We carried out a review of the data available to us about OSJCT Isis House Care & Retirement Centre on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about OSJCT Isis House Care & Retirement Centre, you can give feedback on this service.
OSJCT Isis House Care and Retirement Centre accommodates up to 80 people in one purpose-built building. On the day of our inspection 76 were living in the home.
People's experience of using this service
People told us staff were caring. Staff's commitment and compassion enabled people to receive care from staff who knew them well.
People received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff fully understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.
Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely, and people received their medicines as prescribed.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.
The registered manager and staff strived to provide safe care and support. The registered manager worked with GPs and other healthcare professions to ensure the service responded to people's changing needs safely and effectively. People's care was personalised and matched their needs, which promoted their wellbeing and improved their quality of life.
Staff culture was positive, and the team was caring. This had resulted in the provision of compassionate and personalised care. The service had a clear management and staffing structure in place. Staff worked well as a team and had a sense of pride working at the service. The provider had quality assurance systems in place to monitor the quality and safety of the service. The registered manager was robustly supported by the area manager.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection:
At our last inspection in April 2017 the service was rated as Good.
Why we inspected:
This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.
Follow up:
We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.
At the last inspection, the service was rated Good.
At this inspection we found the service remained Good.
Why the service is rated good:
People remained safe living in the home. There were sufficient staff to meet people's needs and staff had time to spend with people. Risk assessments were carried out and promoted positive risk taking which enable people to live their lives as they chose. People received their medicines safely.
People continued to receive effective care from staff who had the skills and knowledge to support them and meet their needs. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to access health professionals when needed and staff worked closely with people's G.P's to ensure their health and well-being was monitored.
The service continued to provide support in a caring way. Staff supported people with kindness and compassion. Staff respected people as individuals and treated them with dignity. People were involved in decisions about their care needs and the support they required to meet those needs.
The service continued to be responsive to people's needs and ensured people were supported in a personalised way. People's changing needs were responded to promptly. People had access to a variety of activities that met their individual needs.
The service was led by a registered manager who promoted a service that put people at the forefront of all the service did. There was a positive culture that valued people, relatives and staff and promoted a caring ethos.
Isis House is a care home providing care and support to 80 older people. The home offers residential care, nursing care, Intermediate care and dementia care. The home is part of The Order of St John Community Trust. On the day of our visit 78 people were living at the home.
We carried out an unannounced comprehensive inspection of this service on 18 June 2015. Breaches of legal requirements were found relating to insufficient staffing levels and consent under the Mental Capacity Act 2005. We also identified concerns with the accuracy and details of some care plans and the lack of opportunity for people to leave the home and maintain local community links. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to providing sufficient staff to support people’s needs and having suitable arrangements in place for obtaining, and acting in accordance with, the consent of service users in relation to the care and treatment provided for them in accordance with the Mental Capacity Act 2005. The provider sent us an action plan in July 2015 stating the action they would take to improve the service to the required standard.
We undertook this focused inspection to check that they had followed their plan and to confirm that they now met the legal requirements. At this inspection we found actions had been completed and improvements made. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for OSJCT Isis House Care and Retirement Centre on our website at www.cqc.org.uk.
There was a registered manager in post. 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 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 sufficient staff to meet people’s support needs. We saw staff were not rushed in their duties and had time to talk with people and complete administration tasks. Where people required the support of two staff members, this requirement was consistently fulfilled. Records confirmed sufficient staffing levels were consistently maintained.
The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves. People’s capacity to make decisions was assessed appropriately.
The service sought people’s consent. We observed staff seeking consent in line with the MCA 2005 and records confirmed people were involved in reviews and decisions around their care. Where people lacked capacity to make certain decisions their best interests were considered and decisions were made in the least restrictive way.
People’s care plans were personalised, accurate and regularly reviewed. We saw where people’s care was closely monitored, records were accurate and up to date ensuring the support plans reflected people’s situation and current needs.
A range of activities were available to people reducing the risk of social isolation. People also had the opportunity to maintain community links. People went out to local places of interests and events and the service provided a mini bus for people to enjoy activities outside of the home.
This inspection took place on the 18 June 2015 and was an unannounced inspection. At the last inspection on 18 May 2014 the service had met all of the outcomes we inspected.
Isis House is a care home providing care and support to 80 older people. The home offers residential care, nursing care, Intermediate care and dementia care. The home is part of The Order of St John Community Trust. On the day of our visit 80 people were living at the home.
There was a registered manager in post. 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
There was not sufficient staff on duty to support people and meet their needs. People and staff told us there were not enough staff. Care workers were very busy and appeared rushed in their duties. One member of staff said “We are working flat out just to do basic care". As a consequence, some people did not receive appropriate support with regard to eating their meals.
The registered manager and staff were aware of their responsibilities under the Mental Capacity Act 2005 (MCA) which governs decision-making on behalf of adults who may not be able to make particular decisions themselves. However, mental capacity assessments were not always complete and we could not evidence how the service had obtained some people’s consent.
Staff understood the needs of people and provided care with kindness and compassion. People had access to activities such as and arts and crafts, games and religious services. Some people told us activities were good. However, some felt differently. One person said “I’ve never been on an outing since I’ve been here. They’ve never asked me”.
People were safe. Staff had received regular training to make sure they stayed up to date with recognising and reporting safety concerns. Records confirmed the service notified the appropriate authorities where concerns relating to suspected abuse were identified.
Where risks to people had been identified risk assessments were in place and action had been taken to reduce the risks. Staff were aware of people’s needs and followed guidance to keep them safe.
People received their medicines as prescribed. Staff carried out appropriate checks before administering medicines. Records were accurately maintained and all medicines were stored safely and securely.
People told us they were confident they would be listened to and action would be taken. The service had systems to assess the quality of the service provided in the home. Learning was identified and action taken to make improvements which improved people’s safety and quality of life. Systems were in place that ensured people were protected against the risks of unsafe or inappropriate care.
Most staff spoke positively about the support they received from the registered manager. Not all staff supervision records were up to date. Staff told us the registered manager was approachable and there was a good level of communication within the home.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.
The home offered residential care, nursing care, intermediate care and dementia care. The home is part of The Order of St John Community Trust.
We considered our inspection findings to answer questions we always ask;
Is the service safe?
Is the service effective?
Is the service caring?
Is the service responsive?
Is the service well-led?
This is a summary of what we found;
Is the service safe?
People were cared for safely. Risk assessments were in place and regularly reviewed. People's needs were assessed and reflected in the care plans.
There were arrangements in place to deal with foreseeable emergencies. There was emergency lighting and plans for managing the person's needs in the event of a power failure. Each person had an emergency evacuation plan for use in the event of a fire.
At our previous inspection we raised concerns that medicines were not always kept safely and securely because one of the fridges containing medication was broken. We had also seen some medication was not stored in a safe and secure way. Since our inspection the provider had purchased a new fridge for each clinical room. Daily temperature checks of the clinical rooms and medication refrigerators were recorded. They showed that the refrigerators were working effectively. We saw that all medication was locked away. in cupboards and metal trolleys which were secured to the wall when not in use. We concluded that appropriate arrangements were in place and medicines were kept safely and securely.
Systems were in place to make sure that managers and care workers learnt from events such as accidents, incidents and complaints. This reduced the risks to people and helped the service to continually improve.
The provider understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The manager had previously made DoLS applications where it was in a person's best interest to do so. There were no people subject to a DoLS at the time of our inspection.
Is the service effective?
The service was effective. People had individual care plans which set out their care needs. People's needs were assessed and people told us they were involved in their plans of care. Specialist dietary, mobility and equipment needs had been identified in care plans where required.
