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Care Services

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Fir Trees, Dukinfield.

Fir Trees in Dukinfield is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs, caring for adults under 65 yrs, dementia and physical disabilities. The last inspection date here was 28th December 2018

Fir Trees is managed by Meridian Healthcare Limited who are also responsible for 30 other locations

Contact Details:

    Address:
      Fir Trees
      Gorse Hall Road
      Dukinfield
      SK16 5HN
      United Kingdom
    Telephone:
      01613382977

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2018-12-28
    Last Published 2018-12-28

Local Authority:

    Tameside

Link to this page:

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Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

28th November 2018 - During a routine inspection pdf icon

We carried out an inspection of Fir Trees on the 28 November and 4 December 2018, the first day of the inspection was unannounced. The service was last inspected in March 2017, where we identified four breaches in regulations 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities). The service was given an overall rating of Requires Improvement. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Effective, Responsive and Well-led to at least good.

During this inspection we checked to see if the breaches in regulation had now been met. We found the provider had taken the necessary action to meet the regulations.

Fir Trees is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Fir Trees is situated in the Dukinfield area of Tameside and provides accommodation for up to 46 people who require accommodation and personal care. All rooms provide single accommodation and have en-suite facilities. Bedrooms are located over two floors and can be accessed by stairs or passenger lift. Communal bathrooms and toilet facilities are available throughout the home. The home is divided into two floors; each floor consists of a lounge and dining area there is a small laundry area and a kitchenette upstairs used by staff to make snacks and drinks. There is also a lower ground floor area that is currently used for storage and meetings. The main laundry and large kitchen are located on the ground floor. There is an enclosed garden area for people to use.

At the time of the inspection there were 42 people living at the home.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Clear management systems were in place to monitor and review the quality of service provided. Opportunities were provided for people who used the service, their visitors and staff to comment on their experience and share ideas. This enabled people to experience safe and effective care and support.

The management and administration of oral medicines was safe. Action had been taken to improve records for the administration of topical creams and the thickening of fluids.

Systems were in place to minimise the risk of cross infection. Improvements had been made to the laundry so that soiled items were managed safely. The home was found to clean, tidy with no malodours.

Risks identified within the environment and to people’s care had been assessed and planned so that people’s health and well-being was maintained.

Effective systems were in place to ensure the premises and equipment were regularly serviced and safe to use. Plans were in place to enhance the environment, particularly for those people living with dementia.

Staff knew how to keep people safe and understood their responsibilities in protecting people from abuse and knew what to do should an incident arise.

People’s autonomy, choice and community presence was promoted with a range of activities and opportunities both in and away from the home. Consideration was also given to people’s religious and cultural needs.

Systems were in place to ensure sufficient number of staff were provided. Relevant information and checks were obtained when recruiting new staff. Opportunities for staff training and development were provided helping to ensure staff had the knowledge and skills needed to meet the specific needs of people safely and effectively.

Suitable arrangements were in place to meet people

23rd March 2017 - During a routine inspection pdf icon

This inspection was carried out over three days between 23 and 27 March 2017. Our visit on 23 March was unannounced.

We last inspected Fir Trees in April 2015. At that inspection we rated the service as good in all domains.

Fir Trees is one of 14 care homes in Tameside owned by Meridian Healthcare, part of the organisation HC-One. Fir Trees is situated in the Dukinfield area of Tameside and provides accommodation for up to 46 people who require accommodation and personal care. All rooms provide single accommodation and have en-suite facilities. Bedrooms are located over two floors and can be accessed by stairs or passenger lift. Communal bathrooms and toilet facilities are available throughout the home. The home is divided into two floors; each floor consists of a lounge and dining area there is a small laundry area and a kitchenette upstairs used by staff to make snacks and drinks. There is also a lower ground floor area that is currently used for storage and meetings. The main laundry and large kitchen are located on the ground floor. There is an open patio and lawned area next to the car park; there is no accessible, enclosed garden area for people to use without supervision.

At the time of our inspection there were 44 people living at Fir Trees.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out this inspection in response to information of concern we received around safeguarding of people from the risk of harm. These concerns were regarding safe and effective pressure care practice.

Care records at the home showed us that people received input from health care professionals, such as opticians and podiatrists. We found people had received the necessary care and support when they needed it. For example, referrals to district nursing team for assessments due to concerns for someone’s skin integrity.

