Forest Lodge Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

The provider supported people in a way that was safe. There was a learning culture where staff undertook regular training and lessons were learned when things went wrong. Risk assessments were in place which included information about how to mitigate the risks people faced. Systems were in place to protect people from abuse. There were enough staff working at the service and robust recruitment practices were followed. Effective systems were in place for the prevention and control of the spread of infection. Medicines were mostly managed in a safe way, although we found some errors with medicine records.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives told us that staff had the skills to do their job and knew how to provide the support people needed.

The service had a positive culture and attitude to safety and ways of learning, particularly from things that went wrong. The Registered Manager told us how incidents were analysed to ascertain things that could be learnt when things had gone wrong.

The provider had a learning culture in place. For example, staff undertook regular training to help them learn and develop skills and knowledge required for their role. This included training about dementia awareness, manual handling and basic life support. The provider also learned from accidents and incidents. These were reviewed to see what action could be taken to help prevent similar accidents from re-occurring.

People and relatives told us that people were able to transition between services in a smooth and safe way, and that people’s needs were assessed before transitions between services. We were told that the service sought to admit people to hospital where it was appropriate to do so.

The Registered Manager told us how the home worked with a number of health professionals. We heard how the home worked predominantly with hospital services to carry out assessments for people to be discharged into their care. The Manager told us the home had access to a weekly GP call as well as a rapid response service to access support for anyone whose needs rapidly change.

We asked the host local authority about this service as part of this assessment. They did not express any concerns about safe systems for people’s pathways and transitions between different care services.

The provider carried out pre-admission assessments before people started using the service. This included information about individual needs as well as risks to their own and other’s safety. We found that detailed care plans and risk assessments were completed for people to support them to receive person-centred care. This included information around communication and personal behaviour support plans. Systems were in place to ensure that these were reviewed. During our visit we observed that some care plans were due for review which we discussed with the Registered Manager.

People and relatives told us that people were safe at the service. One person said, “I am very safe and well cared for here.” Another person said, “They have to hoist me, but they do that safely and very well.” A relative told us, “I believe [person] is safe.”

Staff told us about the safeguarding training they received, this was carried out annually and was part of the providers mandatory training programme. Staff were able to describe the types of abuse and how they would report it. They told us about the people within their own organisation they would talk to as well as statutory bodies external to the organisation they could report their concerns to.

We observed staff interacting with people in a way that protected people from the risk of harm. Where people appeared anxious or distressed, staff were able to support people to become calm. Staff had undertaken training in Positive Behaviour Support. The registered manager told us on very rare occasions it was necessary for staff to use physical restraint with people. We noted that staff had undertaken training about how to do this in the least restrictive way. Staff told us this was only ever used as a last resort.

The home had systems in place for reporting to the local authority and to CQC. We saw evidence of how information was gathered and analysed within the organisation and the ways in which this information was used for future learning.

People and relatives were involved in how risks were managed for people. A relative told us they were involved in developing care plans and risk assessments for the person. The said, “I told them at the beginning, they asked me about [person] and I told them.”

Staff were aware of people’s risks and how to manage this to keep people safe. This included being aware of people’s preferences and routines. Staff told us they followed people’s individual care plans and risk assessments to manage risk to themselves and other people. This information was stored on an electronic records system and accessible to staff.

Staff were observed to support people in a way that promoted their safety and in line with risk assessments.

Risk assessments were in place for people. These set out the risks people faced and included information about how to mitigate those risks. They covered risks including skin integrity, oral care, nutrition and hydration and medicines. We saw for one person they were at risk of constipation due to one of the medicines they took and the risk assessment stated this needed to be monitored daily. However, records showed this was not done. We discussed this with the deputy manager who told us they would address this.

People and relatives we spoke with did not express any concerns relating to the safety of the premises.

Staff told us part of their job was identifying hazards that could be a danger to the people living in the home or their colleagues. We learnt that the home had people responsible for maintenance of the building.

We saw during our visit that the environment was safe. All areas were clean and well maintained. At the time of our visit the lift was out of service. However this had been reported and mitigations had been put in place to ensure that people and staff were kept safe. People had access to a spacious garden area and there were activity rooms on each floor.

Processes were in place to help ensure the premises were safe. These included regular fire safety checks, such as testing fire alarms, and ensuring proper maintenance of equipment and the building.

People and relatives told us there were enough staff working at the service. A person said, “The carers do the best they can and look after me well and there are plenty of staff around. I have no problems or trouble here.” They added, “If I ring my call bell, they come quickly.” A relative said, “Yes there are enough staff, they do look after them properly. I have seen it myself.” Another relative told us, “Recently there have been enough staff. It was understaffed but it seems fine now.”

Staff told us about their induction when they started their employment. This included reading information about people and a period of working alongside experienced staff, allowing them to get to know people they will support.Staff told us about the training they received, both online and face to face. Staff said they felt they had all the training they needed to be able to offer the support to people in their care.

People seemed generally well supported, there appeared to be adequate numbers of staff to meet people’s needs. People were kept free from danger and we saw many positive interactions between the people living in the home and the staff supporting them.

The provider had robust processes in place to ensure that staff were recruited safely. This included checks on right to work and Disclosure and Barring Service (DBS) who provided information including details about convictions and cautions held on the Police National Computer. We reviewed staff rotas and found that the service ensured that there were sufficient numbers of staff to provide care. During our visit we observed that there was enough staff to keep people safe. This included close supervision for people who required additional support.

People and relatives told us the premises were clean. A person told us, “My room is cleaned every day.” Another person said, “They wear PPE when doing tasks.” A relative said, “Yes, it is clean.”

The manager told us about the range of personal protective equipment the home provided to staff to minimise the risk of infection. They told us the home provided gloves, aprons and a variety of other equipment available to maintain high standards of hygiene.

We observed the premises to be clean and free from offensive odours during our inspection, and COSHH products were seen to be stored securely and safely. We saw designated cleaning staff carrying out cleaning duties during the inspection. We observed that staff wore PPE where appropriate to do so to help reduce the risk of the spread of infection.

Processes were in place to help with infection prevention and control. There was a policy in place to help guide staff practice, and staff had undertaken relevant training. There were cleaning schedules in place to ensure areas of the service were cleaned as required.

People told us they were supported to take medicine. One person said, “They watch me take my medicine.” Another person said, “I always get my medication on time and they watch me take it.”

Medicine in the home were administered by qualified and registered nurses. They told us they undertook regular medicines administration training. They had a good understanding of the medicines people took and said they had enough time to carry out medicine rounds.

Overall, we found that processes supported the safe administration of medicines. The arrangements for the storage of medicines were appropriate, medicines were stored in locked cabinets inside designated and locked medicine rooms. Medicine Administration Records were maintained, these were found to be accurate and up to date and provided an audit trail of medicines that were given. Controlled drugs were stored, record and administered in line with legislation. Stock balances were kept of medicines, although we found 2 instances where there was a slight variation in the number of medicines in stock and those recorded as being in stock. Guidelines were in place for the use of PRN [as required] medicines, although on 1 of these it did not record the maximum amount to take within a 24 hour period.