Care workers told us they felt supported in their role. One care worker told us "I love my job; we are a good supportive team'. Another told us 'the manager is very approachable and supportive'. Care workers received an annual appraisal and were able to complete appropriate training. This meant care workers were appropriately trained and supported to care for people living and staying at Isis House.
Is the service caring?
The home was caring. People we spoke with were complementary about the home. One person said, "staff are always very pleasant, helpful and prompt when I buzz for them'. A relative told us "It's very good, caring. Mum's safe and well looked after'. During the SOFI observation we observed a person who was in bed and may not have been able to summon care workers. Throughout the observation we noted that whenever care workers walked past this person's room they went in. At times care workers stayed for a few minutes chatting to the person without performing any care tasks. On other occasions the person was assisted to have a drink or change position. This meant that this person received appropriate care and benefitted from good interactions with care workers. Throughout our inspection the atmosphere was pleasant and we observed many interactions between care workers and people that were caring, relaxed and friendly.
We found that people's privacy and dignity was protected. Care workers we spoke with could describe the action they would take to ensure people's privacy and dignity was protected during care tasks. These included keeping curtains drawn, closing doors and ensuring people were covered during personal care. People we spoke with told us that they felt care workers respected their privacy. One person told us 'they always knock on my door and close the curtains'.
Is the service responsive?
The home was responsive. We saw evidence that care workers recognised when a person's condition changed or their health had deteriorated and sought the help and advice of other professionals. For example, we saw that one person had suddenly become unsteady on their feet and had a fall. Their urine was tested which identified they had an infection. The GP was contacted who prescribed antibiotics. It was noted that following the antibiotics this person's mobility had improved. This showed us that care workers were responsive to people's needs.
Is the service well-led?
The service was well led. The home worked with other agencies and services to make sure people received the care they needed.
Care workers told us they felt able to raise any concerns with the manager. One care worker told us ''the manager has an open door you can talk to them about anything'. This meant that care workers felt confident that they would be listened to and that any concerns they had would be taken seriously.
During our inspection we looked at the quality assurance systems that were in place. The information reviewed demonstrated that the service was monitored on a consistent basis to ensure that people experienced safe and appropriate support, care and treatment.
Before people received any care or treatment they were asked for their consent and the care staff acted in accordance with their wishes. One person we spoke with told us, 'I am always asked before they do anything, they always knock'. One care worker we spoke with told us, 'it's important not just to ask first but to always explain what we are doing as we go along'. We observed that staff asked people for consent before giving treatment.
People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We looked at nine people's care records. Records showed individual support plans were person centred and regularly reviewed. They covered a range of areas relevant to the individual's needs such as personal care, continence and nutrition.
People we spoke with told us the food was good. One person told us 'the food here is very good'. Another person told us, 'I like it here, the food is very good and I am comfortable'. People were provided with a choice of suitable and nutritious food and drink. One person told us, 'there is plenty of food and a wide selection'.
We found that medicines were not always stored correctly and at the correct temperature, which increased the risk of medication errors and harm to people.
People were cared for, or supported by, suitably qualified, skilled and experienced staff. Appropriate checks were undertaken before staff began work. In all files we reviewed staff had DBS (Disclosure and Barring System) checks in place. There were also two references in place from previous employment.
The provider had an effective system to regularly assess and monitor the quality of service that people receive as they undertook regular audits of the service. People who used the service, their representatives and staff were asked for their views about their care and treatment and they were acted on. We saw the results from the most recent satisfaction survey and saw that the results were very positive.
People said that 'staff were kind and considerate'. People told us they are consulted regularly about the care they received. They were also asked about how the home was managed and had made comments about the food and activities. People told us that these had been acted on. Comments included 'lots of activities' ,'food is fantastic '.
We were told that the home made sure that they were safe from harm. There was a receptionist on duty throughout the day. When there was no one on reception, people had to ring the bell and be signed in and out. Some people had their medication managed for them. People had signed to say they agreed with this. People told us that medication was administered safely by people who had been trained to do so.