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Forest Lodge Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 January 2020

About the service:

Forest Lodge is a residential care home that provides personal and nursing care to people aged 65 and over and people living with dementia. At the time of the inspection 49 people were using the service. Care and support was provided in one adapted building. The building had three units providing care to people: Beech, Ash and Cedar Unit.

Forest Lodge is owned and operated by the provider Sussex Healthcare. Services operated by the provider had been subject to a period of increased monitoring and support by local authority commissioners. As a result of concerns previously raised, the provider is currently subject to a police investigation. The investigation is on-going, and no conclusions have yet been reached.

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

People and their relatives spoke highly of the service. Comments included, “I am as happy as I can be here, yes I feel safe as everything is made to make you feel safe here,” and “Perfectly safe here, I watch and listen and formulate, I have never seen anything to worry me or I would be doing something about it.” Risks associated with people’s care were not however, consistently safe. Where people displayed behaviours which challenged, robust guidelines and risk assessments were not always in place. The risks around restrictive practice were not regularly reviewed and documentation to monitor people’s behaviour were not accurately completed.

Quality assurance frameworks were in place; these were not consistently effective in driving improvement or identifying shortfalls. Forest Lodge has been in continuous breach of regulations since May 2018 and internal quality assurance frameworks have failed to drive and sustain improvements. Accurate documentation was not consistently maintained. Links and engagement with the local community required strengthening.

People were not always supported to have maximum choice and control of their lives. The application of the Mental Capacity 2005 was inconsistent and people’s capacity to consent to specific decisions had not always been assessed. The provision of activities required further development. Activities were not consistently meaningful or tailored to people's needs. The care planning process required further development to ensure people's social and emotional needs were understood and met. The risks associated with social isolation had not always been assessed or mitigated. We have made a recommendation for improvement. Further work was required to ensure information about people's care and treatment was always made available in the most accessible way.

Staff felt supported and had access to a range of training. People's nutritional needs were met, and people spoke highly of the food provided. Risks associated with catheter care, skin integrity and dehydration were managed well. People had ongoing access to healthcare professionals and staff recognised and responded well to signs that a person's health might be deteriorating. Advanced decision care plans were in place and the registered manager was working with staff, people and relatives to make these care plans more personalised.

People told us they felt safe living at Forest Lodge. Relatives also confirmed that they felt confident leaving their loved one in the hands of staff. Systems were in place to determine staffing levels and safe recruitment practices were operated. People told us that staff responded promptly to their care needs. People and staff spoke highly of the registered manager and the registered manager was compassionate about ensuring people received high quality care

The provider employed a team of dedicated housekeepers. Staff had access to personal protective equipment (PPE) and the service presented as clean and tidy. People and their relatives told us staff were kind and caring, listened to them and respected their choices. People were encouraged to be involved in their day to day care and be as independent as pos

Inspection areas

Safe

Requires improvement

Updated 29 January 2020

The service was not always Safe.

Details are in our Safe findings below.

Effective

Requires improvement

Updated 29 January 2020

The service was not always Effective.

Details are in our Effective findings below.

Caring

Requires improvement

Updated 29 January 2020

The service was not always Caring.

Details are in our Caring findings below.

Responsive

Requires improvement

Updated 29 January 2020

The service was not always Responsive.

Details are in our Responsive findings below.

Well-led

Requires improvement

Updated 29 January 2020

The service was not always Well-Led.

Details are in our Well-Led findings below.