The Firs Care Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We reviewed 3 quality statements in this key question. We observed some care that was not dignified and not personalised. However, we also observed some interactions between people and staff that were positive and it was clear staff knew people.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us they thought the staff were kind, however, we found some elements of care were not meeting expected standards. For example, people sitting together at lunch were not given their meal at the same time. This meant people were sat waiting and watching others eat for over 10 minutes before they received their meal. This did not promote dignity.

Management told us they carried out checks to make sure staff were working to their expected standards. Staff we spoke with told us they enjoyed their work and liked working with people living at the service.

We heard positive feedback from visiting professionals about the care at the service. Professionals told us they thought the service provided good care and they had not seen anything of concern.

We observed some positive interactions between people and staff. We saw staff communicating well with a person whilst using equipment to help them mobilise. We observed staff sitting down with 1 person to help them eat, discreetly encouraging them to eat their meal. However, we also observed some care that was not person-centred. For example, staff had a continence chart which had set times to check people’s incontinence aids. This did not promote personalised or dignified care individual to each person.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People’s experiences were not consistently supportive of promoting their independence at all times. For example, for 1 person we observed they were supported to be involved in carrying out activities of daily living. However, for other people we saw opportunities for independence were not being promoted. People’s experiences of being able to make choices were not always being promoted by good practice. For example, people were being asked what they wanted for lunch at 10.30am. People living at the service with dementia may have forgotten what their choice were by lunch time. In addition, people may not have understood what the options were. The registered manager told us there were pictorial menus available on the wall in the dining room. These would help people with dementia make their menu choices. However, people were being asked what they wanted for lunch in the lounge and staff did not use the pictures to help people choose.

Staff gave us examples of how they promoted people’s independence as much as possible during personal care. Staff told us they encouraged people to do as much for themselves as possible. The care manager told us people could have visitors when they wished.

Whilst we observed 1 example of good practice for 1 person, we did not observe people’s independence being consistently promoted. We also observed limited opportunities for people to make simple choices with daily life. For example, the TV was on in the lounge with a film playing. One person told us they did not like the film and had not chosen it to watch. We observed people having tea and biscuits. Whilst they were offered a choice of drink, they were given 1 biscuit each and not able to choose from what was available.

People were able to have visitors when they wished. There were no restrictions on visiting at the service. People’s records demonstrated they had reviews of their care and had been involved in discussions. Where appropriate people’s relatives had also been involved.

At times people were not having support to minimise their discomfort and distress. This was because there were not enough staff available to immediately respond to their needs.

Staff told us they knew how to respond to people’s distress and gave us examples of different strategies they used. One staff member told us, “Some people might be uneasy or stressed, we can leave them at times and go back. I ask them is there anything that can change their mood. I try to address the problem. We do have time mostly, but it all depends on the staffing.”

We observed when staff were available, they responded to people’s calls for support. However, there were times when we observed people calling and staff not being able to immediately respond. The provider told us they were going to improve outcomes for people by increasing numbers of staff.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.