Forest Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

We saw evidence that accidents and incidents were discussed at staff meetings and analysed to identify any trends or themes. Where serious incidents had occurred, root cause analysis investigations were carried out to identify what could have been done better and what could be learnt.

Staff said, “Mistakes are discussed openly through incident reporting, supervision, team meetings, and reflective learning to promote improvement.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The registered manager explained, “People would never been sent to the hospital alone, they always have an escort to advocate with them, day or night. There would always be someone with them until admission.” The electronic care system used by the home had a hospital pack function that detailed all the essential information the hospital would require to safely support the person.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People and their relatives told us they felt safe at the home. Staff were trained in safeguarding and knew how to recognise and report any signs of abuse. Staff said, “I ensure the safety of the individual and take action if there are immediate risks. I listen and reassure the person, taking concerns seriously and record concerns accurately. I would report to the Nurse in charge and the line manager and escalate to the CQC as required.”

People who had certain restrictions placed on them, called Deprivation of Liberties (DoLS), and where decisions were made in their best interests, the correct paperwork was in place, ensuring it was done legally in line with the Mental Capacity Act.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were personalised and gave clear guidance to staff on how best to support people and empower them to be as independent as possible. People who suffered from agitation had their triggers clearly detailed in their care plans with guidance for staff on how to support them in the least restrictive way.

Where people were at risk of allergic reactions these were clearly documented throughout care plans and guided staff on which activities to avoid that may place the person at additional risk.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

All staff played an active role in the safety of the building, including diligent checks on visitors to maintain a safe environment for the people living at the home.

Fire safety checks were carried out regularly as well as regular comprehensive fire drills. Personal emergency evacuation plans (PEEPs) were implemented on admission and were personalised to ensure the safety of individuals in an emergency.

Safety checks on the water, for both temperature and risk of waterborne diseases, were effectively carried out as well as checks in all other required areas of the home.

Equipment used to support people was regularly checked and the building itself was maintained to a high standard. The head of maintenance was passionate about maintaining a safe environment saying, “We need to make sure it is comfortable and safe, as it is their home.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us, and our observations confirmed, there were enough staff to support people safely. A person told us, “When I press the buzzer they come as quick as they can.” A family member told us, “To me it seems a lot better staffed than most, there is always someone there if you need any help with anything.”

The amount of staff was calculated by taking people’s needs into consideration as well as they layout of the building. Staff said, “We have good staff levels which enables us to take time to spend with residents,” and “When residents require additional support, staffing is adjusted to ensure safe, person-centred care.”

Staff were recruited following appropriate checks and completed a range of training relevant to their roles to enable them to support people safely. Training was discussed at staff meetings in an encouraging way and staff were praised for their completion rates. Staff told us, “I receive regular training in dementia care, safeguarding, MCA/DoLS, medication management, end-of-life care and all mandatory training. This supports me to meet residents' complex needs safely and compassionately.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Infection prevention and control (IPC) was discussed at staff meetings, so all staff were aware of their responsibilities. The provider had a comprehensive IPC policy in place, and all staff had completed IPC training. Staff had good IPC knowledge, they said, “In the event of an infection, the goal will be to prevent the transmission of infections. Isolation of the individuals, if possible, and staff to wear protective personal protective equipment (PPE),” and “I would follow the guidelines set out ensuring I am wearing the correct PPE, washing my hands, and dispensing of PPE correctly to protect the residents I care for.”

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were managed, stored and administered safely. The nursing team were knowledgeable about people’s individual medicine needs and knew when to escalate any medicine concerns to the GP.

Where people were supported with covert medication, (medicines administered without the person’s knowledge) the correct legal authorisation was in place. Care plans guided staff on how best to support people with this, for example their preferred drink or food to mix it with, in line with pharmacy instructions.