CQC report explained · a nursing home
What the CQC found at Forest Place Nursing 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, June 2023
Rated Good; inspectors found safe, personalised care and improvements since the previous inspection, with some mixed views about communication.
The inspection was unannounced. Inspectors visited on 9 May 2023 and reviewed information from before the inspection, including feedback from relatives, staff and other professionals. They spoke with 8 people, 14 relatives and staff, and reviewed care plans, medicines records, recruitment files and quality checks.
The home was rated Good overall. Safe, Responsive and Well-led were each rated Good. Inspectors found enough staff, safe medicines arrangements, suitable infection controls and good knowledge of people's individual needs. People were supported with activities, relationships and end-of-life preferences.
The previous rating was Requires Improvement. The earlier inspection found breaches relating to person-centred care and good governance. Inspectors found enough improvement had been made and said the home was no longer in breach of those regulations.
Enough staff
Inspectors found staffing levels met people's needs and supported safe care. Relatives and staff also said there were enough staff.
“The deployment of staff was appropriate and there were enough staff on duty to meet people's needs and to ensure staffs' practice was safe.” from the report
Safe medicines
Medicines records were accurate and people received medicines as prescribed. Staff administering medicines had training and competency checks.
“Accurate medicines records were maintained, and people received their medicines as prescribed.” from the report
Personalised care
Staff knew people's likes, dislikes and care needs. Care plans included individual support and end-of-life preferences where needed.
“People received good, personalised care and support that was responsive to their needs.” from the report
Improved management
The home had improved since the previous inspection. Inspectors found better quality monitoring and said the earlier governance breach had been resolved.
“Enough improvement had been made at this inspection and the provider no longer remained in breach of this regulation.” from the report
Family involvement
Relatives could visit without restrictions, take part in care reviews and use an electronic portal for day-to-day information.
“Relatives confirmed they had had the opportunity to participate in a review of their family member's care needs.” from the report
Minor gaps in risk records
needs fixingMost safety risks were recorded, but inspectors found minor gaps in some information. The registered manager said these had been addressed after the inspection.
“Where minor shortfalls in information were identified, this was discussed with the management team.” from the report
Mixed communication
minorSome relatives said communication was good, but others found it difficult or wanted staff to provide information more proactively.
“Relatives made variable comments relating to communication with the service.” from the report
More community activities wanted
minorPeople had access to activities in the home, but some said they wanted more events in the community.
“People confirmed 'in-house' activities were provided but stated they would like more community-based events in addition to attending the local church.” from the report
- 01How do you make sure the minor gaps found in people's risk information remain corrected and reviewed?
- 02How will you keep families informed proactively about changes, appointments and care outcomes?
- 03What community-based activities are currently available, and what more is planned?
- 04How often will you review my relative's care plan and involve the family?
- 05Which parts of the service's care have not been reassessed since the previous inspection?
This was an unannounced focused inspection covering Safe, Responsive and Well-led; the other key-question ratings were carried over from the last inspection. This explanation was written from the published report of 22 June 2023 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, February 2023
Rated Requires Improvement; inspectors found risks in care records, medicines, person-centred care and management oversight.
This was an unannounced focused inspection. Inspectors visited on 22 November 2022 and carried out further inspection activity until 7 December 2022. They spoke with people, relatives and staff, observed care, and reviewed care, medicines, staff and management records.
The home had enough staff, staff understood how to report abuse, and infection control arrangements were judged effective. However, some risk assessments and monitoring charts were incomplete. A medicines trolley was not locked because there were no keys at the time, creating a risk that people could access medicines.
People did not always receive personalised care or enough support to take part in activities and follow their interests. Some relatives also found it difficult to understand staff. Management systems did not reliably identify and address problems, including repeated concerns about care records, activities, incidents and complaints.
The overall rating was Requires Improvement. Safe, responsive and well-led were also rated Requires Improvement. The home had been rated Requires Improvement at the previous inspection and remained in breach of regulations. This was the sixth consecutive inspection with that rating.
Staffing
Inspectors found enough staff to meet people's needs, with minimal agency staff use. Staff recruitment and induction included training and shadow shifts.
“The service had enough staff to meet people's needs.” from the report
Infection control
Inspectors were assured that the home used PPE safely and had arrangements to prevent and manage infections.
“We were assured that the provider was using PPE effectively and safely.” from the report
Family involvement
Families were kept informed about people's health and wellbeing and could access daily notes through the electronic system.
“People's families were kept informed about their relatives' health and wellbeing.” from the report
Working with professionals
Other professionals gave positive feedback about communication with the home. The home had also responded to concerns about admitting people with complex needs.
“The service had been responsive to issues raised by other professionals.” from the report
Care records and medicines
seriousRecords did not always give staff enough information to provide safe care, and some monitoring charts were incomplete. A medicines trolley was not locked during the inspection, creating a risk that people could access medicines.
“People's records did not always contain all the information staff needed to enable them to provide safe care, charts were not always completed fully, and people's medicines were not always stored safely.” from the report
Person-centred care
seriousMany people were in bed and most were not taking part in meaningful activity. Care plans did not give enough individual guidance, and care was often focused on tasks rather than the person's wider needs.
“The service did not always support people to follow their interests or encourage them to take part in social activities relevant to their interests.” from the report
Management oversight
seriousThe provider's monitoring systems had not brought about the improvements needed. Incidents and complaints were not analysed robustly enough to identify themes and ensure lessons were acted on.
“The provider had consistently failed to improve the quality of the service.” from the report
Communication
needs fixingSeveral relatives said they struggled to understand some staff, including because of language barriers. Inspectors also received a concern about staff understanding information about a person's healthcare needs.
“People's relatives described struggling to communicate with staff, many of whom did not have English as a first language.” from the report
- 01What has changed to make sure every person's risk assessment and care plan contains clear, individual instructions for staff?
- 02How do you check that medicines trolleys are locked and medicines are stored safely on every shift?
- 03What activities are available for people who spend much of the day in bed, and how are their personal interests recorded and supported?
- 04How do you make sure staff can communicate clearly with each person and understand their healthcare needs?
- 05What action has been taken in response to the warning notice, and how do you measure whether incidents, complaints and care-record problems are being fixed?
This was a focused inspection of Safe, Responsive and Well-led only; Effective and Caring were not inspected and the overall rating used ratings from the previous inspection for the questions not inspected. This explanation was written from the published report of 1 February 2023 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 Place Nursing Home
9 rated inspections over 7 years: the service has improved, from Inadequate to Good.
- June 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: Requires improvementCaring: Requires improvementResponsive: GoodWell-led: Good
- February 2023Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- September 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Requires improvement
- March 2021
Location report published without a new overall rating.
- March 2021Requires improvementstayed Requires improvementSafe: GoodWell-led: Good
- January 2020Requires improvementstayed Requires improvementSafe: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- March 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- February 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- September 2016Requires improvementup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2016InadequateSafe: InadequateEffective: InadequateCaring: InadequateResponsive: InadequateWell-led: Inadequate
- May 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- February 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
35 live-in carers within about an hour of Essex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
“She brought fun and stimulation into mums life.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.