Forest Brow Care Home

Updated 12 August 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 carried out by 2 inspectors, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service

Service and service type

Forest Brow Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Forest Brow Care Home 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 not a registered manager in post. The manager had been in post since April 2023 and had submitted an application to register with CQC as manager of the service.

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 professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke to 2 people and one relative during the inspection site visit. We received written feedback from 9 relatives and spoke to 1 further relative via telephone. We spoke to 8 staff including the manager, care staff, kitchen and domestic staff. We spoke to the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke to one visiting health and social care professional on site and one professional via telephone. We spoke to the local fire and rescue service to gain feedback about the fire safety at the service.

We looked at 6 people’s care plans, medicines administration and care records. We reviewed a range of documents remotely including, quality and safety audits, service improvement plans, maintenance records, records of compliments/complaints, staff recruitment and training records, records of incidents and accidents. We made observations of care and support being carried out in communal areas of the service.

Updated 12 August 2023

About the service

Forest Brow Care Home is a residential care home providing accommodation and personal care to up to 32 people. The service provides support to older people, some of whom were living with dementia. At the time of our inspection there were 18 people using the service. Accommodation was set in one adapted building over three floors.

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

The provider had worked to make significant improvements to the service since our last inspection, which means they were now meeting the requirements of regulations. Additional work was required for the provider to demonstrate that they were meeting the characteristics of good in all the key questions we looked at. However, at this inspection we found that people were not at risk of harm and work was in progress to address the issues found.

The provider had made improvements to their medicines management systems and processes. However, further improvements were required in some areas such as auditing to make processes more robust. The provider had increased the number of permanent staff in place and was working towards ensuring all staff deployed overnight had the required skills and training. People were protected from the risk of suffering abuse or coming to avoidable harm. There were effective systems in place to analyse incidents and put measures in place to reduce the risk of recurrence.

Since our last inspection, there was a new management team in place. People, relatives’ and staff were positive about the management and told us they were confident in their ability to manage the service. The manager and nominated individual had a good understanding of their role and regulatory requirements. There had been lots of positive engagement with people, relatives and staff who told us they felt listened to and respected. We received positive feedback from health and social care professionals about the provider’s efforts to improve the quality of the care since our last inspection.

The provider had made improvements to ensure that staff received appropriate training and support in their role. Some care plans contained contradictory information, specifically around eating and drinking, but staff mitigated any risks through their knowledge of people’s needs. Care records were not always completed accurately, with some staff citing issues with recording systems as contributing factors towards this. People were supported to have maximum 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.

People and relatives told us they were happy with the care provided. They told us that staff were caring, committed and empathetic. They said the provider had made significant improvements in increasing the number of permanent staff, which had a positive effect on the atmosphere at the service and consistency of care. They told us they felt consulted about their care and were treated with dignity and respect.

People told us they received personalised care in line with their needs. The provider had made significant improvements to help ensure that people were busy and active throughout the day. This included organising structured activities or events and spending informal time with people talking and reminiscing. There were systems in place to help ensure people were responded to appropriately when they had concerns or complaints.

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 4 January 2023). We issued warning notices in relation to breaches in regulations 12, 13 and 17 and identified other breaches in regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. We subsequently inspected the service (published 7 March 2023) to check whether the provider had made improvements in relation to regulations 12 and 13. We found that the provider was in breach of these regulations and further improvement was required.

This service has been in Special Measures since 22 December 2022. 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. At this inspection the service has been rated requires improvement.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.