The inspection took place on 8 and 9 October 2018. It was unannounced.

Fir Villa provides accommodation and personal care for up to 24 residents. Accommodation is provided in the main house and there is a one-bedroom cottage, known as The Owls Nest which is situated in the grounds of the home. The home is staffed 24 hours a day, at the time of the inspection there were 22 people living at the home.

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.

At our last inspection we rated the service good. At this inspection, although there were some improvements needed to how the provider manages people’s medicines, the provider responded immediately and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns to people. We therefore kept the overall rating of good in place.

People being supported at Fir Villa told us they felt safe, although some areas of practice within the service were not safe, and placed people at risk. For example, one person’s medicines had not been administered for seven days. There were gaps in fridge temperature records and no records were kept of the room temperatures where back up stocks of medicines were stored. Discrepancies that the inspection team found had not been brought to the attention of the registered manger and appeared to occur when the staff member responsible for medicines management was on annual leave, which meant the oversight of people’s medicines was not robust.

Staff showed a good awareness of safeguarding procedures and knew who to inform if they saw or had an allegation of abuse reported to them. The registered manager was also aware of their responsibility to liaise with the local authority if safeguarding concerns were raised.

The provider had suitable processes to assess people’s needs. Care plans were detailed and contained risk assessments that documented areas of risk to people, such as nutrition and hydration or pressure areas. Staff sought consent to care.

The provider employed enough staff to cover the needs of the home and there was a robust recruitment and selection process in place where staff had been subject to criminal record checks before starting work at the service.

The provider had infection control arrangements in place and the home was clean, tidy, and free from any unpleasant odour. Accident and incident reporting was robust. Staff knew the reporting process. Records showed that staff had taken proper action where necessary and made changes to reduce the risk of a re-occurrence of an incident.

Staff and volunteers had the skills, knowledge, and experience to support people. Supervision and appraisals were completed regularly to develop and motivate staff to improve on the care and support being delivered.

Staff supported people to eat, drink and keep a balanced diet. People told us that they had choices of food and that the quality of the food was good. People told us they had access to healthcare services such as GPs, Dentists, and Chiropodists.

People were supported to take part in activities. The provider helped people celebrate special occasions such as birthdays and religious festivals such as Christmas.

People told us they were encouraged to give their views and raise concerns or complaints.

The leadership was visible and accessible. The registered manager understood the importance and responsibility of their role and had clear lines of responsibility and accountability. There was evidence that learning from incidents and accidents and investigations took place and appropriate changes were implemented

There were effective quality a

This inspection took place on 12 April 2016 and was an unannounced inspection.

Fir Villa provides accommodation and personal care for up to 24 residents. Accommodation is provided in the main house and a one bedroom cottage, known as The Owls Nest which is situated in the grounds of the home. The home is staffed 24 hours a day

At the time of our inspection there were 22 people living at the home. 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.

The atmosphere in the home was relaxed and welcoming. People and their visitors described Fir Villa as a home from home. One person told us “It’s a real home from home here and you would struggle to find anywhere better.” A visitor said “Nothing is too much trouble. The staff are so happy and friendly and they always have time for my [relative].”

There were sufficient staff to meet people’s needs and help keep them safe. Staff were available when people needed them and they responded quickly to any requests for assistance. One person said “If I need anything; the staff are always there.” Another person said “Sometimes I use my call bell and somebody comes before I know it.” A member of staff said “I love coming to work and what’s really good is that we can spend so much time with people.”

People told us they received care and support from kind and caring staff. Throughout this inspection we saw people were supported in a friendly and gentle way. Personal care was provided to people in a way that respected their privacy and dignity. One person told us “The staff have always got a smile on their face. They are all so very kind to me and so patient.” Another person told us “Everything is perfect. I couldn’t be happier. The staff are lovely and will do anything they can to help you.” A visitor said “The staff are so happy and friendly. It’s like you’re part of a big family. I know they adore my [relative].”

People's health needs were monitored and they had access to healthcare professionals according to their individual needs. Incidents and accidents were analysed to ensure people received the support they required to maintain their health and well-being. A visiting health care professional described the care people received as “Excellent.” They said “The staff here are so knowledgeable about people and they inform us and work with us if there are any concerns.”

People had their nutritional needs assessed and received meals in accordance with their needs. Where people required physical assistance to eat this was provided in a dignified manner. People were complimentary about the food served in the home. One person said “I am certainly well fed and the meals are excellent.” Another person told us “It’s good home cooking. Very good indeed and plenty of it.”

