Forge House Care North Kent

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider carried out detailed and comprehensive assessments of people’s needs before they used the service, and people communicated with us that were involved in the assessment process. A relative told us, “All the staff from Forge House Care know exactly what [person’s name] needs are and react and manage them very well. For example, carers will very quickly spot if there is a behaviour changes as a result of a UTI, quickly get a urine sample to the GP, and will do all they can to ensure antibiotics are quickly prescribed, (even at weekends).”

People’s care plans were robust and included nationally recognised assessment tools, such as the Malnutrition Universal Screening Tool (MUST) to assess people’s nutritional needs, and WATERLOW, to assess people’s skin integrity and reduce the risk of developing pressure ulcers.

The manager told us they sought and reviewed feedback from other health care professionals involved in people’s care to maximise the health and well-being of people using the service. They told us, “We want the audits we undertake, for example, medicines, nutrition, and hydration, to ensure that people are kept happy and healthy, and so we can pick up on any changes as soon as they appear.” Staff told us they continually assessed people’s health and updated records to accurately reflect their needs. Staff we spoke with knew people’s needs thoroughly. For example, one staff member told us how they supported a person to stay calm by ensuring they had their colouring book with them during a fire drill.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s nutritional and hydration needs were assessed and planned for. Care plans were detailed with the support people needed, care was coordinated between professionals, and staff followed the advice and guidance given to keep people safe. People who had specific dietary needs, including pureed, vegetarian, and gluten-free, received meals tailored to meet their needs and preferences.

People chose what they wanted to eat and drink, and staff assisted people to prepare the meals and drinks of their choosing. One staff member told us, “[Person’s name] enjoys chopping their vegetables and we help them to do this safely.” Care staff ensured people had an adequate nutritional intake, and appropriate referrals were made to the GP, dietician and the speech and language therapy team (SALT) if any concerns arose. Staff interacted well with people and supported them in a calm, pro-active, reassuring and kindly manner.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had access to comprehensive and detailed care plans, training and support from senior leaders. Multiple professionals were involved with people’s care and support due to the complex needs of some people, and staff worked jointly with other services and professionals to ensure people received effective and timely care.

Each person had a hospital passport which they took with them when they transferred to hospital or moved between services. A hospital passport is a document containing important information about the person and their health needs. Staff told us they wrote detailed handover reports and shared relevant information about people appropriately with other services and teams involved in caring for people, to ensure people’s needs, and any changes in their needs were understood and followed.

The manager told us, “We have close partnership working with many professionals including the Parkinson’s nurse, the dietician, SALT team and psychiatry service. We have pharmacy reviews and work closely with the District Nurses, the Mental Health crisis team, the local authority safeguarding team and the GP. Handover notes from the live in carers are recorded directly onto the system including forthcoming appointments for people.”

The provider supported people to manage their health and well-being to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to the healthcare services they needed, to maximise their health and well-being. Care records showed that a range of health care professionals were involved in the care and treatment of people, and staff made appropriate and timely referrals to relevant health care professionals when needed. For example, one person received support from a particular health nurse every 2 weeks to help them explore a particular area of their life.

People’s care plans detailed how staff could support people to have healthier lifestyle habits that were person-centred. For example, one person’s care records showed staff how to build a health bedtime routine by developing a good rapport with them so they could trust and listen to the staff when they gave them advice and reassurance.

Staff followed the recommendations of professionals who confirmed that the staff team worked closely with them to ensure that people’s health care and medical needs were optimised.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

The management team visited people in their homes routinely to check they were happy with their care. The manager told us, “We want to encourage people and their families to share their thoughts, opinions and preferences. This participation ensures that people’s individual needs are met in the way they want.”

Staff told us, “People are involved in their care reviews. The outcome of their care review is recorded onto the system by the care coordinators, and focuses on their well-being, any concerns, and suggestions they might have. By listening to people and helping them to express their views, they shape their own care.”

Care plans detailed the outcomes expected from the care and treatment delivered to people, and staff knew what those outcomes were. For example, we saw oral health care risk assessments for people and associated guidance for staff to support them to remain healthy. One person’s care plan was reviewed by the Positive Behaviour Support (PBS) co-ordinator following any physical intervention. Each intervention was reviewed for triggers and as a result, the number of physical interventions had declined.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and their relatives, where necessary, gave their consent and treatment to the care and treatment they received, and people’s liberty was promoted in line with legal guidance.

People’s capacity to make specific decisions was assessed and documented in their care plans. Where people had been assessed as lacking capacity to make a specific decision, relatives and relevant health and social care professionals were involved in making a best interests’ decision on the person’s behalf, for example when a person needed to use a seat harness or wear a head protector to keep them safe.

Staff had completed training in the MCA and DoLS and understood their responsibility to obtain consent from people in line with the MCA. People communicated they made choices about day-to-day decisions such as how to spend their day, what to wear, and what they wanted to eat and drink. One staff member told us, “People are as fully involved as they can and want to be. For example, one person’s capacity can fluctuate because of their mental health condition. Their care plan is clear about what decisions they can make, and when their (loved ones) need to be involved so that a best interest’s decision can be made on their behalf.”