Forest Manor Care Home

On this page

• 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

People did not always receive person-centred care. People were not supported with their personal care needs in a responsive or personalised way and relatives told us they were discouraged from bringing personalised items into the home. People and relatives gave mixed feedback about the availability of resident and relative meetings. The home worked well with other professionals within the local community which ensure people received responsive care when enhanced or complex needs were identified. People had been consulted about their wishes for future care and treatment and supported to implement appropriate documentation to support this.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not receive person-centred care. People told us they were not always supported with personal care in their chosen way or as often as they would like. A relative we spoke with said, “I wanted to bring [relative] some nice toiletries in, but I was told not to as the home provides them, that doesn’t seem right as [name] loves a certain kind of perfume.”

We spoke with one staff member and asked them to describe how they delivered personal care to a person that morning. The staff member was unable to locate any toothbrush or toothpaste for that person and confirmed they had not offered the person any support with oral hygiene that day. We raised this with the registered manager who took immediate action and addressed this with staff involved. During lunch we heard one staff member telling a person their behaviour ‘was disgusting’ and not providing any further support to the person or assistance to deescalate the situation. We spoke with this staff member who stated, “[Name] is always like that.”

Our observations supported the feedback we received from people. We observed people in stained clothing that had dried food and faeces on them. Some people looked unkempt regarding things like having their hair washed and brushed and support with shaving. Daily notes reviewed did not support that people had been fully supported with these needs. We could not see personalised toiletries in people’s rooms and staff advised these were kept in a store cupboard. However, all products were generic and not labelled for individuals meaning we were not assured that people had access to their own products.

People told us they had access to health professionals such as dentists, district nurses and physiotherapists. One person said, “I see the district nurses coming in and out all the time and the GP is here regularly too, I don’t have any concerns.”

Staff told us they were supported by nurses who were employed by the home and could raise concerns about people. One staff member said, “The nurses are very open to hearing our concerns and act quickly on checking people.” The registered manager told us they had a strong relationship with the local GP practice, and they were responsive and provided a same day service for any concerns raised.

A visiting professional told us the home had been proactive in identifying a newly admitted person’s needs and making the appropriate referrals for support.

The provider had policies and guidance in place to ensure people received care and continuity and ensure people with protected characteristics were treated equally. Best interest decisions had been completed with the involvement of the person, their family and a medical professional in line with best practice guidance.

People and their relatives said they were supported with information in an accessible way that met their communication needs. People told us they had been included in their care plan but did not have access to the record itself. One relative said, “I was here when it was originally discussed but I have never seen the care plan. I don’t know if it matches what we discussed at the time.”

Staff were knowledgeable about accessible information and could describe methods to support people with receiving information in a way they could understand. However, through observation on the day we did not see staff using these techniques. For example, staff did not use pictures or items to help people understand and make decisions, for example, at mealtimes.

Care plans contained detailed information on how people wished to be supported and what format was most appropriate for their needs. We saw that methods such as easy read or large print documents were available. However quality monitoring processes had not identified the issue seen on assessment which had resulted in people not always having access to the information relevant to them.

Everyone we spoke with told us they knew how to raise or concern or give feedback if they needed to and everyone said they were confident the registered manager would respond. One person said, “I would speak to [registered manager] when I raised something before, she acted very quickly.” However, where people lacked capacity or were unable to speak up, we did not see any evidence within care plan to show that their opinions or feedback had been sought.

Staff told us they attended regular meetings, in which they were asked for feedback and everyone we spoke with told us they would be confident to give feedback or raise concerns in this format. The registered manager assured the assessment team that competency checks and consistent supervision would be undertaken with immediate effect and we saw evidence of this on day 3 of our onsite assessment.

The registered manager told us they held regular resident and relative meetings but we saw that attendance was poor and received feedback that some people were not aware of when the meetings were taking place. We described the feedback received and the registered manager gave assurances that people would be spoken with again and made aware of meeting date and times.

People told they us they were supported appropriately to access care and support relevant to them in a timely manner. Care plan records supported this.

Staff told us they had received training on people’s unique health conditions. This meant they could recognise changes in the person’s health in order to take appropriate action. For example, staff were knowledgeable about people living with diabetes and how to identify symptoms of high or low blood sugars.

A visiting health professional told us that staff always contacted them if there were concerns. They also listened to any advice given which had resulted in positive outcomes for people. For example, people had successfully recovered from pressure damage to their skin.

The registered manager had introduced procedures and guidance for staff on how to support people with requests for healthcare professionals in out of hours situations. This had resulted in more responsive care for people.

People were unable to tell us how they felt about being treated fairly and without discrimination, however records showed that staff consistently sought advice or contacted other professionals. This meant we were assured people had a positive experience.

Staff were knowledgeable about the provider’s equality and diversity plan. The manager described how having a workforce of diverse culture was promoting understanding and open communication between people and staff. The registered manager said, “I have an open-door policy and staff do use it, we take time to discuss people’s needs and take appropriate action as what is right for one person, it may not be right for another.”

Records demonstrated that the management team acted on concerns and made appropriate referrals to other professionals however outcomes were not consistently recorded and therefore staff were unable to assess whether actions had fully supported and met people’s needs.

People told us they had been supported to develop a care plan for their future care and where appropriate had been supported to put DNACPR and ReSPECT forms in place. These documents help staff and other professionals follow people wishes in times of emergency.

Staff we spoke with were knowledgeable about the type of care and support people required as they reached the end of life. Staff described the importance of family involvement, making choices and maintaining dignity. Staff confirmed they had completed training in end-of-life care.

We saw evidence of end of life and advance care planning. While the home was not currently supporting anyone with end-of-life care, records contained detailed personalised information regarding people’s wishes.