Forest Home

Updated 30 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by 1 inspector.

Service and service type

Forest Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Forest Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations. At the time of our inspection there was not a registered manager in post. A manager had been in post for 1 year and had applied to register with CQC. At the time of writing this report CQC had rejected this application as some documentation provided was out of date.

Notice of inspection

This inspection was unannounced. Inspection activity started on 02 August 2023 and ended on 30 August 2023. We visited the care home on 16 and 29 August 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.

During the inspection

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 5 people who used the service and 7 people’s relatives about their experience of the care and support provided. We spoke with the manager, the provider, a senior care worker, 2 members of catering team, 3 members of care staff and an activity co-ordinator.

We reviewed a range of records. This included 3 people’s care plans and a staff personnel file to review the provider’s recruitment practices, including induction arrangements. We undertook a physical count of a random selection of medicines and reviewed 5 people’s medicine records. We also looked at the provider’s staff training records and supervision arrangements. A variety of records relating to the management of the service, quality assurance information and policies and procedures were viewed.

Updated 30 September 2023

About the service

Forest Home is a residential care home providing personal care and accommodation for up to 39 people. The service provides support to older people and people living with dementia. At the time of our inspection there were 36 people using the service in 1 adapted building, with 1 wing specialised in providing care to people living with dementia.

People’s experience of using this service and what we found

There was a lack of robust management oversight in some areas of the home. Some quality assurance monitoring was undertaken however, this was not always effective as the shortfalls found at inspection had not been identified through this monitoring. Medicine management was not always robust, however, concerns identified at the inspection were addressed by the manager immediately with support from the GP.

People’s care records, care plans and risk assessments would benefit from further detail to help and support staff to provide personalised and consistent care. Some practice in the home did not always promote people’s dignity and privacy, we have made a recommendation about promoting and respecting people’s dignity.

Some areas of the home were tired and in need of refurbishment. The manager advised this was taking place gradually. The home lacked dedicated storage facilities and consequently easily became cluttered and therefore harder to maintain good Infection Prevention Control (IPC) practice. Some staff training was not up to date or in place. For example, diabetes awareness and some refresher training, whilst it had been booked, was overdue. The manager demonstrated this training had now been booked prompted by the inspection.

People told us they felt safe and staff said they knew how to report concerns. People, relatives and staff said there were enough staff deployed to meet people’s needs. People’s relatives told us, and we saw in records and through our observations, that changes to people’s health were identified and managed. People had access to food, drink and call bells throughout our inspection. We saw there were records kept of fluids consumed, these checked daily by the manager to satisfy themselves people were receiving adequate hydration.

People and relatives said they were treated with care, kindness, dignity, and respect. Staff had a good knowledge and understanding of people's specific care and support needs and how they wished to be cared for and supported. The relationship between staff and people using the service was positive.

The provider had a complaints policy and procedure in place. People, and those important to them, could raise any concerns and complaints easily. People and relatives said they felt the service was able to meet people’s individual needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 08 July 2017).

Why we inspected

This inspection was prompted by a review of the information we held about this service. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified breaches in relation to medicines management and monitoring and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.