CQC report explained · a residential care home
What the CQC found at The Firs
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured about infection prevention, personal protective equipment, testing, visiting arrangements and COVID-19 vaccination requirements. They did not review the full Safe key question.
- Effective?
- Good
- The Effective key question was not covered by this focused inspection.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff offered choices, supported independence and adapted communication to people's needs.
- Responsive?
- Good
- Care plans had become more personalised and included people's histories, routines and preferences. People were supported with activities, communication and contact with family and friends.
- Well-led?
- Good
- Inspectors found a positive culture, teamwork and quality monitoring. A new manager was registering with the CQC and had previous experience as a registered manager.
What inspectors found, March 2022
The Firs was rated Good; inspectors found kind, personalised care and better activities, while Safe was inspected but not rated.
This was an unannounced focused inspection on 2 February 2022. One inspector spoke with people, relatives, staff and other professionals. They reviewed care plans, complaints, training information and infection control records, and observed care.
Inspectors found that people were treated kindly and with dignity. Care plans included people's routines, histories, communication needs and preferences. Activities had become more personal, and people were supported to keep in touch with relatives and the local community.
The home was rated Good overall. Caring and Responsive improved from Requires Improvement to Good. Well-led remained Good. Safe was inspected for infection prevention and COVID-19 arrangements, but its rating was not reviewed and remained previously rated Good.
Kind and respectful care
Staff were patient and caring, especially when people were distressed or needed help to understand what was happening. People were offered choices and their dignity was respected.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised care plans
Care plans included people's preferred routines, life histories, communication needs and important personal information. This helped staff provide care suited to each person.
“Care plans were detailed and personalised to enable staff to provide care and support in a way that ensured people's preferred routines were honoured.” from the report
Meaningful activities
The home consulted people and families about their interests. Activities included art, reminiscence and gardening, with further community projects planned.
“Activities included group and one to one time with people. They had art sessions, reminiscence and gardening projects on the go.” from the report
Maintaining family contact
People were supported to keep in touch through telephone calls, video links and visits. A visiting pod enabled visits during lockdown and outbreaks.
“The provider had built a visiting pod which enabled family to visit even at times of lockdown as the entrance was separate to the home and the pod was fully screened.” from the report
Improved overall rating
The overall rating improved from Requires Improvement to Good. Caring and Responsive both improved to Good, while Well-led remained Good.
“The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.” from the report
Refurbishment was unfinished
minorThe home was cleaner and more homely than at the previous inspection, but the refurbishment programme was still in progress.
“There has been a refurbishment programme to improve the building and fabric and furnishings. This was still work in progress” from the report
- 01Which parts of the refurbishment programme are still unfinished, and when will they be completed?
- 02How will you make sure my relative's care plan includes their history, routines, communication needs and preferences?
- 03How will you provide activities that match my relative's interests, including one-to-one activities if needed?
- 04How can relatives visit if there is an infection outbreak or further lockdown restrictions?
- 05How are complaints recorded and followed up if a family raises a concern?
This was a focused inspection of Caring, Responsive and Well-led, with infection prevention and control checked under Safe; Effective was not covered, and the other ratings were not re-rated. This explanation was written from the published report of 4 March 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, December 2020
Rated Requires Improvement; inspectors found major safety, training and leadership improvements, but some refurbishment and care planning work was unfinished.
This was an unannounced, focused inspection on 8 October 2020. Inspectors checked whether the home had acted on its improvement plan and whether it met legal requirements. They spoke with people, relatives, staff and healthcare professionals, observed care, and checked care, medicine, staffing and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found people were protected from avoidable harm, medicines were managed safely, staff training had improved, and managers were monitoring risks and quality more closely. Infection control arrangements, including those for COVID-19, were also found to be effective.
The overall rating was Requires Improvement because this was a focused inspection and the home still had unfinished improvement work. Some paintwork and carpets needed attention, and relatives had not yet all been involved in reviewing care plans. The home had previously been rated Inadequate and placed in Special Measures, but it was no longer Inadequate or in Special Measures after this inspection.
Improved safety
Risks from hot water, falls, pressure damage and the environment were being checked and managed. Staff understood how to reduce risks to people.
“At this inspection we found improvements had been made to how risks to hot water were being monitored and actions taken if they found the temperature was a risk.” from the report
Infection control
The home had improved its cleaning and infection control arrangements. Inspectors found the home was clean and fresh smelling and that COVID-19 measures were in place.
“At this inspection we found all areas including communal and bedrooms smelt fresh and clean.” from the report
Staff training
Training had improved and a new system made it easier for managers to see what staff had completed or still needed.
“A new training matrix had been introduced which helped the management team see what training had been completed and what training needed to be planned for.” from the report
Management oversight
Inspectors found meaningful audits and closer monitoring by the manager and provider quality team.
“At this inspection we found there were clear and meaningful audits showing who monitored each aspect of care delivery and the environment.” from the report
Kind relationships
People appeared relaxed with staff, and relatives described staff as caring and competent. Staff respected people's wishes and choices.
“People were moving around freely and interactions between people and staff were relaxed and showed there was good rapport between them.” from the report
Care plan involvement
needs fixingThe home was still working through a programme to share care plans with relatives and obtain their agreement or signature. This had been slowed by lockdown restrictions.
“This was work in progress which had been slowed due to the home having to 'lockdown.'” from the report
- 01Which refurbishment work remains outstanding, including the worn paintwork and stained carpets, and when will it be completed?
- 02How will you involve my relative and our family in reviewing and agreeing their care plan?
- 03How do you monitor staff working additional hours, and how often does this still happen?
- 04What is the current position on any outstanding Deprivation of Liberty Safeguards applications?
- 05How will families visit their relatives during restrictions, including through the conservatory visiting area?
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 9 December 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 The Firs
9 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- March 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2020Requires improvementup from InadequateWell-led: Good
- February 2020Inadequatedown from Requires improvementSafe: Requires improvementEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- April 2019Requires improvementstayed Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2018Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: Good
- November 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- November 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- January 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 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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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.”
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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.