Firtree House Nursing Home

Updated 4 March 2023

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

The inspection was carried out by 3 inspectors. An Expert by Experience contacted relatives by telephone. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Firtree House Nursing 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. Firtree House Nursing Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was a registered manager in post. The registered manager was not available during our inspection.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we received about the service since the last inspection. This included details about incidents the provider must notify us about, such as serious injuries. We sought feedback from the local authority and other professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 11 relatives about their experience of the care provided. We observed multiple interactions between people and staff throughout the day. We spoke with 10 members of staff including the regional manager, acting deputy manager, nurses, care staff and a range of support staff. We looked at records relating to people’s care and support including risk assessments, care plans and medicine administration records. We looked at 4 staff recruitment files. A variety of records relating to the management of the service were reviewed including health and safety checks, meeting notes, training records and audits.

Updated 4 March 2023

About the service

Firtree House Nursing Home is a care home providing accommodation with nursing and personal care for up to 50 people across two adjoining wings. People had varying needs, including people with nursing needs and people living with dementia. At the time of our inspection there were 31 people using the service.

People’s experience of using this service and what we found

Risks to people’s health and welfare had been assessed but some risk assessments lacked detail. Checks and audits had been completed on all aspects of the service, but they had not identified some of the shortfalls found during the inspection.

People were supported by staff who knew them very well. Staff understood risks and how to manage these safely. Staff were described by people and relatives as kind, caring and friendly. One relative said, “The staff are amazing, so caring and cheerful, they do a wonderful job. I am confident [relative] has the best care. They are so kind to me too.”

People told us they were happy and felt safe living in Firtree House and relatives agreed. One relative said, “Oh yes, they are definitely safe. They are well looked after, and they deal with issues very quickly.” Staff had been trained in safeguarding and knew how to report any signs of abuse.

Staff were recruited safely and there were enough staff to meet people’s needs. Staff had training appropriate to their role and regular supervision. Checks had been made on the environment in line with health and safety requirements. Medicines were managed safely, and staff followed appropriate infection control guidance.

People’s needs were assessed before they moved into the home to ensure the service could meet their needs and preferences. People were supported to maintain good health and had access to doctors and other healthcare professionals when they needed them.

People had been asked their opinion about the care and service they received, and their suggestions had been acted upon.

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

The last rating for this service was good (published 16 October 2020).

Why we inspected

We received concerns in relation to the management of people’s nursing care needs and the escalation of concerns to healthcare professionals. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the effective section of this full report. We have found evidence that the provider needs to make improvements in other areas. Please see the safe section of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Firtree House Nursing Home on our website at www.cqc.org.uk.

Follow up

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