Forest Homecare Suffolk

Updated 23 May 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

This inspection was carried out by an 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

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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.

Inspection activity started on 14 March 2023 and ended on 22 March 2023. We visited the location’s office on 14 March 2023.

What we did before the inspection

We reviewed our systems and information we held about 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 took this into account when we inspected the service and made judgements in this report.

During the inspection

We spoke with 8 people who used the service and 7 relatives about their experience of the care provided. We also had contact with 15 members of staff including care staff, office staff, review staff, the head of operations and the registered manager. We reviewed a range of records. This included 4 people’s care plans and a variety of other records relating to the management of the service were also considered as part of the inspection.

Updated 23 May 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Forest Homecare Suffolk is a domiciliary care agency providing care to people in their own homes.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection there were 39 people receiving personal care and support from the service.

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

The provider could not demonstrate how the service met the principles of right support, right care, right culture. This meant we could not be assured of the involvement of people who used the service in their care and support. Initially the provider told us they did not support any people who lacked capacity, had a learning disability or who were autistic. However, we identified that there were people being supported by the provider who had a learning disability.

Right Support

We found guidance within people’s care plans for staff members to follow when supporting autistic people or people with a learning disability were not sufficient. Care plans and risk assessments did not provide staff with information on how to promote their independence.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Staff training in record keeping needed to be improved in relation of the use of the Mental Capacity Act 2005 (MCA).

The service did not plan for any staff travel time between care calls and care calls were frequently shortened to enable staff to be on time for the following person’s care.

Right Care

People's care and support plans did not always reflect their range of needs or promote their wellbeing and independence. This meant they did not provide detail on the specific actions staff should take to ensure practices were least restrictive to the person and reflective of a person's best interests.

Right Culture

People were not empowered to influence the care and support they received.

The provider did not have adequate knowledge of the ‘Right Support, Right Care, Right Culture’ guidance. In addition, in July 2022 the Health and Care Act 2022 introduced a requirement that regulated service providers ensure their staff receive training on learning disability and autism which is appropriate to the person’s role. The Oliver McGowan Mandatory Training on Learning Disability and Autism is the standardised training that was developed for this purpose and is the government's preferred and recommended training for health and social care staff to undertake.¿The provider had not heard about this training and staff working for Forest Homecare Suffolk had not undertaken it.

Quality and safety monitoring systems were not robust. There was a lack of governance processes and systems to help ensure the safe running of the service. This meant the provider could not be proactive in identifying issues and concerns in a timely way.

The provider was not able to demonstrate how they would meet the underpinning principles of Right Support, Right Care, Right Culture’. We signposted the provider to relevant information.

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 8 August 2019).

The overall rating for the service has changed from good to inadequate based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Forest Homecare Suffolk on our website at www.cqc.org.uk.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We also received concerns in relation to the management of medicines and the leadership of the service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, staffing and governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

The overall rating for this service is 'Inadequate' and the service is therefore in 'special measures'. This means we will keep the service under review and, if we do not propose to cancel the provider's registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.