We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask; Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well led?
This is a summary of what we found-
Is the service safe?
During our inspection, we observed there were enough skilled staff on duty to meet the needs of people living at the home. The provider had an effective recruitment procedure. This included completing all security checks before anyone commenced work at the Firs Rest Home. This helped ensure the safety of all people at the rest home. We were informed that a senior member of staff was always on call in case of emergencies.
Deprivation of Liberty Safeguards (DoLS) become important when a person is judged to lack capacity related to making informed decisions about their care and support. The provider told us an application had been made for a DoLS in January, 2014. We checked the application and all paperwork had been completed appropriately and recorded in the provider`s audit file.
The provider had policies in place to record any incidents or accidents. Any concerns that were expressed were discussed at the next staff meeting. This helped ensure that any identified incidents were learnt from and was aimed at improving the quality of service provided at the rest home.
Is the service effective?
During our inspection, people living at the care home told us they were happy with the care and support they received at Firs Rest Home. One person told us, "I really feel safe here - everybody gets very well looked after here." We observed and talked to staff members and it was clear they had a good understanding of the needs of all the people they cared for. This was confirmed by a doctor who was visiting the rest home who commented, "This is a very friendly home - staff have a good knowledge of the residents needs."
We observed good interaction between staff members and people living at the home. We were able to speak to several people and one said, "Everyone is brilliant here - there is always someone there for you." Another person commented, "The staff are lovely - they are really helpful to me." We saw evidence of a multi-agency approach to providing care. On the day of our inspection, a doctor and a community nurse attended appointments with people living at the home. We also noted the provider contacted other professionals, for example the pharmacist. This was related to a change of medication for one of the people living at the rest home which showed the provider acted in the person`s best interests and protected their welfare.
Is the service caring?
We looked at individual care plans during our inspection. We noted, that as far as possible, people living at Firs Rest Home or their families had been involved in writing up their care plans. People`s wishes and preferences had been recorded and their care and support had been provided in accordance with their wishes. This reflected a person centred approach to providing care.
People living at the rest home were supported by attentive and caring staff members who were patient when trying to understand people`s different support needs. We noted people were supported with their personal care needs and if necessary, at meal times they were assisted with eating their food. One family member who was visiting said, "The staff are great - I hope I end up here."
Is the service responsive?
Staff meetings were held regularly at the rest home which were aimed at improving the quality of care and support provided to people living there. The outcome from one meeting was a decision that staff completed a communication book during each shift detailing the care and support that had been provided. This helped ensure people received a continuity of care and so had their needs met appropriately.
We were told by the provider that the need for an improved complaints procedure had been identified. Consequently, a dedicated log book had been provided which helped ensure any complaints were listened to and responded to in an acceptable time frame. People could be assured that all complaints were investigated thoroughly and action taken if necessary.
Is the service well-led?
The provider told us, and we saw evidence, that Firs Rest Home worked well with other agencies. This meant people received the support they needed when they needed it. One family member said, "If there is ever a problem they get in touch with us straight away - they are very good like that."
We saw details of monthly audits that had been conducted related to the environment, infection control procedures and people`s nutritional needs. Weekly fire alarm checks were also held. Hoists and lifts were audited on a quarterly basis which helped people receive the support they needed. External audits were also observed. Worcester County Council (WCC) had recently completed an audit of all individual care plans. During 2012-13, WCC awarded the rest home with an award for, `Improving the Quality of Person Centred Dementia Care.` In March, 2013, a pharmacy audit was completed with no concerns recorded. Overall, the rest home had a quality assurance system in place that identified any concerns and addressed them immediately.