Background to this inspection
Updated
16 November 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by one inspector.
Service and service type
Lady Forester Community Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
This service is also a domiciliary care agency. It provides personal care to people living in their own flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
The first day of this inspection was unannounced. The second day was announced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection-
We spoke with 10 people who used the service and three relatives about their experience of the care provided. We spoke with eight members of staff including the provider, registered manager, home manager, quality assurance manager, registered nurses, nurse assistants and care assistants. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We reviewed a range of records. This included four people’s care records and multiple medication records. We looked at three staff files in relation to recruitment, supervision and training. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
16 November 2019
About the service
Lady Forester Community Nursing home is care home providing nursing care to a maximum of 35 people. At the time of the inspection, 25 people were using the service. Accommodation is provided in one adapted building. The provider also operates a domiciliary care service to people living in their own homes. At the time of the inspection, four people were receiving assistance with their personal care needs. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
People were protected from the risk of abuse because the provider’s systems ensured staff were suitable to work with people. People told us they felt safe and risks to people’s safety and well-being were assessed and monitored. There were sufficient numbers of staff to meet people’s needs in a safe way.
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. People said staff always asked for their consent before helping them.
People had their needs assessed and were supported by staff who had the skills and experience to meet their needs. Staff monitored people’s health and well-being and worked with other professionals to make sure they received the care and treatment they needed. People’s nutritional needs were met and everyone we spoke with was happy with the food and drinks provided.
People were supported by kind and compassionate staff who ensured they were fully involved in decisions about their care. People were treated with respect and their right to privacy was understood and respected by staff. People were supported to remain as independent as possible.
People received a service which met their needs and preferences. There were opportunities for social stimulation and people could see their friends and family whenever they wanted. People were treated as individuals and chose how they spent their time. People and their relatives felt confident and comfortable to discuss any concerns with staff. People could be confident that their wishes for end of life care would be respected by staff.
The home was well led by the provider, a registered manager and experienced management team. People could be confident the systems in place to monitor standards of care, respond to concerns and plan on-going improvements were effective. Staff were well supported and motivated. This led to a happy and inclusive environment for people to live in.
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 requires improvement. (Report published October 2018) and there were three breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.