CQC report explained · a residential care home
What the CQC found at The Firs Residential Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2023
Rated Inadequate and placed in special measures; inspectors found serious risks to people's safety, care and living conditions.
Inspectors visited on 28 September and 10 October 2023, with inspection activity ending on 24 October. They spoke with people, relatives, staff and health professionals. They observed care and checked care records, risk assessments, medicines, staff records, complaints, accidents and quality checks.
They found serious problems with fire safety, cleanliness, repairs, staffing and the management of risks. The fire alarm had been switched off, some fire safety work had not been completed, the building was in poor repair and there were infection control concerns. The home did not always have enough skilled staff to support people safely.
Care records sometimes conflicted or had not been updated after people's health or needs changed. People were not always involved in care decisions, received limited meaningful activities and were not always supported in a person-centred way. Staff were generally kind, but leadership was weak, there was no registered manager and previous improvements had not lasted.
The overall rating is Inadequate. Safe, effective and well-led were rated Inadequate. Caring and responsive were rated Requires Improvement. The home is in special measures, so CQC said it would keep the home under review and normally re-inspect within six months.
Kind staff
People and relatives mostly said staff were kind and caring. Inspectors also saw staff giving reassurance and encouragement during care.
“In the main people spoken with told us that staff were kind and caring when supporting them.” from the report
People enjoyed meals
People told inspectors they generally enjoyed their meals and could get drinks when they wanted them. However, choices and dietary records were not always handled well.
“People told us, and we saw that people seemed to enjoy their meals.” from the report
Some health partnerships
A visiting health professional said staff followed their advice. Inspectors also found that the home worked with health and social care professionals to support people's wellbeing.
“A visiting health professional told us they were confident staff followed their guidance and advice when caring for people.” from the report
Medicine storage checks
Medicines were stored securely and temperature checks were completed. Inspectors still noted that medicine guidance and explanations to people needed improvement.
“Medicines were stored securely, and temperature checks were undertaken to ensure the room did not get too hot, so the medicine remained effective.” from the report
Fire and environmental safety
seriousThe fire alarm had been switched off and required repairs had not been completed promptly. Inspectors also found poor cleanliness, a fly infestation, unsafe flooring and other environmental risks.
“Fire safety risks, cleanliness concerns and environmental health risks to people found during this inspection meant that the CQC made referrals to the fire safety service and environmental health.” from the report
Not enough skilled staff
seriousThere were not enough staff with the skills to support people with complex agitation and dementia. Inspectors did not see required one-to-one support for one person.
“The provider had not made sure there were enough staff available to meet people's needs and promote their safety.” from the report
Limited activities and involvement
needs fixingPeople had limited meaningful activities and could spend long periods without stimulation. People and relatives were not consistently involved in care reviews or supported to express their preferences.
“People's meaningful social opportunities, engagement and activities were limited, and this put people at risk of social isolation.” from the report
Unclear complaints and communication
needs fixingManagement changes meant people and relatives were not always sure who was in charge or who to contact. Complaint records were incomplete and one relative was worried about raising concerns.
“People and their relatives told us they had not seen the complaints process which should detail how the provider would respond to any complaints and within what timescales.” from the report
- 01Is the fire alarm now working, and have all fire doors, damaged windows and other fire safety actions been completed?
- 02How many staff are on duty for each shift, and what additional support is provided for people with complex agitation or dementia?
- 03How are care records and risk assessments updated after an incident, health change or change in dependency?
- 04Who is currently responsible for managing the home, and when will a registered manager be in post?
- 05What meaningful activities are now available, and how are people's individual interests and communication needs used to plan them?
This was an unannounced inspection covering all five key questions; inspectors visited on 28 September and 10 October, with inspection activity ending on 24 October 2023. This explanation was written from the published report of 14 December 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, May 2022
The Firs Residential Care Home was rated Requires Improvement; medicines and infection control improved, but personalised care and oversight still fell short.