We identified breaches of two regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches were around infection control, risk assessments, medication errors and management oversight. You can see what action we told the provider to take at the back of this report.

We made three recommendations in relation to the provider reviewing arrangements in place to establish where there are Lasting Power of Attorney (LPA) arrangements in place and what these say so the service know what decision’s the LPA can make; researching how to make the home more dementia friendly; implementing measures to assist people at the home who live with dementia to help them move around the home easier; and personalised activities being provided at the home.

People, their relatives, visiting professionals and staff spoke highly of the service; one person told us, “I like this place. It’s very clean and I can’t grumble.”

During this inspection we found that there were enough staff available to meet people’s needs and they were being cared for by people who knew them well. Staff we spoke with were aware of each person’s individual care needs.

People were supported by staff who were kind and caring and ensured people’s dignity was respected when providing care and support.

The staff files we looked at showed us that safe and appropriate recruitment and selection practices had been completed by management to satisfy themselves that suitable staff were employed to care for vulnerable people.

Staff we spoke with were aware of how to safeguard people and were able to demonstrate their knowledge around safeguarding procedures and how to inform the relevant authorities if they suspected anyone was at risk from harm.

People are supporte

12th June 2014 - During a routine inspection pdf icon

Our inspection team was made up of an inspector who addressed our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service safe?

Some of the people living in the home could not always express their views, but those that did told us they felt happy and safe. Relatives told us that they felt confident with the care and support delivered by staff in the home. One person told us that they could go home feeling happy and confident that their relative was being very well cared for.

During our visit we saw good examples of care practice and noted that staff took time to follow guidance in care plans so that they provided care and treatment in a safe and effective manner.

Records we looked at indicated that people who lacked capacity were fully protected when decisions were necessary regarding their health and personal care needs.

Record provided evidence that staff had received appropriate training so that they had the skills and knowledge to provide care and support in a safe way.

Is the service effective?

All relatives we spoke with told us that they were very happy with the quality and standard of care provided by staff. They told us that the manager and staff team were very open and responsive and addressed any issues they raised in a friendly, professional and timely manner. Relatives told us that they felt very involved in the care planning process and that they were kept up to date and informed regarding any changes in care needs.

Is the service caring?

All the people we spoke with during this visit expressed satisfaction about the care and support provided to people. Comments included : “The staff are brilliant, they will do anything for us. They are quick to respond to people and they seem to know every single person so well. Nothing is too much trouble for them”.

Care plans were in place and these provided staff with detailed information on how to provide care and support to people in a safe and appropriate way. When we observed staff, we saw that they followed the instructions in the care plans. During our discussions with staff it was evident that they had a good knowledge and understanding of individual care needs. During the day we saw staff engaging in meaningful conversations with people and supporting people to join in activities.

Is the service responsive?

We saw that people’s needs were assessed before moving into the home to ensure that their needs could be met by the skill level of staff employed by the service. We saw that care plans were detailed and there was evidence that they were regularly reviewed. When any changes were identified the care plan was updated. We saw several examples where appropriate referrals had been made to healthcare professionals for additional assessments and guidance in respect of care and treatment.

Is the service well led?

The service had a registered manager in post and a number of senior staff. All the staff and relatives we spoke with spoke highly of the manager and her open and transparent approach in managing the home. People told us they felt confident in raising any issues of concern with the manager and that she was always visible and made herself available. We saw that there were robust auditing and monitoring systems in place and there was evidence that people using the service were regularly consulted on how the service was managed.

18th October 2013 - During a routine inspection pdf icon

We used a number of different methods to help us understand the experiences of people using the service, including observing care and speaking to those people who could give their views on the home. We spoke with ten people who lived in the home about their care and treatment. We spoke with some relatives who were visiting. All the people we spoke with were positive about the care and treatment they received. They spoke highly of the way staff supported them. Some comments included:

"The staff are lovely, they can't do enough for me, all I have to do is ask."

"I am impressed by the knowledge the staff have of people, they always seem to know what they are doing."

During our visit we saw that staff provided kind, sensitive and effective care in a way that ensured people's assessed care needs were met. There was evidence to demonstrate that care and support was centred on people as individual's and considered all aspects of their care needs.

