Fir Trees

Updated 22 November 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of two inspectors.

Service and service type

Fir Trees is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Fir Trees is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced

What we did before the inspection

We reviewed information we had received about the service since it was first registered with CQC. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We reviewed staffing levels and walked around the building to ensure it was clean and a safe place for people to live. We observed how staff supported people and provided care.

We spoke with 6 people who use the service, 5 relatives and 9 members of staff, including the registered manager, care workers, and auxiliary staff.

During the inspection we reviewed medicine administration records for 6 people and looked at medicines related documentation.

We reviewed a range of records including care records for 5 people and additional care records in relation to the management of other specific needs. We looked at 4 staff files in relation to recruitment, training and support. A variety of records relating to the management of the service, including policies and procedures were examined.

Updated 22 November 2023

About the service

Fir Trees is a residential care home providing personal care to up to maximum of 46 people. The service provides support to older and younger adults, and people living with a physical disability or dementia. At the time of our inspection there were 41 people using the service.

People’s experience of the service and what we found.

The management of risk needed further development to ensure it was sufficiently robust to protect people. The management team were very responsive to any areas of concern raised and these were immediately addressed. Safe recruitment processes were generally followed. Feedback about staffing levels was mixed and the management team advised they would continue to closely monitor this. People told us they felt safe. People’s medicines were safely stored, and they were receiving their medicines as needed.

Some improvements to the environment were needed to ensure it was easy to clean and met the needs of people living with dementia. We have made a recommendation about this. People’s needs were assessed before they moved into Fir Trees, and they were supported to access health care services as needed. Staff felt well supported in their roles and accessed all the training needed. People spoke positively about the food. Information about people’s dietary needs was clear but further work was needed to ensure that this was robustly recorded.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and families spoke positively about staff who were caring and knew people’s needs and preferences well. Staff were mindful of people’s privacy and discrete when providing support. People were supported to remain independent, and staff supported positive risk taking as much as possible.

People received person-centred care and were supported to engage in activities which were meaningful for them. Records were not always as personalised, but staff understood people’s likes and preferences. People felt able to raise concerns and were confident these would be addressed. People’s communication needs and the accessible information standards were not clearly recorded, and we have made a recommendation about this.

There were various systems for checks of the safety and quality of the service. The registered manager was able to share how feedback was responded to and used to make changes and improvements in the home. The registered manager had an open door policy which feedback from people, families and staff all confirmed. People, families, and staff spoke about the positive culture at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The service was registered with us on 27 August 2021, and this is the first inspection under this provider. The last rating for the service under the previous provider was Good (published 28 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We have made a recommendation about the environment to ensure it meets the needs of people living at Fir Trees, including for good infection prevention and control and for people living with dementia. We have made a recommendation about the accessible information standard and how its use is embedded within the service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.