This was an unannounced follow-up inspection on 7 and 14 April 2022. Inspectors spoke with people using the home, staff and professionals. They observed care and checked care plans, risk assessments, medicines records, training records and management systems.
There had been clear improvement since the previous inspection. Medicines were managed safely and infection control was better overall. Staff were kind and respectful, people were supported with food and drink, and staff helped people make choices and access health care.
However, some people did not have detailed, up-to-date care plans and risk assessments. Staff had become task-led, so people did not always receive care based on their personal preferences, interests and needs. Records and audits did not reliably identify or correct these problems.
The overall rating Requires Improvement means the home was not consistently meeting the required standard. It was rated Good for Effective and Caring, but Requires Improvement for Safe, Responsive and Well-led.
Medicines were safer
Medicines records, storage temperatures and expiry checks had improved. Staff also had clearer guidance for medicines given when needed.
“Peoples medicines were safely managed.” from the report
Kind and respectful staff
People said staff looked after them well. Inspectors saw staff protecting people's dignity and privacy while giving care.
“Staff were kind, and respectful towards the people they supported.” from the report
Staff training and recruitment checks
Staff completed induction, shadow shifts, training and competency checks. Recruitment included references, right-to-work checks and criminal record checks.
“Staff were trained to care for and support people safely and effectively.” from the report
People's choices were respected
People were supported to choose what to wear, when to get up and what to eat. Staff aimed to use the least restrictive approach and act in people's best interests.
“Staff gave people choice and respected the choices they made.” from the report
Better learning from incidents
The home had made changes after the previous inspection and introduced a clearer process for sharing information with paramedics after an incident.
“Lessons had been learnt from the previous CQC inspection.” from the report
Care was not always personalised
seriousStaff had become focused on completing tasks. Some people had to wait during meals, were discouraged from asking for food between meals, or did not receive support with hobbies and walks.
“Staff worked hard but had become task led. This meant that people did not always receive person centred care and support from staff that met people's individual preferences and holistic needs.” from the report
Care and risk records were incomplete
needs fixingOne risk assessment could not be found, and one person had only a basic care plan despite living at the home for several months. Some records contained incorrect names or dates.
“Not everyone had full and detailed care plans and risk assessments in place even after living at the service for several months.” from the report
Management checks missed problems
seriousAudits did not identify several issues, including incomplete records, inaccurate staffing dependency tools, missing mattress setting records and gaps in fire drill records.
“The providers audits and governance system had not made enough improvement in a timely manner since the last CQC inspection.” from the report
Activities and interests were inconsistent
needs fixingPeople had mixed views about activities. Some people said they did not have proper activities, and a requested walk in the local community had not happened.
“People had mixed views about the activities that took place.” from the report
Some safety records were incomplete
needs fixingThe fire risk assessment did not show whether required actions had been completed, and there was no evidence of a recent night-time fire drill. Cleaning records were also incomplete for two days.
“Recent fire drills to put into practice staffs training were recorded as not being practiced at night.” from the report
- 01How have you completed and checked the full care plans and risk assessments for every resident?
- 02How do you make sure staff have enough time to provide personalised care, including help with hobbies, walks and activities?
- 03What has been done to ensure fire risk assessment actions are recorded and night staff practise emergency evacuation?
- 04Who is currently responsible for management while the registered manager application is being resolved?
- 05How do your audits now identify incomplete records, staffing calculations and other problems before they affect residents?
This was an unannounced follow-up inspection covering all five key questions, with a separate thematic probe about oral health and checks of infection prevention and control. This explanation was written from the published report of 27 May 2022 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 Residential Care Home
5 rated inspections over 5 years: the service has held its Inadequate rating throughout.
- December 2023Inadequatecurrent ratingdown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
Read what inspectors found at The Firs Residential Care Home →
- May 2022Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
Read what inspectors found at The Firs Residential Care Home →
- December 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- October 2019Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2019InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2018
Registered with the Care Quality Commission on 18 September 2018.
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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