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We are carrying out checks at Forest Hospital using our new way of inspecting services. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Good

Updated 9 February 2018

During this inspection, we looked at the three questions, of safe, effective and well-led where we had previously identified concerns. We did not inspect caring and responsive.

We rated Forest Hospital as good because found the provider made the following improvements:

  • All staff and patients were offered debriefing sessions and informed of feedback from incidents they were involved in. Staff received feedback of lessons learned occurring internally and externally to the hospital. We saw written evidence of lessons learned on incident reporting forms.

  • The percentage of staff receiving an annual appraisal was in line with the organisation’s targets. All staff we spoke with said they received an annual appraisal.

  • The provider developed an audit process to monitor the use of the Mental Capacity Act within the hospital and staff knew who to approach for advice.

However:

  • The quality of mental capacity assessments we saw were inconsistent and specific decisions were not recorded.

  • Care plans we saw did not focus on the patient’s strengths and goals and were not recovery orientated. The language used in care plans did not reflect that used by patients.

  • There was no indication in patient care notes to remind staff to consider a further Deprivation of Liberty Safeguards (DoLS) authorisation when the current authorisation was due to end.

Inspection areas

Safe

Good

Updated 31 May 2017

We rated safe as good because:

  • All parts of the building were clean, well maintained and appropriately furnished. The service had a maintenance and cleaning team who were responsible for daily maintenance for this service.
  • Staff we spoke with said there was enough staff to manage physical interventions.
  • Patients we spoke with said they spent regular time with their key worker.
  • Staff were trained to safely meet the needs of patients, a wide range of mandatory and legislative training was provided.
  • There were no blanket restrictions used in this service.
  • The service had a robust medicines management procedure in place.

However:

  • Staff did not receive feedback of lessons learned from incidents at this hospital and debriefing sessions.

Effective

Requires improvement

Updated 9 February 2018

We rated effective as requires improvement in the March 2017 inspection. We found improvements had been made following the requirement notice, but:

  • Staff did not always carry out mental capacity assessments in a consistent way. There were no indicators in patients’ notes to remind staff to consider if a further Deprivation of Liberty Safeguards authorisation was required.

  • Care plans we saw did not focus on the patient’s strengths and goals and were not recovery orientated.

However:

  • There were regular and effective multidisciplinary meetings attended by all staff and effective working relationships with teams outside of the organisation.

  • Various health professionals provided input into the multidisciplinary team and the hospital was looking to review its participants.

  • Staff received various types of supervision according to the frequency stated in the organisation’s policy.

Caring

Good

Updated 31 May 2017

We rated caring as good because:

  • We observed very friendly, caring and positive interactions between patients and staff.

  • Staff understood the individual needs of the patients.

  • Patients told us they were treated with kindness, dignity and respect by staff.

  • Patients were able to raise concerns about the service and received feedback from staff about their concerns.

  • A carer said staff treated patients and carers with dignity and respect.

Responsive

Good

Updated 31 May 2017

We rated responsive to people’s needs as good because:

  • All patients were encouraged by staff to have contact with family and friends.

  • Informal patients could come and go from Forest Hospital without restriction.

  • The hospital followed the provider’s admissions and discharge policies, which resulted in safe patient admission and discharge.

  • Patients’ bedrooms were large, spacious and personalised.

  • Staff appropriately responded and gave feedback to patient complaints.

  • Patients took part in structured therapeutic activities that were available seven days a week.

Well-led

Good

Updated 9 February 2018

We rated well-led as requires improvement in the March 2017 inspection. We found improvements had been made following the requirement notice.

  • The hospital use key performance indicators to measure staff performance.

  • Sickness levels had reduced and there were no reported cases of bullying and harassment

  • All staff knew the organisation’s values.

  • Staff appraisal rates exceeded the organisation’s target. All staff said they received an annual appraisal and mid-year review of their performance.

Checks on specific services

Long stay/rehabilitation mental health wards for working age adults

Good

Updated 9 February 2018

Other CQC inspections of services

Community & mental health inspection reports for Forest Hospital can be found at Barchester Healthcare Homes Limited.