Forest Care Village Elstree and Borehamwood

Updated 25 February 2022

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.

As part of this inspection we looked at the infection control and prevention measures in place. This included checking the provider was meeting COVID-19 vaccination requirements. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors 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.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 07 December 2021 and ended on 03 February 2022. We visited the service on 25 January 2022.

The Expert by Experience contacted people and Relatives on 07 December 2021 for feedback about the care people received.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with 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 used all this information to plan our inspection.

During the inspection

We spoke with six people using the service, seven relatives and nine staff members including the registered manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed seven people's care plans and reviewed the safety of medication administration. We also reviewed a range of records such as quality audits, provider policies and procedures.

After the inspection

We asked health and social care professionals for feedback about the service people received. We received feedback from two health and social care professionals. We continued to seek clarification from the provider to validate evidence found.

Updated 25 February 2022

About the service

Forest Care Village Elstree and Borehamwood is a care home registered to provide personal and nursing care for up to 178 people aged 18 and over with a range of complex health and care needs. At the time of our inspection 143 people were using the service.

Accommodation for people is spread over three floors divided in separate units, each of which have separate adapted facilities. Three of the units specialise in providing care to people living with dementia whereas in the remaining four units are for people with nursing needs. There is also a short stay unit for people needing rehabilitation after a stay in hospital.

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

The registered manager effectively used the providers governance systems to identify areas in the service they provided where improvements were needed. These included improving documentation, recording in care plans and improving communication with health and social care professionals as well as relatives. They also identified the need for a clinical lead for the short stay unit. Regular meetings were in place for staff and people to ensure they were contributing their views about the running of the home and lessons were learnt when things went wrong. There was a service improvement plan in place and actions were checked for completion to ensure improvements were made where needed.

People and their relatives felt the care and support people received was safe and met their needs. Staff were proactive in identifying and reporting any concerns to their managers or external safeguarding authorities if there was a need for it. Risk assessments were developed to give staff guidance in how to reduce risks and keep people safe from harm. Staff wore correct personal protective equipment (PPE) and followed safe infection control processes to protect people from Covid-19. People’s medicines were managed safely. The registered manager had measures in place to help ensure there were enough staff to support people safely.

People’s needs were assessed prior of moving into the home and care plans were developed to ensure their needs were consistently met. Care plans were regularly updated, and people told us they were actively involved in this. People had enough to eat and drink. Staff asked for dietician and other health professionals’ input for those at risk of malnutrition. Staff received training and were supported through supervisions, team meetings and competency assessments to understand and carry out their roles effectively.

People were happy with the daily activities and entertainment offered to them by the engagement team. People told us the care and support they received was personalised and met their needs. Not every person living in the home wanted to discuss their end of life care wishes. For people who wanted and expressed their wishes these were included in their care plan and staff were knowledgeable about their needs.

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

The last rating for this service was good (published 09 October 2019).

Why we inspected

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

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.