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Archived: Forget Me Not Residential Home Good

Reports


Inspection carried out on 20 June 2019

During a routine inspection

About the service:

Forget Me Not is a care home that was providing personal care to 14 predominantly older people at the time of the inspection. The service can support up to 16 people.

People’s experience of using this service:

The registered manager and staff used innovative ways to meet people’s support needs and went the extra mile to provide safe care and support. The registered manager worked closely with the GP and other healthcare professions to ensure the service responded to people’s changing needs safely and effectively. People’s care was highly personalised and matched their needs, which promoted their wellbeing and improved their quality of life.

People told us staff were very caring. Staff consistency and commitment enabled people to receive excellent care from staff who knew them well. People had access to a variety of personalised activities to prevent social isolation and promote their wellbeing. Events were provided that matched people’s personal histories and interests and where possible, people’s wishes were granted.

People living at Forget Me not received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff fully understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were very well supported to maintain good health and to meet their nutritional needs.

Forget Me Not was well-led by a registered manager who continually looked for ways to improve people’s lives. Staff culture was compassionate and caring and this had resulted in the provision of some exceptional care. The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service. The provider had quality assurance systems in place to monitor the quality and safety of the service.

Rating at last inspection:

At our last inspection we rated the service Good. Our last report was published in December 2016.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

Inspection carried out on 18 October 2016

During a routine inspection

Forget Me Not Residential Home is registered to provide accommodation for up to 16 older people, some whom have dementia, who require personal care. On the day of our visit there were 16 people living in the service.

The registered manager has been registered since October 2010. 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 and associated Regulations about how the service is run.

At our previous inspection on 25, 26 and 27 November 2014 we found documentation relating to fire evacuation records were not clear. The service's fire training and evacuation log only recorded fire safety training staff had undertaken. There was no specific detail as to when the evacuations drills had occurred and the outcomes. The service did not always act in accordance with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Advance care

plans used to capture people’s preference for end of life care before their health deteriorated, were developed after some people’s health had deteriorated. The service did not follow legal requirements to notify the Care Quality Commission (CQC) of incidents that occurred in the service.

During this visit we found the service had made the required improvements in those shortfalls identified at the previous inspection.

People were positive about the caring nature of staff. One person commented, “I am quite comfortable with the support I get from staff. Staff are always cheerful. I don’t feel under pressure from any of them.” People were relaxed in their environment and we observed positive interaction between staff and the people they provided care and support to. People’s privacy and dignity was protected and they were actively involved in decisions made in regards to their care.

People and their relatives felt the service was safe. People were protected from the risk of harm because staff were fully aware of their responsibilities in regards to safeguarding. We reviewed all safeguarding incidents reported to the Local Authority and to us by the service and found they had been appropriately responded to in line with legislation. People’s personal safety had been assessed and plans were in place to minimise identified risks.

Staff were appropriately inducted, trained and supervised. People were supported to have enough food and drink. Where people were at risk of malnutrition appropriate action was taken. People’s health care needs were monitored and any changes in their health or well-being prompted referrals to their GP or other health care professionals.

People and their relatives felt the service was responsive. One person commented, “They (staff) are very good at responding to needs promptly.” Reviews of care meetings enabled people and their relatives to discuss the care and support delivered and gave them the opportunity to make any necessary changes. Peoples’ social needs were met because the service had a scheduled program of social activities that prevented social isolation.

People and their relatives were positive about the management of the service. Comments included, “From what we have seen it is always good” and “A good team that works well together.” Quality assurance systems were in place to improve the quality and safety of people who used the service. This included audits that covered areas such as medicine, infection control, and other records relating to the running of the service. This enabled the service to identify where quality or safety was being compromised and take appropriate action. The service sought the views of people and those who represented them and responded appropriately to feedback received.

Inspection carried out on 25, 26, 27 November 2014

During a routine inspection

Forget Me Not Residential Home is registered to provide accommodation for up to 16 older people, some whom have dementia. On the day of our visit there were 14 people living in the service.

This was an unannounced inspection on 25, 26 and 27 November 2014. At our previous inspection in July 2013 the provider was meeting the requirements of the law in all the standards.

The registered manager has been registered since October 2010. 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 and associated Regulations about how the service is run.

People told us they were safe in the home and knew how to raise concerns. The service operated safe practices in the home but documentation in relation to fire evacuation procedures were not clear. We have made a recommendation on the service's evacuation procedures. The service ensured people were provided with safe care and support. Records evidenced recruitment checks were thorough, staff received relevant training, there were sufficient staff to provide care, identified risks were identified and managed and medicines were administered and stored safely.

The service did not always act in accordance with the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Where people lacked capacity to make specific decisions, consent was sought by people not authorised to give it. There was no evidence of best interest meetings recorded, where a permanent decision was made restrict to restrict people's movement, in order to protect them. We have made a recommendation around best practice on 'best interest' decisions for people who lack capacity.  People received care and support from staff who were trained, supervised and appraised. People’s nutritional needs were met; we observed the meals were healthy and well balanced. Where people were at risk of being malnourished, care records showed appropriate action was taken. The service ensured people had access to health professionals, so that they could maintain good health.

People, those who represented them and health professionals said the home was caring. Staff demonstrated good knowledge about the care needs of people they supported. During our visit we observed positive interaction between staff and the people they provided care to. There was a relaxed environment and family members told us there no restrictions placed on how many times they could visit.

People received care that was responsive to their needs. Care plans and risks assessment were regularly reviewed. People told us they were listened to and knew how to make a complaint. We saw complaints received were responded to appropriately. The service ensured people’s social needs were met; people we spoke with and what we observed confirmed this. The service did not follow legal requirements to notify the Care Quality Commission (CQC) of incidents that occurred in the service.

People and their relatives said the home was well managed. Staff spoke positively about the support they received from the registered manager. An observation of a staff team meeting showed staff were able to speak openly, question practice and raise concerns. Quality assurance systems in place were regularly monitored and management meetings recorded areas identified for further improvements. The service sought feedback from people, those who represented them and external agencies to improve the quality of the service provided. There was evidence of appropriate action taken in regards to this but not all feedback was responded to.

We found breaches with the Regulations of the Health and Social Care Act 2008 (Registration) Regulations 2010, which corresponds to regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Inspection carried out on 31 July 2013

During a routine inspection

People were provided with a choice of suitable and nutritious food and drink. One person told us: �They know what I want. The cook talks to me about what foods are on offer�. A recognised screening tool and monthly checks were undertaken to monitor weight and any significant changes. Staff monitored food and fluid intake to prevent any risk of poor nutrition or dehydration and took any necessary action.

People we spoke with said there were enough staff and they had enough time to care for them. Training records viewed showed the two new staff members had undertaken appropriate training and had obtained relevant qualifications in health and social care. There were enough qualified, skilled and experienced staff to meet people�s needs.

We found people could be confident their comments and complaints were listened to and dealt with effectively because the service had an effective system to investigate and resolve complaints.

Inspection carried out on 3 January 2013

During a routine inspection

We spoke with two family visitors and with people living in the home. They told us they had access to all the information they needed to help them make an informed decision about moving into the home. We reviewed four care plans. We saw evidence people's health and personal care needs had been assessed before admission. We saw evidence care plans had been reviewed and changes made where necessary to ensure needs would still be met appropriately.

Care plans included a range of risk assessments, covering for example risks associated with falls and weight loss, together with details of how these were to be eliminated or managed.

People we spoke with told us they felt safe in the home. They said they would raise any concerns they had with their family, care staff, the manager or provider.

All of the staff we spoke with told us they felt very well supported by the manager and provider. They all commented favourably about the excellent 'team spirit' there was in the home. The basic staffing level at night did not provide the number of staff indicated as necessary for the routine care and support of at least one person.

When we spoke with people living in the home, they told us they could raise any concerns or discuss their care with staff, the manager or provider whenever they wanted to. We saw people living in the home as well as visitors going to the office and sitting down to talk to the manager in a relaxed and informal manner.

Inspection carried out on 3 February 2012

During a routine inspection

People who use the service told us that staff were very good at respecting their privacy and would knock on doors before entering and check if they wanted to receive visitors. When they needed assistance with such things as bathing they found it a dignified experience. They said that staff would always ask if they needed help and never assume. People told us they were able to make their own choices and decisions and that staff would assist them and encourage them but never make them do anything they didn�t want to.

People said they or their relatives had been able to visit the service to see if it was suitable for them. They said they had been asked about their needs and staff displayed a good awareness of their needs and a knowledge of them as people. They told us there were activities arranged for them at the service which they were encouraged to participate in and visitors were made welcome. They said that when they experienced periods of ill health staff were attentive towards them. Some people told us the heating would often break down and it could get cold but they were provided with heaters for their rooms.

They told us they felt safe living at Forget Me Not Residential Home and that staff were good at responding to call alarms when they needed them. They said that a member of staff could mostly be located when needed and were always able to do what was required of them. They felt there were enough staff but that occasionally staff could have trouble keeping up with the workload. People said that staff appeared competent and were generally friendly and respectful with them and they were content with the way they were treated.

The people we spoke with said they had never had the need to raise a concern, but if they did they would feel confident and comfortable in approaching the manager or proprietor. They told us they were aware of residents� meetings they could attend. Some of the people and visitors we spoke with could also recall completing questionnaires asking for their views on their care and the service.

One person summarised her experience at Forget Me Not Residential Home by saying: �I�m comfortable here. It�s not regimented�. Another person said: �I�m well looked after here and have no complaints about the experience although I�d still rather be in my own home�.

Reports under our old system of regulation (including those from before CQC was created)