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Forest Lodge Rest Home Requires improvement

Reports


Inspection carried out on 23 July 2019

During a routine inspection

About the service

Forest Lodge Rest Home is a residential care home providing personal care to 27 people aged 65 and over and some people are living with mental health conditions. The service can support up to 28 people.

The accommodation is a large house set in its own grounds next to the local park. There are two floors accessed by stairs or a lift. The upper floor has bedrooms, toileting and bathing facilities. The downstairs provides two communal lounges, a dining area and a conservatory used as a smoking room. There was an outside space to the front of the home which was secure and available for people to use.

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

The provider had completed audits in relation to the service, however these were not always a true representation of the situation and therefore improvements had not always been identified. There was not always staff available to be responsive to people’s needs and some people were unable to request assistance when required. We have made a recommendation the provider empowers people to make choices and encourages them to maintain hobbies and interests.

Staff had received a range of training. In relation to keeping people safe from harm this was understood and the staff knew what areas to report on. However, for some areas the training provided had not always been followed.

There were staff available within the home, however these were not always responsive to people’s needs. The required checks had been completed to ensure staff were safe to work with people. Medicine was managed safely. People’s risks had been assessed and further work was being developed in this area to ensure long term conditions had been reflected.

People could choose their meal and provision was made for people’s dietary or cultural needs. Some people had the facilities within their room to store food and make light snacks of their choice. 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.

Religious needs and cultural respect were embedded within the service. Staff who were able to communicate with people in their chosen language. Other people were supported with different communication methods, for example picture cards or the use of technology.

Staff had established relationships with people. Families were made welcome when they visited, and any relevant information was shared. People’s information was stored securely, and their privacy was respected.

There was a complaints policy which had been followed when any concerns had been raised. People’s views had been considered and suggestions used to develop some aspects of the environment.

Areas of the home were being refurbished and people had been included in the decision making of the colour schemes. The provider aimed to work with a range of partners to drive improvements or reflect the needs of the individual.

You can see what action we have asked the provider to take at the end of this full report.

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 29 March 2017)

At this inspection we found areas required improvement and some areas where the provider had breached the regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Inspection carried out on 21 February 2017

During a routine inspection

This inspection took place on 21 February 2017. Forest Lodge Rest Home is registered to provide accommodation and personal care for up to 28 people with physical and mental health needs. On the day of our inspection 27 people were using the service.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People continued to feel safe and staff ensured that risks to their health and safety were reduced. There were sufficient staff to meet people’s needs in a timely manner and systems were in place to support people to take their medicines.

Staff received relevant training and felt well supported. People were asked for their consent and appropriate steps were taken to support people who lacked capacity to make particular decisions. People were supported to eat and drink enough to maintain good health.

There were positive and caring relationships between people and the staff who cared for them. Staff promoted people’s right to make their own decisions and respected the choices they made. People were treated with dignity and respect by staff who understood the importance of this.

People received person-centred and responsive care from staff who had a clear understanding of their current support needs. Care plans were in place which provided clear information about the care people required. People knew how to make a complaint and there was a clear complaints procedure in place.

There was an open and transparent culture which enabled people and staff to speak up if they wished to. The management team provided strong leadership and a clear direction to staff. There were robust quality monitoring procedures in place.

Further information is in the detailed findings below.

Inspection carried out on 18 & 19 November 2014

During a routine inspection

This inspection took place on 18 and 19 November 2014 and was unannounced. Forest Lodge Rest Home provides accommodation and personal care for up to 28 people with dementia, mental health needs and physical disabilities. On the day of our inspection 28 people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection in August 2013 we asked the provider to make improvements in the safety and suitability of the premises, and this action has been taken.

People told us they felt safe living at the care home. Staff understood their responsibilities to protect people from the risk of abuse. People received their medicines as prescribed and they were safely stored.

People were supported by a sufficient number of staff and effective recruitment and selection procedures were operated to ensure staff were safe to work with vulnerable adults.

Staff had the knowledge and skills to care for people effectively. People received support from health care professionals when needed.

The Care Quality Commission (CQC) monitors the use of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). We found this legislation was being used correctly to protect people who were not able to make their own decisions about the care they received. We also found staff were aware of the principles within the MCA and how this might affect the care they provided to people.

People had access to sufficient quantities of food and drink. People told us they enjoyed the food and there were different choices available.

People were treated with kindness and compassion by staff and caring relationships had been developed. People were able to be involved in the planning and reviewing of their care and told us they were able to make day to day decisions. People were treated with dignity and respect by staff.

People were provided with care that was responsive to their changing needs and personal preferences. The manager had made links with the local community to help people avoid social isolation. People felt able to make a complaint and told us they knew how to do so.

People gave their opinions on how the service was run and suggestions were implemented where possible. There were effective systems in place to monitor the quality of the service. These resulted in improvements to the service where required.

Inspection carried out on 6 August 2013

During an inspection looking at part of the service

We spoke with a relative of a person who used the service. They said, �I�m happy with the majority of care for my relative. I�d give the home about 8 out of 10.�

During our inspection we observed that staff members spoke in a supportive and respectful manner with people who used the service. We saw that people�s care plans contained information to support their care needs.

A member of staff told us, �I�d report any concerns to the manager or the council.�

We saw the safeguarding and whistle blowing policies which contained clear and appropriate information about the different forms of abuse and what action should be taken if abuse was suspected.

We noted that issues found on our previous inspection in relation to the smoking room had not been fully resolved. A relative of a person who used the service told us, �People smoke in the smoking room but the door is often left open. You can smell smoke in the home.�

A person who used the service told us, �There�s generally enough staff around.�

We looked at three staff files and saw that regular supervision meetings were held between the staff and the manager.

We saw the provider had documented actions taken in relation to individual incidents and staff members. The provider had monitored staff practices to identify any areas which required improvement.

Since our previous inspection, the provider has made notifications to the Commission appropriately.

Inspection carried out on 16 January 2013

During a routine inspection

We spoke with seven people who were using the service. One person said, �I love it here, the staff are all lovely and polite. I like my privacy and they respect that.� Another person said, �Most of the staff are great, they are respectful and they know me and what I like.�

On the day of our visit we observed staff responding when people had pressed the call button in their bedroom. Support was provided to people in a timely manner. People who required support to eat their lunch received this support.

We spoke with seven people who were using the service. One person said, �The cleaner cleans my room everyday, the home is kept clean.� Another person said, �They do my laundry for me, they vacuum my room and clean my bathroom. I�m happy with that.�

The records we saw relating to staff training and supervision showed that staff had not received all of the training and supervision required to carry out their role safely and to an appropriate standard.

We spoke with seven people who were using the service. One person said, �There are meetings for the residents. I�m not bothered about going to those however I know I can have my say. They do listen here and try to make changes.� Another person said, �I go to the resident�s meetings, I speak up and I know they listen to us. My relative also has a chat with the manager when they come to visit me.�

Inspection carried out on 6 December 2011

During an inspection in response to concerns

The people we spoke with told us their choices were respected and they felt they were listened to. People told us they had choices over when to wake up and go to bed, what clothes to wear and what they wanted to eat amongst other things.

We spoke to five people who were living at Forest Lodge to ask if they were happy with the care and support they received. We were told �It�s ok, they look after me well but I am a bit bored, there�s not much to do.� , �I am happy here, they look after me well.� and �Yes they look after me well and call the doctor when needed. There�s not much to do and I would like to go out more.�

We spoke to some people who were living at Forest Lodge about how they could be involved in the running of the service. We were told �There are resident meetings but I�m not bothered about those. I haven�t received a survey either but I feel I can have my say if I want to.