Fir Tree House improved from Requires Improvement to Good across all five key questions, with staff consistently praised for their kindness, reliability and person-centred approach. Recommendations were issued regarding care plan accuracy, individualisation and end-of-life planning, though no regulatory breaches were identified.
Concerns (5)
moderate
Care planning
— “one part of their care plan, 'key safe to be used at all times' and yet in another place, 'please ring doorbell to gain entry as key safe not used'.”
moderateCare planning — “recorded as suffering from, 'depression and anxiety' however their risk assessment recorded 'no' under the question, 'does the service used have depression related difficulties?'”
moderatePerson-centred care — “Much of the information in people's care plans were from a pick list meaning it was less person-centred.”
moderateEnd-of-life care — “There were no end of life care plans for people. One person...had no care plan in place. Their end of life care plan recorded, 'no' to the question, 'does the client require support with palliative care?'”
minorRecord keeping — “one person who was female had recorded in their care plan, '[Male name] would like to remain as independent as possible'.”
Strengths
· Staff were kind, caring and had developed strong relationships with people, going above and beyond such as funding birthday parties and assisting with personal errands.
· Introduction of home care management software reduced missed calls and enabled real-time monitoring of care delivery.
· Robust recruitment processes including DBS checks, full employment history and right-to-work verification.
· Sufficient staffing levels with travel time factored between calls, reducing late arrivals.
· Staff received wide-ranging training including dementia awareness, Care Certificate and competency checks.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: End of life care and supportGood
responsive: Meeting people's communication needs and supporting people to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood