Forest Manor Care Home

We found the following examples of good practice.

Forest Manor Care Home ensured current government guidelines in relation to COVID-19 were being followed by staff and visitors to reduce the risk of infection to people living at the home. This included comprehensive checks for visitors and staff on arrival to the home and including covid testing and ensuring vaccination status.

Forest Manor Care Home supported people who lived there to remain connected with friends and relatives through visits, video calls, phone calls and letters.

Forest Manor Care Home had organised their staff and the care home environment effectively to reduce the risk of further infection during an outbreak.

Forest Manor Care Home is registered to provide accommodation and nursing for a maximum of 40 people and people living with dementia in one adapted building. There were 39 people living at the service and one person was in hospital on the day of our inspection visit.

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

People received exceptional care that consistently showed how staff went above and beyond in providing people with excellent individualised care. Staff understood what was important for people and they were innovative in their approach, commitment and compassion in making a difference to people. This had impacted on people achieving positive outcomes. Feedback from people, relatives, friends and external professionals was consistently positive and highly complementary about the care and approach of staff and the leadership of the registered manager.

People received safe care and treatment from staff who knew and understood their needs, including how to manage and reduce known risks. Incidents and accidents were analysed and lessons learnt were shared with the staff team to reduce further risks. Staff protected people from abuse and avoidable harm. The provider ensured staff completed regular training in safeguarding, health and safety including clinical needs. Staff were deployed effectively and staffing was flexible to meet people’s dependency needs. Safe recruitment procedures were used when new staff were appointed. Medicines were managed in line with national best practice and people received their proscribed medicines when they needed. Infection control measures were followed to reduce the risk of infection and cross contamination.

Staff received an induction and ongoing training and development. Recognised assessment tools were used to assess and monitor people’s care needs. People were supported with their nutritional and hydration needs, and staff worked well with external professionals in managing and monitoring health conditions. 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 received a responsive service that met their individual needs. People's diverse needs, preferences and social history was assessed and care plans provided staff with guidance. People received opportunities of social activities and community involvement. Complaints and concerns had been acted upon and investigated in a timely manner. End of life care was discussed and planned with people and their relative or representative. Positive feedback had been received about the staff’s approach to end of life care.

The registered manager was an inspirational leader, who was extremely caring and compassionate and strived to continually provide people with the very best care which was personalised. The culture of the service was open and transparent. The registered manager actively engaged and had developed a positive relationship with the community and external professionals. They continually developed their own learning and shared this with the staff. The systems and processes were effective in monitoring quality and safety and there was good oversight and accountability of the service.

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

Rating at last inspection

The last rating for this service was Good (published 18 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Forest Manor Care Home is registered to provide accommodation for 40 people who require nursing or personal care. At the time of the inspection there were 40 people using the service.

On the day of our inspection there was a registered manager in place. 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 were safe living at the service because staff knew how to recognise and report any incidents of harm. Staff were confident that the registered manager would deal with any concerns that they reported. Systems were in place for staff to identify and manage risks and respond to accidents and incidents.

Staffing levels were adequate to meet people’s needs. Staff received an induction, training and supervision and felt supported by the management team. Staff were recruited through safe recruitment practices.

Medicines were safely administered and stored.

People were asked for their consent before care and support was provided. However, mental capacity assessments were not always in place where needed. The registered manager applied the principles of Deprivation of Liberty Safeguards (DoLS), so that people’s rights were protected.

People received sufficient to eat and drink and their nutritional needs were catered for.

People’s healthcare needs had been assessed and were regularly monitored. The service worked well with visiting healthcare professionals to ensure they provided effective care and support.

Staff were kind, caring and respectful towards the people they supported. Staff were aware of people's support needs and their personal preferences.

People and/or their relatives were involved in the development and review of their care plans. People had access to independent advocacy services should they have required this support. People's independence privacy and dignity were promoted and respected by staff.

People received care and support that was personalised and responsive to their individual needs.

People were supported to participate in activities, interests and hobbies of their choice. The complaints policy was accessible for everyone.

Staff understood the values and vision of the service and had a clear understanding of their roles and responsibilities. The management team was supportive and approachable towards people, relatives, external professionals and staff.

People and their relatives were involved or had opportunities to be involved in the development of the service. There were systems in place to monitor and improve the quality of the service provided.

We reviewed all the information we received from the provider which demonstrated the provider had taken appropriate action. Mental capacity assessments were put in place for each person who used the service, along with a record of a best interest meeting. This shows that the provider had systems in place to protect people who might not be able to make informed decisions on their own about the care they receive.

We looked at the records for a person who had decisions made for them by others and found that records did not reflect that the provider had acted in accordance with legal requirements.

We looked at the care plans and risk assessments for three people who used the service. These reflected good practice, identifying risks to people's health and recording how the risks were to be managed.

We observed how people spent their time each day and what the arrangements for their social and recreational activities were. The systems in place took account of people's individual needs and supported their wellbeing.

We looked at nutrition and hydration assessment records and care delivery records which showed people who used the service were supported to have adequate nutrition and hydration.

We undertook a brief tour of the premises and checked cleaning records that showed the environment was well managed and clean and there were systems designed to assess the risk of and to prevent and control the spread of a health care associated infection.

We saw a feedback letter from a relative. This told us that the person's relative had recently received end of life care at the home. The letter described that they felt they had received care, kindness and love during difficult times. The staff team put in time and effort into caring for their relative and keeping them comfortable and that they should be proud of the improvements that had been made over the last year.

We found that the provider had made improvements to the service following our last inspection in February 2012. The manager had improved the care planning documentation, admission assessments and incident analysis, which protected people's health and welfare. Quality assurance systems were in place and provided the manager with the information they needed to maintain compliance and continue to develop the service.