Forest Homecare Limited

Updated 28 March 2020

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 Care Act 2014.

Inspection team

The inspection was carried out by one inspector and one assistant inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own homes. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection and to seek permission, if we could visit people in their own homes to speak with them about the service.

What we did before the inspection

Before the inspection, we looked at the information we held about the service. This information included statutory notifications the provider had sent to CQC. A notification is information about important events which the service is required to send us by law.

We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all this information to plan our inspection.

During the inspection

We visited the registered office and spoke with the operational manager, one care co-ordinator and four care staff. We visited four people who used the service with their permission in their own home

We looked at six people’s care records and a selection of medication administration records (MARs). We looked at other records including quality monitoring records, recruitment and training records for three staff and other records regarding the management of the service.

After the inspection

We spoke with 20 people and five relatives of people using the service on the telephone to gather their views of the service. We also spoke with 5 healthcare professionals.

Updated 28 March 2020

About the service

Forest Homecare Limited is a domiciliary care agency. The service provides personal care to people living in their own homes. Not everyone who used the service received personal care. The Care Quality Commission (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 270 people who used the service that received personal care.

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

The leadership of the service continued to be outstanding. People, staff, relatives and external professionals were extremely confident in the management of the service. The operational manager and registered manager, supported by their senior management team, had established a person-centred ethos amongst the workforce, that consistently delivered quality care. The service was extremely well-led. Robust systems to monitor and assess the service provided helped the registered manager to identify where improvements were needed, and these were addressed quickly. People were asked for their views about the service and these consistently demonstrated a high level of satisfaction relating to the service they received. All staff spoken with were extremely passionate about providing high quality care to people. Service governance systems and oversight of the service were robust. Issues were identified, and actions taken to address any shortfalls.

People were supported by staff in a way which was exceptionally caring and compassionate. The people we spoke with, their relatives and health care professionals without exception praised the staff and the organisation of the service. People considered they were truly involved in their care planning and were treated with respect and dignity.

At this inspection we found substantial evidence that demonstrated people received an outstandingly caring service which continued to be delivered by a service which was rated outstanding in the key question for well-led at the last inspection. This was due to excellent leadership from the operational manager, registered manager and well-trained staff.

Everyone we spoke with provided exceptional feedback about how caring and supportive the staff were and so often went the extra mile to ensure people were content. They told us about the positive impact the service had on their lives such as enabling them to stay in their own homes and maintain or increasing their independence. The service had worked with other professionals to develop a rehabilitation function as the need to support people out of hospital to prevent delayed discharges had been identified as under resourced in the area where the service operated. People were assessed in hospital by senior staff of the service and when possible were supported home with a six week care package of rehabilitation delivered by the service.

There was a thorough, co-ordinated and holistic approach to planning, managing and reviewing people’s care and support. Staff took time to get to know people and the comprehensive assessment of their needs identified the support required to meet their specified needs. Staff spoke empathically and respectfully about the people they supported and people told us the staff were motivated, understanding and kind to them. Relatives were extremely pleased with the level of care provided by Forest Homecare and discussed how the support had made positive differences to the quality of their relative’s life.

The operation manager was a leader and a spokesperson for various networking groups and volunteering projects, and promoted a culture of shared learning, staff development and improvement of service provision. Staff were trained, inducted and supervised to ensure they were skilled and competent in their roles. Senior managers also developed staff along with the registered manager so that some staff had become champions in various aspects of care, such as dementia.

The service continued to organise staff into small working teams so that people get to know the staff well who are supporting them. Managers take time to identify staffing interests with the interests of the people they support to increase the likelihood of them enjoying each other’s company while care is being delivered. People told us that the staff came on time and stayed for the full length of the allocated time for their care.

People told us they felt listened to and consulted when planning and agreeing what care and support they needed. Staff had completed safeguarding training and understood their role in identifying and reporting any concerns of potential abuse or poor practice. Staff supported people to take medicines safely. Staff were trained in medicines management and knew how to ensure that people received their medicines on time and as they had been prescribed.

There were sufficient numbers of experienced staff to meet people’s needs. Safe recruitment practices were followed, and appropriate checks completed to ensure that only suitable staff were employed. Staff received induction and on-going training and support that enabled them to carry out their roles positively and effectively. People informed us the staff virtually always came within the schedule time of their care appointment and had never let them down. Should the staff be running late people were informed of this information.

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. Peoples preferences for eating, drinking and meal preparation were clearly recorded in care plans when staff were required to support the person with those needs.

People felt respected and valued as individuals and were fully involved in making decisions about their care and support. Their life histories and routines were discussed and recorded in care plans, and people told us they were involved and included in their reviews and care plans. Complaints were documented and responded to, and people told us they knew how to complain. There was no one receiving end of life care, however staff were trained and skilled in end of life.

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 19 May 2017). The key question for well-led was rated Outstanding

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.