Forest Edge

Updated 1 July 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.

Inspection team

The inspection was carried out by 1 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 Edge 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 Edge 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

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.

During the inspection

We spoke with 6 people who used the service about their experience of the care provided. We spoke with 10 members of staff including the registered manager, deputy manager, senior care staff, cook, housekeeper and care staff.

We reviewed a range of records. These included 4 people’s care records and multiple medication records. We looked at 4 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Following the onsite visits continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from 9 relatives and 4 health and care professionals.

Updated 1 July 2023

About the service

Forest Edge is a residential care home providing accommodation and personal care to up to 32 people. The service provides support to older people who may be living with dementia, sensory loss, physical disabilities, or mental health conditions. At the time of our inspection there were 21 people using the service.

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

Relatives told us their loved ones were safe. However, we could not be assured risks associated with people’s needs were always assessed appropriately or managed. When people had unwitnessed falls no post falls observations were completed. Records showed incidents were not always investigated fully to keep people safe. More robust governance systems needed to be in place to monitor and improve the quality of the service provided.

The provider had not notified CQC of all significant events in line with the requirements of the provider’s registration. We viewed 3 reportable incidents that should have been reported to CQC.

Relevant recruitment checks were conducted before staff started working at the service to make sure they were of good character and had the necessary skills. However, we did find more robust procedures for checking full employment histories were required.

Medicines administration records (MAR) confirmed people had received their medicines as prescribed. However, we found some concerns in relation to recording when prescribed creams were applied. The service has since put in some measures to improve medicines.

The home was clean, and measures were in place for infection prevention and control. We were assured that infection prevention and control practices were in line with current guidance. The home had recently gone through a refurbishment programme to improve the home.

Staff had received training in safeguarding adults and knew how to identify, prevent, and report abuse. There were enough staff to keep people safe. People were supported with their nutritional needs. People received varied meals including a choice of fresh food and drinks. Staff knew people well and treated people with kindness and compassion.

Staff worked collaboratively with health and social care professionals to support people with their healthcare needs. There was a system in place to allow people to express any concerns or complaints they may have.

Staff received regular support and one to one sessions or supervision to discuss areas of development and to enable them to carry out their roles effectively. Training had improved and we received praise from staff about the training. Activities took place both inside the home and outside the home. Staff felt supported by management and enjoyed working at the service and felt staff morale was positive. Staff we spoke with were enthusiastic about their jobs and showed care and understanding for the people they supported.

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.

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 06 December 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

This service has been in Special Measures since 30 November 2022. During this inspection the provider demonstrated 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

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

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.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

We have found evidence the provider needs to make improvements. Please see the safe and well led sections of this full report.

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 Forest Edge on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified a repeated breach of regulation 12 safe care and treatment. There was an additional breach of Regulation 18, due to not sending in notifications as required, 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.