Forest Care Village Elstree and Borehamwood

People were not always supported to be involved in managing risks to their health and wellbeing. Some people’s care documentation did not contain clear and consistent information to guide staff about how to care for them safely. Daily notes showed care plans were not always followed to ensure people received safe care. Medicines were not managed safely, and there was not always guidance to ensure medicines could be administered in line with the prescriber’s intentions. Some areas of the service were not clean or maintained to a standard to ensure infection risk was managed well. There were not always enough staff to meet people’s needs to uphold their dignity or meet their social and emotional needs. Staff did not understand restrictive practice well. Mental capacity assessments lacked sufficient detail to assure us the correct process had been followed and had not always been completed for people who were restricted. Applications had not been applied for in a timely way to ensure people were not unlawfully deprived of their liberty. Staff had received training in safeguarding people from abuse and knew how to report any concerns.

People’s care records did not always contain consistent information regarding their nutrition and hydration needs. There were not sufficient snacks available for people and a lack of fresh fruit and vegetables. People’s dining experience varied across the different communities. Staff were able to tell us who required modified diets.

People did not always receive dignified care. Social interactions with staff were very limited. Staff did not always promote people’s independence and there was a lack of meaningful activity for people, particularly for those not interested in group activities.

Many people told us they did not feel involved in planning or reviewing their care. There was insufficient guidance for staff to know how to meet people’s communication needs.

The provider had a process for staff to raise concerns and encouraged them to do so.