Forest Hill

Areas of the service were not clean or maintained well. There were not enough domestic staff to keep the building clean. People did not always receive their prescribed medicines at the prescribed times. Information in people's care plans was not consistently kept up to date.

The provider had not ensured systems and processes to assess risk and monitor quality were sufficient and effective in driving improvements. There was a lack of robust oversight of the quality of care. The governance systems did not support staff to identify themes of concern and take appropriate action to maintain safe care in a consistent way.

The provider's checks and audits did not identify that people were not consistently involved in planning and reviewing their care. The provider did not always act on feedback received from health and social care professionals in a timely manner to reduce risks to people.

Staff we spoke with demonstrated good knowledge of people's needs, but said they did not always have enough time to read people's care plans. People were not always involved in reviews of their care, particularly where they were less able to communicate their needs.

Relatives had mixed experiences of communication from the provider about aspects of their family members' care. The provider had not taken steps to ensure that people were given information about their care and support in ways which were accessible for them.

Risks associated with the service environment were assessed, but the provider did not always ensure those risk were mitigated.. The provider had a system in place for regular checks on all aspects of the environment. People's needs were assessed, and any risks associated with their health conditions documented. Accidents and incidents were reviewed and monitored to identify trends and to prevent reoccurrences.

People's needs, and choices were assessed in line with current legislation and guidance in a way that helped to prevent discrimination. People were supported by staff to access healthcare services when required. People were supported and encouraged to have a varied diet that gave them enough to eat and drink.

People and relatives spoke positively about the staff who provided support. Staff were caring and showed that they enjoyed the work they do.