- Care home
Forest Care Village Elstree and Borehamwood
Report from 18 January 2024 assessment
Contents
On this page
- Overview
- Kindness, compassion and dignity
- Treating people as individuals
- Independence, choice and control
- Responding to people’s immediate needs
- Workforce wellbeing and enablement
Caring
People did not always receive dignified care. Social interactions with staff were very limited. Staff did not always promote people’s independence and there was a lack of meaningful activity for people, particularly for those not interested in group activities.
This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.
Kindness, compassion and dignity
Feedback from people which contributed to our decision to carry out this assessment included multiple concerns about a lack of dignified, compassionate care and poor attitudes from some staff. A relative said, “[Family member] has complained about the staff. They have hurt [them], been rude to [them]. [Family member] feels they do not like [them].” During the site visits people’s views varied. Some people said staff did not spend time talking to them. A person said, “Staff used to talk to me more. They don’t so much now.” However, another person said, “They're good - all professional and polite - no concerns, they are kind.”
Staff and managers spoke respectfully about people. Managers took timely and appropriate action to address concerns we shared.
An external professional said they believed staff needed training to understand people’s communication needs as people became frustrated when communication between them and staff was difficult.
The care provided to people was not always dignified or compassionate. For example, we observed a person left in wet clothing in the presence of staff. This was not addressed until an inspector intervened. Other people were dressed in grubby, ill-fitting clothing that did not uphold their dignity. We saw staff supporting a person to eat too quickly which also lacked dignity. In the Rainforest community, staff engagement was minimal and for the most part was task focused. People spent much of their time with no interaction. However, in the Avalon and Glastonbury communities we saw several kind, warm interactions.
Treating people as individuals
We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.
Independence, choice and control
People did not always feel their independence was promoted. A person said, “The rehabilitation was non-existent.” Their views varied about whether they had enough to do that was of interest to them. Comments included, “Nothing happens for younger people, I get bored. There’s no community.” and, “I like going round the shops, that’s what I really like to do, but it never happens. I just sit around doing nothing.” A third person said, “I genuinely don't think I am bored. I have enough to do in here.” People told us they were able to maintain relationships with friends and family, who were able to visit freely.
Managers told us about social opportunities available for people and we saw these advertised on posters. They confirmed activities staff worked across all communities as well as in the large atrium, where events took place daily.
The provider had limited opportunities for people who did not wish to participate in group events. We found engagement with people was minimal and task focused; many people spent the day withdrawn without interaction with staff. A person whose care plan indicated a need for positive engagement, was followed by staff who did not look at or speak to them beyond directions, such as “Come this way.” Measures to support people to eat independently, such as finger foods, or plate guards were not available, and staff took over when they were having difficulty. This did not promote their independence.
People’s care records had limited information about their interests and how staff could support them when in distress. Monitoring records showed care plans were not always followed in relation to people’s social needs. For example, 1 person’s care plan indicated they needed a stimulating environment but monitoring records reviewed showed few occasions of engagement beyond tasks such as drinks, meals and personal care.
Responding to people’s immediate needs
Some people told us their needs were not responded to quickly. Comments included, “[They] take 45 minutes to answer the buzzer.”, “Sometimes they hide the buzzer.” And “Staff ignore call bells.” A person told us the wait for nursing care sometimes resulted in them experiencing pain. A relative said staff did not take time to understand what their relative was trying to tell them. In contrast, 1 person told us, “I press my bell and they come quite quickly.”
Feedback from staff was mixed about whether they were able to respond to people’s immediate needs well. Some staff felt they had enough time and were able to meet people’s needs. However, others said there were not enough staff to respond to people’s needs leading to neglect at times and that some staff did not have sufficient skills to care for people well.
We saw a person in distress calling for assistance, but their needs were not attended to until an inspector intervened. On some occasions, staff failed to notice people’s immediate needs unless the person was able to make a request verbally. However, we saw call bells were answered in a timely way during the site visits.
Workforce wellbeing and enablement
We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.