Background to this inspection
Updated
19 January 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 22 November 2017 and was unannounced.
The inspection team consisted of two inspectors, a specialist advisor, and an expert by experience. A specialist adviser is a person with professional expertise in care and nursing. Our specialist advisor had mental health expertise. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. Our expert by experience had experience of dementia care.
We reviewed the Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We looked at information received from local authority and health authority commissioners. Commissioners are people who work to find appropriate care and support services for people and fund the care provided.
We reviewed the provider’s statement of purpose and the notifications we had been sent. A statement of purpose is a document which includes a standard required set of information about a service. Notifications are changes, events or incidents that providers must tell us about.
We spoke with nine people using the service and five relatives. We also spoke with the regional manager, the two registered managers, a deputy manager, the well-being facilitator, the activities co-ordinator, two nurses, seven support workers, and two housekeepers.
We looked at records relating to all aspects of the service including care, staffing, and quality assurance. We also looked at eight people’s care records.
Updated
19 January 2018
This was an unannounced inspection that took place on 22 November 2017.
We carried out an unannounced comprehensive inspection of this service on 6 October 2016. Four breaches of legal requirements were found. This was because the provider had failed to: adequately protect people from potential abuse; promote and respect people’s dignity at all times;
notify us of events and issues they were legally required to; and effectively monitor and assess the quality of the service.
After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. At this inspection we found that action had been taken and all breaches had been met.
Sherwood Forest Care Home is located in Normanton, a suburb of Derby, and provides nursing and personal care for up to 75 older people. Sherwood Forest Care Home has two units, one for people with nursing needs and the other for people living with dementia. At the time of our inspection there were 58 people using the service.
The service has two registered managers. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People said they felt safe at the service because the staff were competent and caring and the environment secure. Relatives said staff were vigilant about people’s safety and prevented or minimised the risk of falls. Staff protected people from harm and knew who to contact if they had concerns about a person’s well-being.
There were enough staff at the service to meet people’s needs. The number and names of staff on duty each day were displayed on a whiteboard so people could see who they were. The staff employed were suitable and safe to work with people using care services. Staff worked together as a team to ensure people received consistent person-centred care.
The staff were well-trained and knew how to support people effectively. They understood people’s physical, mental health, social and cultural needs and ensured they received a personalised service. For example, staff assisted people to move safely, make choices, and have their medicines when they needed them.
People told us that the food was good, they had a choice, and there was enough food available for them. Menus were based on healthy eating choices and people’s dietary needs and preferences. Mealtimes were relaxed and staff socialised with people while assisting them with their meals. Staff encouraged people to drink and remain hydrated.
Staff supported people to maintain good health and access healthcare services in the local community when they needed to. They understood people’s healthcare needs and knew when to refer them for specialist support. Relative’s said staff kept them informed about their family members’ health and communicated any concerns quickly. Staff knew how to support people if they needed end of life care and understood their roles in providing comfort, mouth and other types of care, and pain relief medicines where necessary.
The premises were purpose-built and accessible to people with limited mobility. There were items of interest and reminiscence in the communal areas and corridors following different themes including gardens and the seaside. All areas were clean, fresh, and hygienic.
The staff were caring and understood the importance of treating people with dignity and respect. They took the time to sit with people and chat to them about the things that were important to them such as their families and the things they liked to do. People’s relatives and friends could visit at any time and were made to feel welcome. Staff understood the importance of seeking people’s consent to care and treatment in line with legislation and guidance.
Information about the service was made available to people in user-friendly formats and staff communicated with people in the way best suited to their needs. People told us that if they had any complaints they would tell one of the staff on duty or a manager. The service’s complaints procedure was displayed at the service and people were also given a copy of this when they began using the service.
People received care that was responsive to their needs. Staff worked in a flexible way in response to people’s needs. This meant that some people did not get up until lunchtime which was their choice. Some people preferred to spend time in their rooms rather than the communal lounge and this was respected.
Staff learnt about people’s needs from reading their care plans and talking with them and their relatives. If people had needs relating to disabilities or sensory loss information about these was included in their care records and care plans put in place where necessary.
People were encouraged to participate in both one to one and group activities depending on their preferences. The service’s activity organisers planned weekly programmes of activities based on people’s choices. Culturally appropriate activities were available. For example, we saw a staff member talking with a person in their native language and looking through a newspaper with them that was also in their native language.
People and relatives told us the service was well-led and the staff provided good quality care. Staff told us morale at the service was high, communication good, and teamwork effective. The atmosphere at the service was positive. The provider had systems in place to quality assure the service and help ensure a high standard of care and support was provided.