The Firs Residential Home

Updated 20 December 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was carried out by one Inspector and an Expert by Experience. An Expert by Experience is a person who had personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Firs Residential Home 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. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

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 also reviewed additional information we held about the service, this included previous inspection reports and statutory notifications. A statutory notification contains information about certain incidents and events the provider is required to notify us about by law.

During the inspection

We spoke with five members of staff which included the registered manager, an area manager and care staff. We spoke with six people who lived at the service and four peoples’ relatives. We spoke with one visiting healthcare professional and observed interactions between people and staff.

We reviewed a range of records, including peoples’ care records, staff recruitment files, records relating to safety checks including fire safety and accident and incident records. We also reviewed medicines records and records relating to monitoring and quality assurance.

Following our site visit we contacted four healthcare professionals to seek their views on the service and received feedback from all of them. We also spoke with a further relative. We also received further clarification and documentation from the service to validate evidence found.

Updated 20 December 2022

The Firs Residential Home is a care home without nursing and is registered to provide accommodation and support for a maximum of 38 people. At the time of the inspection there were 33 older people living at the service, some of whom were living with dementia.

Peoples’ experience of using this service and what we found

The provider and registered manager nurtured a culture which truly put people at its centre. Staff were unanimously positive about the registered manager and each other. All of the people and relatives we spoke with were consistently positive about the service. One relative told us, “It’s the best choice we could have made [choosing The Firs]. I have already recommended The Firs.”

Staff feedback about why they worked at the service reflected the service ethos. One told us, "I love my job. I see people here as my family and I care for people like they were my Mum or Nan." Another staff member said, "People rely on us, and the end of the day that’s why we are here. When we lose people here I get emotional as it's like losing a family member.”

The registered manager had ensured the philosophy of the service was embedded into staff practice. Signage about ‘Putting the Residents at the Heart of everything we do’ was displayed in various locations. There was a dignity tree in the hallway and the registered manager told us this was important because the service ethos was about listening to what people want. Each person was given the chance to put a quote on the dignity tree about what was important to them.

The provider and registered manager worked in partnership with other healthcare professionals to ensure people got the support they needed and were committed to continuously improving the service.

The provider and registered manager demonstrated an ability to maintain an excellent standard of care provision through effective governance and oversight. The service were part of a pilot with the local authority to achieve the best outcomes for people. The registered manager had received an award from the local authority as recognition for their commitment to making people's lives better.

The leadership at the service was distinctive and positive feedback about the registered manager. This had achieved excellent outcomes for people and staff. The service was dedicated to ensuring continuous quality improvement to enhance people's lives. The care we observed was person centred and individual to people. We spoke with healthcare professionals who were consistently positive about the service leadership, with one telling us, “From a leadership perspective she’s an example for other to follow. The Firs work so openly with and me and the standards are very high.”

People and their relatives spoke positively of the care staff and we heard of examples where staff went above and beyond to support people. People were empowered to be actively involved in the service. For example, people had been invited to design certain areas of the service and we saw plaques had been placed in these areas to identify this.

There were positive opportunities to be involved with the local community, for example the service were part of a ‘Generational Exchange’ and a ‘National Literary Project’ with the local school. A visitor told us about the positive effect on their relative.

Systems were in place to safeguard people from abuse and peoples’ risks were assessed and well monitored. People were supported to receive their medicines safely. Peoples’ care plans contained good detail about how staff could support them to manage their health conditions and the risks associated with them. Systems were in place to ensure staff were recruited safely. Disclosure and Barring Service checks were obtained. There were enough staff to ensure peoples’ needs were met and people told us staff had enough time to provide the care they needed, and to spend time talking with them.

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.

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

Rating at last inspection and update:

The last rating for this service was Requires Improvement (published 2 March 2021).

Why we inspected

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

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

The overall rating for the service has changed from Requires Improvement to Good based on the findings of this inspection.

Follow Up:

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