A residential care home in Budleigh Salterton has been placed in Special Measures after receiving an 'Inadequate' rating from the Care Quality Commission (CQC).

The CQC inspected The Firs Residential Home, operated by Buckland Care, at the beginning of September and the inspection report was published this week.

The Firs Residential Home currently looks after 28 people and provides care for people living with dementia, mental illness, and/or a physical disability.

Overall the service was rated as 'Inadequate'. For safety, effectiveness and caring the service was rated as 'Requires Improvement'. Responsiveness and leadership were rated 'Inadequate'.

Buckland Care have responded to the report by saying, the 'Firs has already addressed all issues raised in the report' and 'the safety and well-being of our residents is our number one priority'.

At the time of the inspection Devon County Council's adult safeguarding team were investigating allegations of poor care, and the service was being supported by the local authority quality and improvement team.

Because of the concerns identified, the provider decided to voluntarily suspend all new placements to the service until improvements were made.

Staffing and safety were flagged up as problem areas in the report: "People told us they felt safe living at the service. However, not all practices were safe enough.

"People were supported by staff who had been recruited safely. However, people expressed there was not always enough staff to meet their needs.

"The manager was actively recruiting for new staff, but in the meantime was using temporary agency staff to cover staffing vacancies.

"We found the reduction of permanent staff was impacting on the service, as the high use of agency staff meant new systems and processes were not always communicated or embedded."

The CQC inspector also expressed concerns about the risks associated with people's care were not always documented and known by staff. Meaning that there was a risk people received 'unsafe or inconsistent care'.

The inspector did praise the service's environment and its approach to granting its residents a measure of independence. The report states: "People lived in a clean environment and were protected from the spread of infection.

"The environment had been assessed for safety. Some people were supported with some aspects of choice and control in their lives. Overall, staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice."

There were however complaints from residents to the inspector about the quality of meals provided.

According to the report: "People were not complimentary about the quality of meals provided commenting, 'Terrible, it's horrible. You get starchy food such as big pieces of cake. The meat is terrible it's so tough you can hardly cut it'. Other comments included, 'I don't like the food, I'm very fussy. I don't eat vegetables. I always get mash and chopped food, I don't know what it is', and "We have mince, cottage pie, mince, cottage pie".

"People who were at risk of not eating and drinking enough were not being monitored safely. One person was at a high risk of weight loss, and their records showed they had lost seven kilograms in six months. However, there was no nutritional care plan to advise staff how to support the person to maintain a safe weight.

"A member of staff told us, they should offer snacks between meals but explained this was not always possible due to low staffing levels. The new manager explained they were aware of the need to address risks relating to weight loss and told us they were planning to introduce 'nutrition boosts' in future."

The inspector also expressed concerns around potential injuries and a lack of risk assessment or body maps in place to describe what ongoing and preventative support was required to mitigate ongoing risks.

Staffing levels seem to underpin many of problems described by the CQC's inspector, the reports states: "People told us there was not always enough staff to meet their needs. One comment included, 'Sometimes they [the care staff] are good at responding to calls [call bells], but because of the pressure they are under, I couldn't get them, I had to wait ages'.

"Another person told us, 'They're rushed, there's never enough staff'. A relative told us, 'Things have slipped as there are not enough staff'. A member of staff told us, 'Staffing levels are not bad, when we are fully staffed it works. It's when someone doesn't show up we have problems. We manage. I haven't seen anything overly dangerous due to lack of staff'."

During the inspection the manager explained that there were 'a significant number of staffing vacancies at the service, and that recruitment was ongoing' and in the meantime temporary agency staff were being brought in to maintain staffing levels.

The CQC inspector said: "We found the reduction of permanent staff was impacting on the service, as the high use of agency staff meant new systems and processes were not always communicated or embedded."

Now The Firs Residential Home has been placed in special measures it will be kept under review and will be reinspected within six months to check for 'significant improvements'.

According to the CQC: "If the provider has not made enough improvement within this time frame. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures.

"This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration."

Buckland Care director Lianna Birkett has responded to the issues raised in the report: "The Firs has already addressed all issues raised in the report and the team continues to work very closely with Safeguarding and the CQC.

"The safety and well-being of our residents is our number one priority. We now have excellent, experienced new management in place and we are confident that our next inspection will be a vast improvement on the last.

"We want to thank staff for their hard work and residents and relatives for their patience whilst we go through this transition period."

If you would like to read the CQC's report please click on the red button below.