Archived: Firwood House

Updated 21 October 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This was an unannounced inspection on 14 and 15 August 2017. It was undertaken by two inspectors one of who had specialist knowledge of working with rehabilitation services and an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information we held about the service, including previous inspection reports. We contacted the local authority to obtain their views about the care provided. We considered the information which had been shared with us by the local authority and other people, looked at safeguarding alerts which had been made and notifications which had been submitted. A notification is information about important events, which the provider is required to tell us about by law.

During the inspection, we reviewed the records of the home. These included staff training records staff files including staff recruitment, training and supervision records, medicine records complaint records , accidents and incidents, quality audits and policies and procedures along with information in regards to the upkeep of the premises.

We also looked at seven support plans and risk assessments along with other relevant documentation to support our findings. We also ‘pathway tracked’ people living at the home. This is when we looked at their care documentation in depth and obtained their views on the service. It is an important part of our inspection, as it allowed us to capture information about a sample of people receiving care.

During the inspection, we spoke with ten people, one visiting relative, and fourteen staff members including the registered manager and a senior manager from the organisation. We also spoke with three visiting healthcare professionals who visited the service during the inspection.

We met with people and observed support, which was delivered in communal areas to get a view of care and support provided across all areas. This included the lunchtime meals.

Updated 21 October 2017

Firwood House provides intermediate care for up to 20 older people. It provides nursing and personal care for people who require a period of rehabilitation to recover from an injury or illness. For example following a fall, illness such as a stroke or surgery such as joint replacement. There were 13 people staying at the service at the time of the inspection. People who meet the admission criteria usually stay between two to six weeks. The aim of the service is to maximise people’s ability to live independent lives, improve their health and prevent admission to hospital. Firwood House is run by East Sussex County Council in conjunction with East Sussex Healthcare NHS Trust.

There is a registered manager at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This was an unannounced inspection, which meant the provider, and staff did not know we were coming. It took place on 14 and 15 August 2017.

We previously inspected Firwood House in June 2016 where we rated the service ‘requires improvement’ however; there were no breaches of regulations. This was because we found some areas of practice that needed to improve. At this inspection, we found that improvements had been made and improvements were now fully embedded into practice.

People were supported by staff who had taken the time to get to know people as individuals. They had a good understanding of their needs and the support they required to enable them to return to independent living. Staff cared about people, they treated them with compassion and respect. The service was a happy place and we observed relaxed conversations and humour between people and staff.

People were involved in decisions about their own care. They were supported to identify their own goals and what they needed to achieve to return home safely. People’s support plans contained information staff needed to support people appropriately.

There were enough support staff, nurses and therapists on each shift to safely meet people’s needs. Recruitment systems were established and only suitable staff were employed to work at Firwood House.

There were systems in place to ensure medicines were safely managed and people received their medicines as prescribed. Staff had a good understanding of safeguarding and knew what steps to take if they believed someone was at risk of abuse or harm.

Risks were managed safely. Risks to people had been identified and guidance provided for staff about keeping people safe but helping them to maintain their independence.

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

People were supported to eat and drink a variety of foods and maintain a healthy diet. Nutritional assessments were in place to identify people who may be at risk of malnutrition.

There was an effective training and supervision system in place. Staff competencies were regularly assessed. This meant people were cared for by staff that had received training and skills to meet their needs.

People had access to health care services to maintain their health and well-being.

There was clear leadership and staff understood their roles and responsibilities. The registered manager was well thought of by people and staff. There was an open and positive culture which was focussed on ensuring people received good person-centred support and achieving their individual goals. Good communication and teamwork was evident. Staff described an open culture where their views were valued.

People’s feedback was actively sought and used to improve and develop the service. Any concerns or complaint raised were addressed and acted upon promptly.

A quality assurance system was in place to monitor the service and the quality of support people received. This meant areas for improvement were promptly identified and addressed. Systems and processes for monitoring quality were effective in driving improvements.