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CQC report explained · a residential care home, run by Welltower

Fir Trees

Gorse Hall Road, Dukinfield, SK16 5HN

Goodpublished 22 November 2023, 2 years ago

Rated Good: inspectors found the service performing well and meeting their expectations.

The five questions inspectors ask
Safe?
Requires improvement
People were protected from abuse and medicines were stored safely, but risk assessments were not always robust. Inspectors found overly hot water, unsecured items and mixed feedback about staffing levels.
Effective?
Good
People's needs were assessed before they moved in and staff had suitable training. The building and some dietary records needed further improvement.
Caring?
Good
People and relatives spoke positively about staff. Staff were observed respecting privacy, dignity, independence and people's choices.
Responsive?
Good
People received personalised care and took part in activities and relationships that mattered to them. Some personal information and communication needs were not recorded clearly enough.
Well-led?
Good
The home had an open culture and systems for gathering feedback and making improvements. Record keeping and some risk controls still needed strengthening.
The latest report, explained

What inspectors found, November 2023

Rated Good overall, but inspectors found that safety checks and risk management needed improvement.

This was an unannounced inspection over two visits. Inspectors reviewed care, medicines, staffing, records and the building. They spoke with people living there, relatives and staff.

The overall rating was Good. Effective, Caring, Responsive and Well-led were all rated Good. People and families described kind staff, good support and an open management team.

Safe was rated Requires Improvement. Inspectors found risks from very hot water, unsecured items and incomplete risk information. The manager acted straight away when these issues were raised, but inspectors said risk management needed further development.

The home also needed improvements to damaged décor, records about communication and some care details. CQC made recommendations about the environment and the Accessible Information Standard.

What inspectors praised

  • Kind and respectful staff

    People and families described staff as kind and caring. Inspectors saw staff protecting people's privacy and supporting their independence.

    “Staff are good and always kind and caring. They really do look after them.” from the report

  • Good activities and choice

    People were supported to choose their care and take part in meaningful activities. Visitors could come at any time.

    “The activities are great.” from the report

  • Medicines generally safe

    Medicines were securely stored and people received them as prescribed. Staff giving medicines had training and their practice was checked.

    “Medicines were securely stored, and people were receiving support to take their medicines as prescribed.” from the report

  • Open management

    People, relatives and staff described a positive culture. The manager responded quickly when inspectors raised concerns.

    “Registered manager always has an open door, I feel able to raise anything.” from the report
What inspectors were concerned about

  • Risk controls were not robust enough

    serious

    Inspectors found very hot water that could cause scalding, gloves accessible in some areas and unsecured items that could harm a person. Another person's risk from using a flammable skin cream while smoking had not been assessed.

    “The provider had not always effectively assessed risk to ensure people were safe.” from the report

  • Staffing levels were mixed

    needs fixing

    Some relatives and staff said there were times when staffing was not sufficient or responses to bells took too long. The provider said staffing and deployment would be monitored.

    “Sometimes there are not always enough staff. It can take time for them to respond to [family members] bell… .” from the report

  • Building needed repair and updating

    needs fixing

    Damaged wallpaper, flooring, skirting boards and walls made some areas harder to clean. The décor also did not fully support people living with dementia.

    “A number of areas of the home were outdated and paintwork and walls were damaged, making it difficult to ensure effective cleaning.” from the report

  • Some records lacked detail

    needs fixing

    Care records did not always capture people's preferences, communication needs, dietary support or some medicine instructions clearly. The provider was introducing an electronic care planning system.

    “Records did not reflect how the provider was meeting the Accessible Information Standard.” from the report
Questions to ask them, based on this report
  1. 01What has been done to make sure hot water is kept at a safe temperature throughout the home?
  2. 02How are staffing levels and staff deployment monitored at busy times, and how quickly are call bells answered?
  3. 03Which damaged areas of the building have been repaired, and what is the timetable for the remaining refurbishment?
  4. 04Have care plans been updated to record each person's communication methods, preferences, dietary needs and risks?
  5. 05How are medicine instructions, including patch rotation and variable doses, now recorded and checked?

This was an unannounced inspection covering all five CQC questions, including the premises and care, and it was the first inspection under the current provider. This explanation was written from the published report of 22 November 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.

The story over the years

Every inspection of Fir Trees

4 rated inspections over 9 years: the service has held its Good rating throughout.

  1. November 2023Goodcurrent rating
    Safe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good

    Read what inspectors found at Fir Trees →

  2. March 2021Inspected but not rated
    Safe: Inspected but not rated
  3. December 2018Goodup from Requires improvement
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  4. October 2017Requires improvementdown from Good
    Safe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
  5. April 2015Good
    Safe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
  6. August 2021

    Registered with the Care Quality Commission on 27 August 2021.

Ratings and report dates from the Care Quality Commission. A service can also be visited without a new rating being published, so the timeline shows published inspections, not every contact the CQC has had with the service.

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