CQC report explained · a nursing home
What the CQC found at Forest Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2018
Forest Care Home rated Good overall; inspectors found kind, personalised care, but safety needs improvement.
This was an unannounced, comprehensive inspection on 16 April 2018. Inspectors spoke with people, relatives, staff and a pharmacist. They observed care and checked care records, medicines, staffing, training, complaints and quality checks.
The home was rated Good overall. Effective, Caring, Responsive and Well-led were all rated Good. Inspectors found staff were kind, understood people's needs, supported choice and independence, and provided meaningful activities.
Safe was rated Requires Improvement. Inspectors found problems with medicines records and guidance, staff deployment on the inspection day, some care plan details, cleaning records and records after incidents. The home had an improvement plan and said it was addressing some of these issues.
Kind and respectful staff
Staff were described and observed as kind, compassionate, patient and respectful. They supported privacy, dignity, choice and independence.
“People were cared for by staff who showed kindness and compassion in the way they supported them.” from the report
Personalised care
Staff knew people's routines, likes, dislikes and communication needs. Care plans included what was important to each person.
“People's individual needs, preferences, routines and what was important to them had been assessed and recorded and were known by staff.” from the report
Meaningful activities
People were supported to take part in activities that reflected their interests and past lives, including gardening, crafts and community activities.
“People received opportunities to participate in meaningful activities.” from the report
Food and healthcare support
People had choices of food and drink, with support for allergies, diabetes, cultural needs, weight concerns and choking risks. Staff worked with healthcare professionals.
“People received choices of what to eat and drink and menu options met people's individual needs and preferences.” from the report
Improvement leadership
The manager was viewed positively, and the service had audits and an action plan to drive further improvements.
“There was a system of audits and processes in place that continually checked on quality and safety.” from the report
Medicines records and guidance
needs fixingInspectors found gaps in stored-medicine temperature records and incorrect guidance on one form. Records did not always explain why PRN medicines were given, and checks on a pain relief patch were not routinely recorded.
“Some shortfalls were identified in the management of medicines.” from the report
Staff deployment
seriousThe staff team was short by one person on the inspection day. Communal areas were not always monitored, including when people were near a broken glass or might have needed help.
“We were concerned that people in communal areas did not have staff present at all times.” from the report
Care plan detail
needs fixingSome care plans did not give enough detail about how staff should respond to anxiety, mood changes or behaviour. Inspectors said staff knew people well, so this was partly a recording problem.
“We found some inconsistencies in the level of detail provided to staff about how to manage these needs.” from the report
Incident records
minorAccidents and incidents were reviewed, but records did not always clearly show what action or monitoring followed an incident.
“It was not always clear from documentation of action taken post incident.” from the report
- 01What has been changed to make sure medicine storage temperatures are recorded correctly every day?
- 02How do you record why PRN medicines are given and check whether frequent use needs a medicine review?
- 03How do you check that old pain relief patches are removed and that patches remain in place?
- 04How do you make sure communal areas are staffed and monitored at all times, including when staffing is unexpectedly short?
- 05Have all care plans been reviewed to give staff clear guidance about anxiety, mood changes and behaviour?
This was an unannounced comprehensive inspection covering all five key questions, with care and the premises both considered. This explanation was written from the published report of 19 May 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2017
Forest Care Centre was rated Requires Improvement; inspectors found kind and responsive care, but weaknesses in safety, staff guidance, medicines and management systems.
This was an unannounced inspection on 17 January 2017. The inspectors spoke with people living there, relatives, staff and a visiting healthcare professional. They observed care and checked care records, medicines, staff training, recruitment and quality checks.
The home was caring and responsive, with kind staff, activities suited to people's interests, regular care plan reviews and systems for handling complaints. People were supported with food, drink and healthcare, and staff understood safeguarding responsibilities.
The home was not consistently safe, effective or well-led. Risk plans, emergency evacuation plans and behaviour support plans lacked detail. Medicines records and weight monitoring were not always complete. Staff training and supervision were improving, but some areas were still being completed.
The overall rating Requires Improvement means inspectors found important improvements were needed. The report says the registered manager had made progress, but new systems needed more time to become fully established and lasting.
Safeguarding awareness
Staff had safeguarding training and knew how to report suspected abuse. Inspectors also found that safeguarding incidents had significantly reduced after action was taken.
“Staff understood how to identify and report allegations of abuse.” from the report
Kind and respectful care
People and relatives described staff as kind and caring. Inspectors observed calm, respectful support and found that privacy and dignity were maintained.
“People were cared for by staff who showed kindness and compassion in the way they supported them.” from the report
Personalised activities
Activities reflected people's interests, including walks, music, cinema visits, arts and crafts and community trips. Staff also supported people with everyday activities they enjoyed.
“Activities were available to meet people's individual preferences and interests.” from the report
Healthcare support
People were supported to see healthcare professionals when needed. Inspectors found that referrals were appropriate and timely and that staff followed professional recommendations.
“People had the support they needed to maintain good health and the service worked with healthcare professionals to support people appropriately.” from the report
Risk plans lacked detail
seriousSome risk plans did not give staff enough specific guidance. Inspectors found missing or incomplete instructions for choking, seizures, diabetes and repositioning.
“Risk plans had been developed that advised staff of action required to reduce risks; however these lacked detail in places.” from the report
Medicines records
seriousInspectors found an eye drop was not dated when opened, gaps in stock checks and incomplete records for medicines given when needed. People's preferences for taking medicines were not recorded.
“Some inconsistencies were found with the recording of medicines prescribed to be taken as and when required.” from the report
Behaviour support guidance
seriousSome behaviour care plans did not explain clearly what challenging behaviour meant for the person or how staff should respond. One recommended plan had not been provided.
“The lack of clear written guidance for staff meant that people could not be assured that staff fully understood their needs.” from the report
Weight monitoring
needs fixingSome people's weights were not recorded as often as their care plans required. The home had introduced weekly meetings to improve oversight of changing needs.
“Two other people's care plans stated that the individuals were required to have their weight taken each week but we found some gaps in the recording of their weight.” from the report
Care plans not always followed
needs fixingInspectors found examples where care plans lacked detail or were not followed. One person was seen without glasses and shoes despite their care plan saying staff should support them to wear these.
“This person's care records included a recent incident, whereby they had sustained an injury to their foot whilst not wearing shoes.” from the report
- 01What has been done to make risk plans specific for choking, seizures, diabetes and repositioning?
- 02How are medicines given when needed recorded, including the reason they were given and the person's preferred way to take them?
- 03How do you make sure behaviour support plans give staff clear, consistent instructions during periods of anxiety or agitation?
- 04How do you check that people's weights are recorded at the frequency set out in their care plans?
- 05What progress has been made with staff training, supervision and the recruitment of permanent nursing staff?
This was an unannounced comprehensive inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 17 March 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Forest Care Home
4 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- May 2018Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2015Requires improvementSafe: Requires improvementEffective: Requires improvementResponsive: Good
- May 2015
Report published without a new overall rating.
- June 2014
Registered with the Care Quality Commission on 9 June 2014.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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