CQC report explained · a residential care home
What the CQC found at Forest Lodge Rest Home
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, September 2019
Rated Requires Improvement; inspectors found safe and caring support, but concerns about staffing responsiveness, training and management checks.
The home provides residential care for up to 28 older people, including some people with mental health conditions. This was an unannounced, planned inspection on 23 July 2019. Inspectors spoke with people, relatives, staff and a health professional, and checked care, medicines, staff and management records.
The home was rated Good for Safe and Caring. Medicines were managed safely, staff recruitment checks were completed, and people were treated with respect. Inspectors also found that people's cultural, religious and communication needs were supported.
The home was rated Requires Improvement for Effective, Responsive and Well-led. One staff member had not received training but was helping people with moving and eating. Some people were left without staff nearby, activities or a call bell, and some care records and behaviour plans were incomplete.
The overall rating fell from Good at the previous inspection in March 2017. The home breached Regulation 17 because its audits and other checks did not reliably identify or manage risks. Inspectors said no evidence showed that people had been harmed, but the weaknesses placed people at risk.
Safe medicines
Inspectors found that medicines were administered by trained and assessed staff. Records, storage and stock management were checked and found to be safe.
“Medicines were managed safely. People had their medicines administered safely by staff who had received training and competency checks.” from the report
Respectful care
People's privacy, dignity, cultural needs and spiritual choices were respected. Staff used people's preferred languages or other communication methods where needed.
“People's diverse needs were respected, and care plans identified their cultural and spiritual needs.” from the report
Food and health support
People could choose meals and their dietary and cultural needs were considered. Staff monitored weights and supported people to attend health appointments.
“The chef was aware of people's dietary needs and these were catered for.” from the report
Welcoming relationships
Inspectors found established relationships between staff and people. Relatives were welcomed and kept informed about changes in care.
“Relatives were made welcome in the home.” from the report
Weak management checks
seriousSeveral audits recorded that things were in place when inspectors found they were not. This included cleaning supplies, damaged furniture, shared slings and medicine arrangements.
“We found no evidence that people had been harmed however, systems were either not in place or robust enough to demonstrate safety was effectively managed.” from the report
Training and moving support
needs fixingOne staff member had no training but was helping people with wheelchairs and food. Inspectors also found incorrect footwear being used with mobility equipment.
“One staff member had not received any training; however, they were supporting people with moving them in a wheelchair and supporting people with their food and snacks.” from the report
People left without enough support
needs fixingThe communal lounge was unsupervised for large parts of the day. Some people had no call bell and were not encouraged to move, talk or take part in activities.
“The communal lounge was unsupervised for large parts of the day.” from the report
Incomplete care information
needs fixingSome people's life stories and behaviour plans were incomplete. The home also did not always have a specific end of life plan.
“Some people had been in the home several months, family had been regular visitors however, the forms had not been completed.” from the report
- 01What checks now confirm that every staff member is trained before supporting people with moving, wheelchairs or food?
- 02How do you make sure people who cannot move independently have regular interaction, activities and a working way to call for help?
- 03What changes have you made to ensure audits accurately identify cleaning, equipment, medicines and other safety problems?
- 04How are people's life stories, behaviour support plans and end of life wishes recorded and kept up to date?
- 05What action has been taken in response to the Regulation 17 breach, and what evidence can you show that the changes are working?
This was an unannounced planned inspection covering all five CQC questions, with the previous ratings from March 2017 reviewed and the home, care and records assessed. This explanation was written from the published report of 27 September 2019 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
Rated Good; inspectors found safe, kind and responsive care, but some risk assessments needed updating.
This was an unannounced comprehensive inspection on 21 February 2017. Inspectors reviewed information before the visit, spoke with people living at the home, relatives, staff and the manager, and checked care plans, medicines records, training records and quality checks.
The home was supporting 27 people, with room for 28. Inspectors found enough staff, safe medicines systems, suitable training and access to healthcare. People were treated with kindness, dignity and respect, and staff understood their individual care needs. There were clear care plans and a complaints process.
The home remained Good in every area and overall, the same rating as at the previous inspection. Inspectors noted that some risk assessments were not accurate, although staff were managing the risks safely and the manager was updating the records.
Safe staffing and medicines
People and relatives said there were enough staff, and inspectors found systems that supported medicines being given correctly and on time.
“We saw that appropriate systems were in place to ensure that people received their medicines as prescribed and at the correct time.” from the report
Kind and respectful care
Staff had positive relationships with people and respected their choices, dignity, privacy and personal preferences.
“There were positive and caring relationships between people living at the home and staff and people praised staff's caring attitude.” from the report
Individual care
Care plans described the help people needed, what they could do independently and their preferences. Staff understood changes in people's needs.
“There were detailed care plans in place which gave information about any assistance people required as well as tasks they could carry out independently.” from the report
Open leadership
Inspectors found clear leadership, an open culture and regular checks on the quality of the service.
“There was an open and transparent culture which enabled people and staff to speak up if they wished to.” from the report
Some risk assessments were inaccurate
needs fixingInspectors found that risks had not always been assessed correctly. For example, one falls assessment said a person walked around the home when they needed staff help to change position. Staff were managing the risk safely, and the manager was updating some assessments.
“Whilst risks to people's health and safety had not always been appropriately assessed, they were well managed.” from the report
- 01How have you checked and updated the risk assessments that were found to be inaccurate?
- 02How quickly will care records be changed when a person's mobility or falls risk changes?
- 03What activities are currently available, given that the report described activities as occasional?
- 04How do you check that medicines administration records remain complete and correct?
- 05How are staffing levels changed when people have planned appointments or activities?
This was an unannounced comprehensive inspection covering all five questions and the overall rating. This explanation was written from the published report of 29 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 Lodge Rest Home
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- September 2019Requires improvementcurrent ratingdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- March 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- July 2011
Registered with the Care Quality Commission on 21 July 2011.
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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