Forrester Court

Updated 25 April 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service and to provide a rating for the service under the Care Act 2014.

The inspection took place on 19 and 26 February 2018. The inspection team consisted of one inspector, a bank inspector, an expert by experience and a specialist advisor. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. On this inspection the specialist adviser was a nurse with expertise in dementia care. The first day of our inspection was unannounced, but we told the provider we would be returning for a second day.

Prior to the inspection we reviewed the information we held about the service. We spoke with the service GP and a member of the falls team and contacted a representative from the local authority to obtain their feedback.

During the inspection we spoke with 12 people using the service. Some people could not let us know what they thought about the home because they could not always communicate with us verbally. We therefore used the Short Observational Framework for Inspection (SOFI), which is a specific way of observing care to help us to understand the experience of people who could not talk with us.

We spoke with 11 care workers, four team leaders (two of whom were nurses), one activities coordinator, the regional head chef, the deputy manager, registered manager and regional manager for the provider. We looked at a sample of 10 people’s care records, five staff records and records related to the management of the service.

Updated 25 April 2018

We conducted an inspection of Forrester Court on 19 and 26 February 2018. The first day of the inspection was unannounced. We told the provider we would be returning for the second day.

At the last inspection on 12 and 15 December 2016, we asked the provider to take action to make improvements in relation to maintaining safe staffing levels and good governance and this action has been completed.

Forrester Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Forrester Court provides care and support for up to 113 people who require nursing and personal care. There were 98 people using the service when we visited. There are three floors within the building and each floor consists of two units. Three of the home’s units are for people who have nursing needs, two of the units are for people with residential care needs, some of whom have early onset dementia and the remaining unit is home to those with palliative care needs.

There was a registered manager at the service. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

There were enough suitably trained staff scheduled to work during our inspection and prior to this. The provider operated safer recruitment practices by carrying out appropriate pre-employment checks.

Care staff were appropriately inducted and received ongoing training and support through supervisions and appraisals to conduct their roles safely.

The provider identified and appropriately managed the risks to people’s safety. Where incidents occurred, the provider had a good system in place to record and learn from these to minimise the risk of a reoccurrence.

People told us they felt safe within the home. The provider operated a transparent safeguarding process to keep people safe.

Good infection control practices were operated throughout the building. There was a dedicated sluice on each unit for the hygienic removal of disposables such as incontinence pads.

People were supported to maintain a healthy diet. Care records contained a good level of detail about people’s health and nutritional needs. Kitchen staff were also aware of people’s nutritional requirements and offered people choices with their meals.

People were supported with their healthcare needs. People’s care records contained a good level of detail about their current needs and care staff assisted them to access external healthcare professionals when needed.

People using the service and their relatives were involved in decisions about their care and how their needs were met.

The organisation had good systems in place to monitor the quality of the service. Feedback was obtained from people through monthly residents and relatives meetings as well as annual questionnaires and we saw feedback was actioned as appropriate. There was evidence of further auditing in many areas of care and action was taken to rectify any issues identified as a result.

There were good systems in place for the safe management and administration of medicines. Staff had completed medicines administration training within the last year and were clear about their responsibilities.

Staff a good understanding of their responsibilities under the Mental Capacity Act 2005. Mental capacity assessments were completed when needed and we saw these in people’s care files. Authorisation had been sought and obtained from the local authority where staff felt it was in a person’s best interests to deprive them of their liberty.

People told us care staff were caring and our observations supported this. Care staff demonstrated they knew people’s likes and dislikes in relation to their care and demonstrated an understanding of people’s personal circumstances. Care staff respected people’s privacy and dignity and people’s cultural and religious needs were met. People’s end of life care needs were sought and followed.

People knew how to make complaints and there was a complaints policy and procedure in place.

The service employed five activities coordinators who delivered a varied activities programme. People’s feedback was sought in relation to the activities on offer and the timetable was altered in accordance with people’s views.