We saw that staff supported and encouraged people to maintain an adequate diet and hydration. We saw appropriate action being taken when staff identified people who were at risk of poor nutrition and dehydration. Appropriate care plans and monitoring was in place to ensure that people received a well-balanced diet and adequate hydration.

There was an effective complaints system in place enabling people to express their views and opinions.

During our visit we found the home to be clean and tidy.

18th December 2012 - During a routine inspection pdf icon

People who used the service suffered with varying degrees of dementia, which limited the number of people we could speak with in order to obtain their views about the service. In light of this we spoke with their relatives to find out what they thought of the service and how their relative was being looked after.

The people who used the service said they were happy living at the home and had no complaints to make. Their comments included:

“The staff are nice. I have never been treated badly.”

“Everything is ok, I’m a bit bored but otherwise no complaints.”

Relatives of the people who used the service said they were very happy with the way their relative was looked after and they had no concerns to raise about their safety and welfare. Their comments included:

“My mum is extremely well looked after. The staff are so gentle in the way they look after people.”

“The care is excellent, I couldn’t fault any of them. I am very happy with the way my relative is looked after. The girls are always very busy and I have noticed they could do with more staff.”

“My mum feels safe. I have never heard or seen anyone treated badly in this home.”

“The new manager is very nice. She is very keen and appears to well organised.”

25th August 2012 - During a routine inspection pdf icon

We spoke to several people living in the home, sometimes in one to one arrangements and in group settings. All the people we spoke to expressed satisfaction about the care and support they received and there was a general consensus that the home was fully meeting individual care needs.

People told us that they felt their health care needs were being met and that the staff were quick to respond to any concerns and always called a G.P. to come out in a timely manner. One person said, “ If anyone needs a doctor the staff call one out immediately. I just had the doctor to come and see me yesterday. The staff called him when I told them about my problem. The staff make sure I get my medication on time.”

People told us that staff treated them well and that they had no complaints. They said the staff always took time to explain any queries about their care. One person told us that staff always listen, although sometimes they can be busy, “as there are a lot of poorly people here”.

People said they were happy with the meals served in the home, and that they were regularly consulted about their menu and meal choices. One person told us that alternatives were always made available if the meal of the day was not to their liking.

People told us that there were some activities available during the day but that these were not offered in a consistent manner and that it depended on how much time the staff had available. People told us that they would like the opportunity to try out different activities, as sometime it was boring with nothing to do.

Some of the comments from people included:

“I find it comfortable here, the staff are very nice and friendly and look after me very well. I have never found fault. Sometimes there are activities but not very often, sometimes we do armchair exercises”.

"It’s A1 here. Staff will help you with anything at anytime, even in the night”.

“Living here is free and easy and I can go to my room at any time”.

1st January 1970 - During a routine inspection pdf icon

This inspection was carried out over two days on 3 and 6 March 2015.

We last inspected Fir Trees in June 2014. At that inspection we found that the service was meeting all the regulations of HSCA that we looked at.

Fir Trees is a purpose build establishment, situated in Dukinfield and provides accommodation for up to 46 older people. The home is owned and managed by Meridian Healthcare Limited.

Accommodation is provided on two floors with stairs and a passenger lift between the floors. The home had four vacancies at the time of our inspection.

A manager was in post at the time of our inspection. Although the manager was not yet registered with the Care Quality Commission a date had been set for the manager to attend interview with the Commission.

A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The building was generally well maintained, clean, tidy and free of any unpleasant odours but there were some areas of the home where furniture and carpets were showing significant signs of wear and tear.

The atmosphere in the home was calm and relaxed and staff interacted with people in a light hearted way whilst respecting people’s privacy and dignity at all times.

People who used the service and the visitors we spoke with were positive and complimentary about the attitude, skills and competency of the statt team. Individual care was assessed and planned and was subject to regular review.

During our visit we observed the interactions taking place between the manager, staff team and visitors to the home. We noted that these interactions were open and transparent.

We found staff recruitment to be thorough and all relevant pre-employment checks had been completed before a member of staff started to work in the home.

The manager led by example and spent time working with staff, supporting them whilst carrying out their care duties.

Some people who used the service did not have the ability to make decisions about some parts of their care and support. Staff had an understanding of the systems in place to protect people who could not make decisions and followed the legal requirements outlined in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS).

 

 

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