?
- Good
- This key question was not inspected during this focused visit. The report says the previous rating was used when calculating the overall rating.
- Responsive?
- Requires improvement
- This key question was not inspected during this focused visit. The report says the previous rating was used when calculating the overall rating.
- Well-led?
- Requires improvement
- The home had supportive management, regular meetings and systems for gathering feedback. However, some risk assessments and monitoring charts were not reliable, and audits had not identified all the shortfalls found by inspectors.
What inspectors found, March 2023
Rated Good overall; inspectors found safe, effective and caring support, but management checks and some care records needed improvement.
This was an unannounced focused inspection on 10 and 17 January 2023. Inspectors reviewed information, spoke with people, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
The home was rated Good overall. Safe and Effective were rated Good. People and relatives said they felt safe and described staff as kind, caring and friendly. Staff understood people's needs, medicines were managed safely, and people could access healthcare.
Well-led was rated Requires Improvement. Some risk assessments were inaccurate or lacked detail. Monitoring charts were not always completed consistently. The home's audits had not found all these problems.
The inspection was focused on Safe, Effective and Well-led. Caring and Responsive were not inspected at this visit, so their earlier ratings were carried forward when calculating the overall rating.
Kind and caring staff
People and relatives described staff as kind, caring and friendly. Inspectors found that staff knew people well and understood their needs.
“Staff were described by people and relatives as kind, caring and friendly.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment records showed checks on employment history, references and criminal-record information.
“There were enough staff deployed to meet people's needs.” from the report
Safe medicines
Medicines were stored securely and records were completed accurately. Nurses had been trained and assessed as competent to give medicines.
“Medicines were managed safely in line with national guidance.” from the report
Good access to healthcare
People were referred to doctors and other health professionals when needed. Their care records included health needs and details of professional visits.
“There was input from health care professionals such as GPs or tissue viability nurses where appropriate.” from the report
Risk records lacked detail
needs fixingSome risk assessments were inaccurate, had not been updated after changes, or lacked enough information about risks such as constipation and catheters. Staff knew people's needs, but the records could not always be relied on.
“Risk assessments were not always completed accurately, and some assessments had not been updated when changes had been made.” from the report
Monitoring records were inconsistent
needs fixingCharts for weights, fluids and repositioning were in place but were not always completed consistently. Inspectors found no evidence of harm, but said this created a potential risk that people might not receive the right care.
“Although there was no evidence people had been harmed because of this, there was a potential risk people might not get the right care.” from the report
Audits missed problems
needs fixingThe home carried out regular audits, but these checks had not identified some of the recording problems found during the inspection. The provider said its audit and monitoring processes were under review.
“However, internal audits had not identified some of the shortfalls found during this inspection.” from the report
- 01How have you updated risk assessments where people's needs or treatment have changed?
- 02How do you check that weight, fluid and repositioning charts are completed every time?
- 03What changes are being made to the audit system after it missed the problems found by inspectors?
- 04How will you show that the improvements to risk records and monitoring are working?
- 05What were the ratings for Caring and Responsive at the previous inspection, and when will these areas next be reviewed?
This was an unannounced focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 4 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2020
Firtree House Nursing Home was rated Good after improvements; inspectors found safe care, enough staff and stronger quality checks, but this visit only assessed Safe and Well-led.
Inspectors made an unannounced focused inspection visit on 30 September 2020. They spoke with people living in the home, relatives, staff and managers. They reviewed care plans, medicines records, safety records, policies, audits and staffing information.
Safe and Well-led were both rated Good. Inspectors found that people were protected from abuse, medicines were managed safely, staffing levels were sufficient and recruitment checks were in place. Infection prevention and control arrangements were also considered effective during the COVID-19 pandemic.
The home had improved from Requires Improvement at the previous inspection. The earlier problems with medicines, care records, quality checks and notifications to CQC had been addressed. This report only covers Safe and Well-led. Ratings for the other areas were carried forward from the previous comprehensive inspection.
Safe medicines
Medicines were stored securely, given at the right time and supported by complete records and guidance.
“Prescription and administration records were complete and accurate.” from the report
Staffing
Inspectors found enough nurses and care staff on duty. Shifts were reliably filled and no agency staff were being used.
“There were enough nurses and care staff on duty.” from the report
Safety systems
Risks such as falls, pressure damage, burns and fire were being managed. The home also reviewed incidents and took action to reduce repeat risks.
“When things had gone wrong suitable action was taken to reduce the chance of the same thing happening again.” from the report
Stronger management checks
The home had improved its monitoring of care and its process for notifying CQC about significant events.
“Quality checks had been strengthened to more closely monitor the provision of nursing and personal care.” from the report
Inspectors raised no specific concerns in this report.
- 01How have you continued to check that patch medicines, thickened drinks and injected medicines are managed safely?
- 02What are the current staffing levels on each shift, and are shifts still being filled without agency staff?
- 03What quality checks are now completed, how often are they reviewed, and what action is taken when a problem is found?
- 04What are the current ratings and recent inspection findings for Effective, Caring and Responsive, which were not assessed in this visit?
- 05How do you keep relatives informed about infection control and visiting arrangements?
This was a focused inspection of Safe and Well-led, including infection prevention and control; the other ratings were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 17 October 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Firtree House Nursing Home
5 rated inspections over 7 years: the service has held its Good rating throughout.
- March 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2020Goodup from Requires improvementSafe: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodWell-led: Requires improvement
- June 2018Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- July 2013
Registered with the Care Quality Commission on 4 July 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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