The inspection took place on 9 March 2018 and was unannounced. This was the first inspection of this service for the provider, Ashmere Derbyshire Limited.

The Firs Care Home with Nursing is a care home that provides accommodation with personal care and is registered to accommodate 42 people. The service provides support to older people who may also be living with dementia. The shared accommodation is on the ground floor and there are bedrooms on the ground and first floor. The home also provided an extra care service which provided a specialist dementia care service for 12 people. The home is located in the Ripley. There are public facilities and public transport services within easy reach of the home.

The Firs Care Home with Nursing is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 32 people using the service.

There was a registered manager in post. 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.

Medicine systems needed to be improved to ensure it was clear what medicines people received and this was recorded. We have made a recommendation about the management of some medicines.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People made decisions about how they wanted to receive their care although information was needed about how people had decided not to be resuscitated. People received support to stay well and had access to health care services. People liked the food that was prepared and they had a choice about what they ate and drank. Staff had opportunities to develop further skills and knowledge to work effectively in their roles.

There were enough staff to provide support to people to meet their needs. Staff had a good understanding of safeguarding people and what constituted abuse or poor practice and how to act if they suspected harm. People’s risks associated with their care were identified, assessed and managed to reduce this. Staff had been suitably recruited to ensure they were able to work with people who used the service.

People had developed positive relationships with the staff who supported them respectfully and with kindness. Staff knew people and their family well. The staff understood the importance people placed on their possessions and enabled them to look after them.

People were able to regularly review their care to ensure it was still relevant for them. People enjoyed a varied programme of entertainment and support with their hobbies.

People’s family and friends were welcomed into the home and they continued to play an important role. People knew how to make complaints and were confident that the staff and provider would respond to any concern and they could approach them at any time.

People felt the home was well managed and the registered manager was approachable and keen to listen to their views. Systems were in place to assess and monitor the quality of the service. People and staff were encouraged to raise their views about the service on how improvements could be made.