Forge House Care North Kent

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People communicated to us that their care and support was person-centred, and they had consistent staff that knew them well. Staff described how they supported people at their pace, spending time listening and getting to know people’s preferences and specific care needs. One staff member told us, “We use people’s preferred names and check what pronoun they wish to be identified as.”

One relative told us, “Staff know [person’s name] likes programmes about animals and wildlife, and the programmes which might frighten or upset her are avoided.”

People’s care plans were person-centred with detail about how they liked to be supported and areas of activity where they remained independent. For example, one person’s oral care plan outlined what toothbrush and toothpaste they used, and how they liked to brush their teeth before choosing their clothes. Another person’s care records detailed why it was important for staff to explain what the weather was like before they chose their clothes and shoes for the day.

People’s bedrooms were clean, tidy and personalised with their own furniture, photographs, books, toys, games and bedding.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service worked with a range of health professionals involved in people’s care. Information was shared with staff regarding any changes to people’s health or care needs.

Staff shared with us how they supported people, and relatives told us they felt staff communication with them was good. One health care professional told us, “I have a good working relationship with the team at Forge House Care, who are approachable and available.” One relative told us, “I regularly see [person’s name] care plan and I have always been involved in reviewing it. Forge House Care are superb at getting people, relatives, and the professionals involved with care plans.” Another relative told us, “I am regularly sent photos of the activities she does.”

People were supported by dedicated staff teams that promoted the continuity of their care. People created their own weekly activity planners and were engaged in a range of activities to stimulate them and occupy their time, both at home and in the community.

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The service had an Accessible Information Standard (AIS) policy in place and people were able to access information. Staff told us, “We make sure people, as far as possible, can understand the information around them, including when making decisions and giving consent. Information is provided in the format that makes most sense, for example, one person uses a picture board.”

Information in people’s care records was accurate, up to date, and reflective of people’s current needs. Each person possessed a communication care plan, identifying any barriers to communication. For example, one person’s care plan stated the importance of talking to them in simple sentences and giving them a running commentary about the activity taking place in that moment, because this enhances their understanding of the situation and supports their engagement with the team around him.

People had access to the opticians, hearing services, physical and mental health support and advocacy where needed.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

The provider had a complaints policy and procedures in place which people and their relatives knew about. The service encouraged people to give their feedback and share their concerns. One relative told us, “I have always been able to talk to the manager when I have needed to, and the responses to any email, phone call or message have been quick.” Another relative told us, “Staff always respond promptly and respectfully. I feel heard and valued as part of [person’s name] support network.”

We saw records of complaints made about the service. The manager had addressed them in line with their complaint’s procedures, investigated fully, and responded to the matter, giving an apology when needed. Lessons learnt were shared with staff as part of improving overall service quality.

People’s relatives or advocates were involved in care planning, and care plans detailed which family member, or advocate, had an oversight of the care planning and review process.

Annual surveys were sent to people, their families, staff, and health colleagues to gain feedback about the service. Team meetings for staff were held every 3 months, and the Director of the service arranged regular round table meetings with staff to discuss what was going well and consider areas of improvement. As a result of recent staff survey feedback, the service is looking at initiative to improve staff recognition.

The service held family days every 6 weeks, where relatives can join their loved ones for food, drink and a chat, providing another opportunity for the service to gain feedback.

Staff told us they felt a sense of empowerment when their voices were heard, and their feedback was acted upon.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

There were processes in place to ensure people had equal access to their home and the services provided. The manager told us people were admitted to the service based on their care needs and the capacity of the service to meet those needs.

People were supported to access the community in a variety of ways. For example, several people had mobility cars, and additional staffing was deployed to support people safely when in the community. Care plans detailed people’s equipment requirements to promote their independence. There were adapted facilities such as grab rails in bathrooms to support people overcome physical challenges, and staff supported people to their iPad, mobile phones and laptops to watch films and keep in touch with friends and family.

Staff had completed training in equality and diversity. We observed staff treating people as individuals, using their preferred pronouns and names. Staff actively kept the environment free from obstacles to maximise the safety of people to walk freely around their home, and they knew the procedures to follow in an emergency.

Professionals we contacted told us the service was proactive and responsive. They could contact the service anytime and their queries would be responded to. One relative told us, “[Person’s name] leads a much fuller life now; she swims, has haircuts, and pub lunches. When she first arrived at Forge House, she was essentially agoraphobic.” Another relative told us, “They have transformed [person’s name] life with opportunities they give her.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The service encouraged people to give their feedback and share their concerns about the service. Regular residents’ and relatives’ meeting took place, and staff met 3 monthly to hear updates and voice any issues. One relative told us, “I have often met with members of the managerial staff at my request. Any suggestions I make are always followed up. There is always a ‘we will be able to help’ attitude from senior managers which is backed up by actions.”

Staff recognised and respected people’s social needs, religious backgrounds and cultural needs. For example, where people preferred to have personal care given by a female carer, this was facilitated.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

End of life care planning was considered for everyone. Where it was not appropriate to discuss with people, this was documented with the reason why.

People’s care records contained information and documents about their DNACPR status (do not attempt cardiopulmonary resuscitation) This is an advanced decision not to attempt CPR; it is not about other treatments or care. Staff were aware of people’s wishes and had completed training in end-of-life care.

At the time of our inspection, no one was at the end of their life. Staff told us they worked closely with people, their relatives and professionals to ensure people’s needs were met. The manager told us the service provided emotional support to families, ensuring that people’s lives were celebrated, and supported staff with therapeutic, counselling and time off as needed following a person’s death.