CQC report explained · a residential care home
What the CQC found at The Firs Care Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, June 2018
The Firs Care Home was rated Good overall, with Outstanding caring and inspectors finding safe, personalised care and effective leadership.
Inspectors visited without notice on 8 and 9 May 2018. They spoke with people living in the home, relatives, staff and health professionals. They observed care and checked care plans, medicines records, staffing, training and quality checks.
The home was rated Good for being safe, effective, responsive and well-led. Caring was rated Outstanding. Inspectors found kind and respectful staff, enough staff to meet people's needs, safe medicines systems and care plans that reflected people's individual preferences.
This was an improvement from the previous inspection. Earlier concerns about care plans had been addressed. The home had already improved its responsive rating to Good, and inspectors found that these improvements had continued.
Kind and personal care
Staff were consistently described as kind, compassionate and respectful. Inspectors saw people who appeared comfortable and relaxed with staff.
“The service was exceptionally caring. The service worked to create a homely, comfortable environment where people were supported to develop strong relationships with each other and care staff.” from the report
Safe staffing
Inspectors found enough staff to meet people's needs. Staffing was reviewed using people's needs and call bell response times.
“People were supported by sufficient numbers of staff.” from the report
Safe medicines
Staff were trained to give medicines safely. Records checked by inspectors had no gaps, and medicines were stored and disposed of safely.
“People received their medicines safely from staff that had the required skills and knowledge to carry out this task.” from the report
Personalised care plans
Care plans included people's routines, preferences, life histories and specific support needs. They were reviewed when people's needs changed.
“Each person had a care plan which was tailored to meet their individual needs.” from the report
Active quality checks
Management used audits, staff feedback, incidents and other checks to identify problems and make changes.
“There was an effective quality assurance system in place to ensure any improvements needed within the service were identified and the necessary action was taken to implement change.” from the report
Activities coordinator not in post
minorPeople had activities and social opportunities, but there was no activities coordinator at the time of inspection. Senior management was overseeing activities while an appointment was hoped for.
“At present there was no activities coordinator in post, although it was hoped to make an appointment in the near future.” from the report
- 01Who currently plans and leads activities, and how are activities matched to my relative's interests and abilities?
- 02How will you involve my relative and our family in writing and reviewing their care plan?
- 03How do you check that staffing remains sufficient at busy times, including the afternoon?
- 04If my relative may lack capacity for a decision, how will you involve them and record the decision in their best interests?
- 05How will you record and respect my relative's wishes about end of life care?
This was an unannounced comprehensive inspection on 8 and 9 May 2018, covering all five CQC questions and reviewing care, medicines, staffing, records and management. This explanation was written from the published report of 7 June 2018 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, May 2017
Rated Good overall, but responsive care was Requires Improvement because some risk records and interactions were not consistently right.
This was an unannounced focused inspection on 13 February 2017. Inspectors checked whether improvements had been made after the previous inspection. They spoke with people using the home, relatives, staff and managers, observed care and looked at five care records.
The home had rewritten its care plans. They contained detailed information about people's needs, preferences and support. People, relatives and staff had helped develop them, and they were being updated as needs changed.
There were still problems with some risk assessments. Records about nutrition and pressure ulcer prevention did not always match people's actual needs. Inspectors also saw two examples where dignity and communication could have been better. The overall rating stayed Good, but Responsive was Requires Improvement because good practice had not yet been shown consistently over time.
Detailed care plans
Care plans had been rewritten with detailed information about individual needs, preferences and support. People, relatives and staff had contributed to them.
“The information within people's care plans was detailed and reflected individual needs, personal preferences and the support required.” from the report
Staff knew people well
Staff were generally aware of people's needs and preferences. Inspectors saw many positive interactions and found that requests and call bells were dealt with promptly.
“Staff knew people well and were responsive to their needs.” from the report
People and relatives felt able to raise concerns
People and relatives knew how to complain or raise an issue. They said concerns had been dealt with quickly and to their satisfaction.
“People and their relatives were aware of how to raise a concern, if they were not happy with the service.” from the report
Support to take part in activities
Some people were supported to walk or visit the local shop. Others enjoyed music, visitors and community activities.
“During the inspection, staff accompanied some people to go for a walk or to the local shop.” from the report
Some risk records were inaccurate
seriousSome assessments did not match information in people's care plans. This could mean that needs linked to eating, weight loss or pressure ulcer prevention were not managed as planned.
“There were assessments which identified potential risks to people. These included the risk of malnutrition, pressure ulceration and falling. However, not all were accurately completed.” from the report
Dignity and communication were not always right
needs fixingOn one occasion, staff spoke about a person rather than speaking to them. On another, a staff member helped someone eat without sitting beside them, which did not protect their dignity or safety.
“There was no acknowledgement of the person and what they wanted.” from the report
Activities provision was still developing
minorThe home was recruiting a full-time staff member to organise social activities. Managers hoped this would help people go out more often.
“They said they hoped this would enable people to go out more often to places within the town, such as the library.” from the report
- 01How do you check that risk assessments match each person's current needs, especially around nutrition, weight loss and pressure ulcer prevention?
- 02How often are care plans and risk assessments reviewed, and who checks that changes are recorded accurately?
- 03How do you make sure staff speak directly to people and protect their dignity when providing help with eating or personal care?
- 04Has the full-time activities post been filled, and what activities and outings are now available?
- 05How can relatives raise a concern, and how will you keep them informed about changes in their family member's needs?
This was a focused inspection of Responsive care to check whether earlier legal requirements had been met; it did not reassess the other four questions. This explanation was written from the published report of 6 May 2017 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 The Firs Care Home
3 rated inspections over 2 years: the service has held its Good rating throughout.
- June 2018Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- May 2017Goodstayed GoodResponsive: Requires improvement
- April 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2014
Report published without a new overall rating.
- February 2014
Report published without a new overall rating.
- November 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- August 2011
Registered with the Care Quality Commission on 23 August 2011.
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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