Forest Court Care Home

Forest Court Care Home is a residential care home providing personal and nursing care to up to 40 people. The service provides support to people who live with dementia and who live with other needs which have an impact on their mental health. At the time of our inspection there were 33 people using the service.

People are accommodated in one adapted building across 2 floors. On the ground floor there are several communal rooms for people’s use. Additional space also allows people to walk with purpose. An enclosed garden, with a circular footpath, is accessible from one of the communal rooms. People have their own bedrooms with toilet and washing facilities. There are additional communal toilets and bathrooms which have been adapted to support people who are less able to bathe independently.

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

All of the 8 relatives we spoke with provided us with positive feedback, about how staff kept their relative safe, how they were kept updated about their relative’s health and how they were supported to be involved in the planning of their relative’s care. They found the staff to be supportive and friendly and described the registered manager as being approachable and easy to speak with.

There were arrangements in place to support people to stay safe. The provider was reviewing their processes to ensure they could continue to support people safely, in the event of delayed ambulance response times. This included emergency situations associated with seizures and falls.

We have made a recommendation in relation to the provider’s pre-admission assessment record.

There had been challenges in recruiting and retaining staff, but the provider had taken action to ensure there remained enough staff to meet people’s needs. Successful, recruitment of staff from overseas had helped to improve this situation. The provider had reviewed their recruitment processes to ensure robust recruitment practices were maintained.

People’s medicines were managed safely, and people were supported to take their medicines as prescribed. This included when people lacked the mental capacity to consent to take medicines which they required for their physical or mental health. Staff worked closely with the attending GP to ensure people’s medicines were appropriately reviewed.

Measures were in place to keep the environment maintained and clean. Actions were taken to prevent the spread of infection.

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.

People’s relatives and representatives were consulted and kept informed about people’s care and supervision needs. Care was planned in discussion with people and their representatives to ensure care was personalised and delivered in people’s best interests. People’s care and support was adjusted when their health declined and at the end of their life to support a comfortable and dignified death.

People were supported to take part in activities which were both therapeutic and socially beneficial. The activities co-ordinator worked alongside the care staff when people expressed signs of distress, and used activities which were meaningful to people to help retain their wellbeing.

The provider’s representatives had processes in place to monitor the quality of services being provided to people and to ensure the business remained financially viable. The registered manager and operations manager provided leadership and guidance to staff so they could carry out their roles effectively and safely. They ensured the service’s policies and procedures were updated and best practice guidance was in place for staff to follow.

Staff meetings and daily staff handovers took place to aid effective communication between staff about people’s needs. There were processes in place to assess, monitor and act on risks.

Plans were in place to reintroduce face to face relative meetings, following restrictions during the pandemic. Processes were in place to respond to feedback received and to listen to and address any complaints.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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 24 April 2020). The rating following this inspection remains the good.

Why we inspected

The inspection was prompted in part due to concerns received about how people were supported to move, how their personal care was delivered, the administration of medicines and the management of the service overall. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the safe, responsive and well-led sections of this full report.

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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forest Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Forest Court Care Home is a residential care home which provides personal and nursing care for up to 40 people. At the time of the inspection 37 people, predominantly over the age of 65 years lived there. The home specialises in supporting people who live with advanced dementia and those who also have some mental health needs.

People were accommodated in one adapted building which provided a selection of communal areas, on one level, to meet people’s diverse needs. People had private bedrooms with washing and toilet facilities. A secure garden provided people with outside space they could enjoy safely.

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

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. Staff had a good understanding of the legislation which helped to protect people who lacked mental capacity.

A person-centred approach to care was adopted and staff supported people to live well with dementia. This was achieved by staff having a good knowledge of people’s health conditions and how these affected people’s behaviour and abilities.

Staff knew people well and they acted to support people’s wellbeing. Staff responded quickly to people’s distress giving them reassurance, comfort or space as required. One relative said, “The staff seem to have the right approach to get things done, they really are marvels at what they do."

A whole team approach was in place to support people’s safety and reduce risks to people. Risks to people’s health were identified and there were robust arrangements in place to reduce these.

Staff worked closely with a range of health and social care professionals to support people’s physically and mental wellbeing. People’s increased frailty was recognised, and people were supported to have a comfortable and dignified end of life.

Support was provided to people to eat and drink enough and to take their medicines as prescribed. A relative said, "[Name] has put on weight since he moved in, which is a very good sign. The food is really good and always looks very nice."

The home’s environment was spacious and provided ample room for people to choose where they sat and to walk with purpose.

Staff had a genuine interest in improving people’s quality of life by providing one to one activities and social activities. These were designed to support people cognitively and keep them socially engaged.

Staff worked closely with those who mattered to people. Staff recognised that family, friends and pets were as integral to supporting people who lived with dementia as their care was. One relative said, "We feel part of the family, we are always made to feel welcome and offered a cup of tea and a biscuit. There is no problem with us bringing the dog with us…” Relatives were also provided with the support they needed as they experienced the journey of supporting a loved one who lived with dementia.

People were treated with respect and their dignity maintained. Staff were patient with people and valued what they had to offer. One member of staff said, “There is nothing better than sitting with and engaging with the resident.”

People and their representatives were able to raise a complaint and have this addressed and resolved where at all possible. Senior staff were available for people or their representatives to discuss concerns with them. Feedback and suggestions were sought from people’s representatives and relatives and acted on.

The provider monitored the quality of care and service provided to people. There were systems and processes in place to drive improvement where required. Although the service was currently managed by the deputy manager in the registered manager’s absence the systems and processes which supported the smooth running of the home were being maintained.

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

Rating at last inspection

This service was registered with us on 6 March 2019 and this is the first inspection.

Why we inspected

This was a planned inspection based on when the provider registered the service.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.