CQC report explained · a residential care home
What the CQC found at The Firs Residential Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed and reviewed, medicines were managed safely, staffing was sufficient and infection control arrangements were suitable.
- Effective?
- Good
- This question was not given a rating in the report.
- Caring?
- Good
- People and relatives said staff were kind, respectful and listened to them. Inspectors saw person-centred care and support for people's privacy, dignity, independence and choices.
- Responsive?
- Good
- This question was not given a rating in the report.
- Well-led?
- Good
- Inspectors found positive leadership, good teamwork and effective quality checks. The management worked with health professionals and used feedback and audits to improve the service.
What inspectors found, December 2022
Rated Good; inspectors found safe, kind and well-led care, with the overall rating improved from Requires Improvement.
Inspectors made an unannounced visit on 1 November 2022. They spoke with people living at the home, relatives, staff and health professionals. They observed care and checked care records, medicines, recruitment files, safety checks and quality records.
They found people were safe, treated with kindness and involved in decisions about their care. Staff understood people's needs, medicines systems were safe, staffing levels met people's needs and infection control arrangements were suitable.
The home had a positive culture and strong oversight from its management. People and relatives gave very positive feedback. The home also supported activities, community links and improvements based on people's views.
The overall rating was Good. Safe and Well-led improved from Requires Improvement at the previous inspection, while Caring remained Good. Effective and Responsive were not given ratings in this report.
Kind, respectful care
People and relatives spoke very positively about the care. Staff were seen treating people with dignity and supporting their choices and independence.
“In addition to this, we saw that all staff interactions were person-centred, courteous and dignified.” from the report
Safe care arrangements
Risks were regularly reviewed and medicines were ordered, stored and given through safe systems. Inspectors also found enough staff to meet people's needs.
“There were safe and effective systems for the ordering, storage, administration and returns of medicines.” from the report
Strong leadership
The home had clear management arrangements, effective audits and a focus on learning and improvement. Staff and health professionals were positive about the leadership.
“Well established systems and processes to monitor quality were in place.” from the report
Involving people
People were involved in decisions about activities, the home's environment and their own care. The home also supported links with a local school and other community projects.
“People were empowered to be actively involved in the service.” from the report
Employment history records
minorInspectors advised the home to make sure staff records contained a full employment history in line with requirements. The report does not say that this caused harm.
“Advice was given around ensuring a full employment history was obtained in line with requirements.” from the report
- 01How do you make sure staff records now contain a full employment history?
- 02How many staff are usually on duty for the number and needs of residents, and how are gaps covered?
- 03Are all outstanding Deprivation of Liberty Safeguards applications now progressing, and how do you review them?
- 04How would you support my relative's specific interests, routines, independence and communication needs?
- 05How do you keep relatives informed if there is an incident, a change in health or an infection outbreak?
This inspection rated Safe, Caring and Well-led; Effective and Responsive were not given ratings in this report, and infection prevention and control was considered under Safe. This explanation was written from the published report of 20 December 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.
What inspectors found, March 2021
Rated Requires Improvement; inspectors found kind, responsive care and recent safety improvements, but said governance was not yet fully established.
Inspectors visited on 19 January 2021. They spoke with people, relatives and staff, and reviewed care plans, medicine records, recruitment files and management records. They also checked infection prevention and control.
The home had improved since earlier inspections. Infection control was robust, staffing was sufficient, medicines were managed safely, and care plans were detailed and regularly reviewed. People were treated with kindness and had personalised activities and support to keep in touch with relatives.
The overall rating was Requires Improvement. Safe and Well-led were Requires Improvement. Effective, Caring and Responsive were Good. The improvements were recent, so inspectors wanted more evidence that they would continue over time.
Infection control
Inspectors found strong infection prevention practices, with staff following them and the home kept clean.
“There were robust infection control practices and staff were following them.” from the report
Kind and respectful care
People appeared happy and well cared for. Staff supported dignity, privacy, choice and independence.
“Staff treated people with dignity and respect and people were supported by staff to maintain their appearance.” from the report
Personalised care planning
Care plans had been reviewed and rewritten so they reflected people's needs, wishes and preferences.
“At this inspection we found they had reviewed and rewritten all of the care plans to ensure they were accurate and reflected people's needs and preferences.” from the report
Activities and family contact
The home provided varied activities based on people's interests and worked to maintain contact with relatives during pandemic restrictions.
“Activities and engagement provision was person centred, consistent and showed clear positive outcomes for people.” from the report
Staffing and medicines
There were sufficient staff on duty, recruitment checks were completed and medicines were administered and recorded safely.
“There were now sufficient staff on duty to meet people's needs and spend time with them.” from the report
Safety assurance
needs fixingSafe was rated Requires Improvement because the improvements followed serious earlier infection control failings and had not yet been shown to be sustained.
“This meant some aspects of the service were not always safe and there was limited assurance about safety.” from the report
Governance still bedding in
needs fixingThe home had introduced better audits and improvement plans, but inspectors said the management systems needed more time to become fully established.
“However, the improvements to the providers governance system were recent and yet to be fully established and embedded to demonstrate sustained and continuous improvement.” from the report
- 01What checks are now used to make sure infection control standards remain strong?
- 02How often are safety and quality audits completed, and what happens when they identify a problem?
- 03How will you show that the recent governance improvements are being maintained over time?
- 04How are staffing levels reviewed when new people move into the home?
- 05How will my relative's care plan, activities and contact with family be reviewed and updated?
This was a planned inspection covering all five key questions, including infection prevention and control under Safe; the report also describes earlier targeted inspections focused on infection control. This explanation was written from the published report of 2 March 2021 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 Home
5 rated inspections over 5 years: the service has held its Good rating throughout.
- December 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2021Requires improvementup from InadequateSafe: Requires improvementCaring: GoodWell-led: Requires improvement
- January 2021Inadequatestayed InadequateSafe: Inspected but not rated
- November 2019Inadequatedown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- July 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2016
Registered with the Care Quality Commission on 8 January 2016.
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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17 live-in carers within about an hour of Devon
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,270 a week. 15 can care for a couple. 13 years' experience on average.
“She is such a warm and gentle person while being professional and competent at the same time.”
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.