Lady Forester Residential & Day Care Centre

Updated 26 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was completed by 2 inspectors.

Service and service type

Lady Forester Residential & Day Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and personal care as a single package under one contractual agreement dependent on their registration with us. Lady Forester Residential & Day Care Centre is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 2 relatives. We observed staff engagement with people to support us to understand people's experience of care. We spoke with 7 staff including care staff and the registered manager. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records. This included 5 people's care plans, multiple medicine administration records and 3 staff recruitment files. We also reviewed a variety of records relating to the management of the service, including policies and procedures.

Updated 26 September 2023

About the service

Lady Forester Residential and Day Care Centre is a residential care home providing accommodation and personal care to a maximum of 14 people. The service has an adjoining day care centre which can be accessed by people living at the home and by the wider community. The service provides support to older people and at the time of our inspection there were 12 people using the service.

The home is run as a charity and the board of trustees act as the provider of the organisation.

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

Since our last inspection, the provider had made improvements in all areas of the service, including the governance of the home and these improvements were ongoing. Significant improvement was seen in the environmental issues we identified at our last inspection. Further time was needed to ensure the improvements and new systems were fully effective, embedded in all staffs’ practice and able to be sustained.

Overall management of people’s medicines had improved. The systems which monitored medicines however, needed further improvement.

The provider’s governance systems, although improved did not always identify and capture where there were concerns and so required improvement.

People's risks associated with their care had been reviewed and guidance for staff was improved upon. People’s care plans were more specific and person centred. This was an area of continued improvement.

People were supported to have 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.

There was an increased oversight at the service by the provider and new nominated individual, who was at the home daily. The management team were open and they recognised further improvements were required at the service. The provider had an ongoing improvement and action plan were in place.

Staff understood how to protect people from harm and followed safe hygiene practices to prevent and control infection. People were supported by enough staff who had been safely recruited. The provider had systems in place to make sure lessons could be learnt from accidents, incidents and when things went wrong.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 26 April 2023). Breaches in regulations relating to safe care and treatment, staff training and recruitment and governance were identified. We took enforcement action after the last inspection and imposed 2 conditions onto the provider’s registration.

At this inspection we found significant improvements had been made but these needed to be embedded into everyday practice. We found the provider remained in breach of some of the regulations. The provider continues to meet the conditions and sends us monthly action plans as per the conditions on their registration.

This service has been in special measures since 9 March 2023. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in special measures.

Why we inspected

We undertook this focused inspection to check the provider now met their legal requirements. This report only covers our findings in relation to the key questions safe and well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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.

The overall rating for the service has changed from inadequate to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Lady Forester Residential & Day Care Centre on our website at www.cqc.org.uk.

Enforcement

At our last inspection we idnetified a breach in relation to staff training. We did not look at this as part of this inspection.

We have identified a continued breach in relation to the governance of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.