The arrangements for social activities were innovative and focused on meeting people’s individual needs. The home employed a very enthusiastic activity co-ordinator who developed a very varied and innovative programme of activities for people. Outside entertainers and visitors to the home included shows put on by a community theatre group, singers, musicians and visits from various animals. There was a strong emphasis on enabling people to continue with their individual hobbies and interests. There were strong links with the local community.

Staff knew how to recognise and report abuse. They had received training in safeguarding adults from abuse and they knew the procedures to follow if they had concerns. Risks to people were well managed and people were supported to be as independent as they could be.

The service made sure medicines were stored securely and there were sufficient supplies of medicines. Peo

People told us that they understood the care choices available to them, and could have their views taken into account in the way their care was delivered. A person’s relative told us, "We discussed his needs." Another person’s relative said, "He is fussy about food. They let him select"

People's needs were assessed and care was planned and delivered to meet people's needs. A person’s relative told us, "We received a home visit and pre-assessment." We found that people's care was regularly reviewed and their personal information was held securely. A visiting family member told us, "I am completely happy with what they have done."

We saw that people’s needs were met by sufficient numbers of staff with the right knowledge, experience, qualifications, and skills. A relative told us, "There is always enough staff. They are always doing something, not just standing around chatting to each other.”

We found that people were protected from abuse, or the risk of abuse, and their human rights were respected and upheld.

We found that people benefitted from safe quality care, treatment, and support due to effective decision making and management of risks to their health and welfare.

People that we spoke with told us staff were respectful to them and asked for their consent daily. People and their representatives told us staff provided the care and support that they needed. One relative told us “He is looked after very well here. We are absolutely delighted.”

People received the medicines they had been prescribed when they needed them. People told us they could have pain relief if they needed it. One person told us “I get my medicines every day. One person gives the medicine out and the other person looks after the trolley.”

There were effective recruitment and selection processes in place for staff recruited to work in the home. We saw that the provider had checked whether people had any criminal convictions or cautions and had ensured that they were not on the list of people barred from working with vulnerable adults. Staff we spoke with confirmed that they had not started work at the home until all of the appropriate checks had been completed.

People’s personal records including their medical records were accurate and fit for purpose. We checked other records relevant to the management of the services and saw that they were accurate and fit for purpose. All of these records were kept securely and could be found promptly.

People using the service described Fir Villa as a “home from home” and they confirmed that they were able to make choices about all aspects of life at the home. People told us that they chose what time they got up, when they went to bed and how they spent their day. Comments included “we can do what we like really”, “you are never made to do anything you don’t want to do”, “the staff are lovely and they always respect your decisions”.

Each person is provided with a copy of a menu and they confirmed that they were able to make choices about what they would like to eat. During the afternoon a member of staff informed people of the tea time choices and recorded each person’s preference.

During our visit we observed people moving freely around the home. Some people had chosen to spend the majority of their day in their bedroom. One person said “you can come to your room when ever you like and if you need help you just ring the bell and the staff come quickly”, “they check on me regularly and bring me cups of tea”.

Some people spoken with were aware that they had a care plan and they said that they were always asked about the care they needed and of their preferences. One person said “the staff know me well and they know how much help I need”. Another person told us “I am always treated with respect by the staff and I never feel rushed”.

People appeared very comfortable in the presence of staff and it was evident that staff knew people well. They were skilled in recognising and responding to people’s needs even though some people were unable to make their needs known verbally. Staff interactions were noted to be kind and respectful. The atmosphere in the home was relaxed and inclusive and people were offered assistance with personal care in a dignified and discreet manner. Staff were observed knocking on people’s bedroom doors before entering.

People living at the home told us that they were very happy with the care they received. Comments included "It's wonderful the way we are looked after", "They look after you very well" and "I get all the help I need."

We were able to speak with two visitors and they told us “you couldn’t find a better home than this”, “the care is second to none and all the staff are so kind and caring”. Both confirmed that communication had been “excellent” and that the home kept them very well informed about their relative.

During our visit we observed that staff offered assistance to people in a discreet and respectful manner. We noted that everyone living at the home was very well presented demonstrating that staff took time to support people with personal care and dressing.

No concerns were raised with us during our visit and people told us that they would feel comfortable in raising concerns if they had any. One person said “you would only have to say if you were worried about something and it would be dealt with”. Another said “the owner is wonderful and would always sort things out for you”.

Everyone asked said that they felt there were always enough staff on duty to meet their needs. One person said "There are plenty of staff and they are always quick to help." Another person said "Staff will do anything for you, you only have to ask."

People told us that they were well informed about life at the home and that their views were regularly sought. Comments included “we have regular meetings so we always know what is going on”, “they are very good at keeping you up to date about things”. One person said “we are just one big happy family”.