Firs Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 66 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a proactive and positive culture of safety, based on openness and honesty. They listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. Accidents and incidents were appropriately recorded and monitored for themes and trends. Where people required input from external professionals, this was identified and referrals made. For example, where a person had an increase in falls a referral was made to external professionals for an assessment.

The service worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. Systems were in place to assess and record people's needs and wishes prior to them using the service. We received positive feedback from professionals who worked with the service, they told us staff worked closely with them to meet people's needs. One professional said, “The staff are very responsive. They take action, anything we ask them to do, they do.” The provider had recently implemented online care planning systems, which allowed staff to share information with partners, where appropriate.

The service worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The service shared concerns quickly and appropriately. Staff were trained and understood their responsibilities to keep people safe. Staff told us they felt comfortable to whistle blow and were confident the manager would take action, one staff member said, “I have never seen anything that concerns me, but if I did, I would report I to the manager straight away and they would take action.” People told us they felt safe living at the service. One person said, “Oh yes, I feel safe here, the staff are so good. I want to live here because the atmosphere is so friendly.”

The service did not always work well with people to understand and manage risks. They did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Some improvements were required to ensure records relating to people's choking risks and dietary needs were correct and up to date. This was brought to the registered managers attention during our inspection and action was taken to ensure these records were correct. Nutritional and weight monitoring was in place and people had baseline observations monitored on a monthly basis or as required. People had some risk assessments in place, and associated care plans to guide staff about how to keep people safe. However care plans relating to assisting people in the event of a seizure could be more detailed. Where people required support with mobilising and pressure care, support was provided in a safe way.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. Appropriate environmental safety checks were in place, such as lifting equipment checks. Equipment was in place and safe for use, such as pressure relieving equipment, falls safety equipment and mobility aids. Fire safety systems were in place and people had personal evacuation plans, which provide guidance to staff and emergency services in the event of an emergency.

The service made sure there were enough qualified, skilled and experienced staff, who received effective support and development. They worked together well to provide safe care that met people’s individual needs. Staff were trained in a range of subjects to enable them to safely support people, such as dementia, catheter care and basic life support. People, relatives and staff told us there were enough staff. One staff member said, “We have enough staff on every day, it has been increased and has worked well.” Staff were mostly recruited safely and staff had police record checks in place. However, we did find 1 missing previous employment reference for a staff member, this was brought to the attention of the registered manager on the day of inspection and action taken to address this. Staff received inductions when they joined the service, and the management team had completed leadership qualifications.

The service did not always assess or manage the risk of infection. They did not always detect and control the risk of it spreading. Whilst the provider had completed some refurbishments to the service, such as new flooring and chairs, some improvements were required to ensure the home fully adhered to safe IPC practices. The home had a malodor, and cleaning and maintenance was needed in some areas. For example, we found some PPE stations which did not contain adequate supplies of PPE, some bathroom equipment to be rusty, laundry areas untidy and hoist slings which did not contain people's name labels. This placed people at risk of cross contamination. Enough domestic staff were deployed, however systems required strengthening to ensure the service was clean in all areas.

Some improvements were required to how medicines were managed. More robust records were required to ensure staff understood how and when to administer as required medicines. We found some missing protocols, to guide staff about when people received as required medicines and the effectiveness of these medicines following administration. We also found some creams in bedroom areas which did not contain open date labels. People received their medicines as required and staff completed accurate MAR charts. This included body maps and records when people required patches and creams. Controlled drugs were managed and stored safely. Staff were trained prior to administering medicines to people. Systems were in place to audit medicines practice, to ensure people were receiving their medicines safely. One person said, “I had a new tablet and staff explained to me what it was for.”