We carried out a review of the data available to us about Osborne House 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 Osborne House, you can give feedback on this service.
Osbourne House is a residential care home providing personal care to up to 32 people. The service provides support to older people, some of whom are living with dementia. At the time of our inspection there were 26 people using the service.
People’s experience of using this service and what we found
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. We made a recommendation to review procedures for recording capacity assessments and best interests decisions to ensure they contain sufficient detail.
People living in the home were safe. Recommendations made at our last inspection in relation to the medicines policy, laundry procedures and audits had been acted upon. Staff were kind and caring and were confident in identifying and reporting concerns about potential abuse. There were sufficient staff to ensure people’s needs were met. There were risk assessments in place to support staff in providing safe care for people.
The service was well led. The provider and registered manager had acted on all recommendations made at our last inspection. There was a positive, person centred culture in the service. People received good care and staff were valued and listened to. The needs and views of people in the home and their families were taken in to consideration in the running of the home. There were systems in place to monitor the quality and safety of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 8 November 2019). A further inspection report was published in November 2020 and this found that the service was no longer in breach of regulation but that some improvements were still required. Three recommendations were made in relation to medicines, infection control and audits. At this inspection we found improvements had been made and the rating of the service improved to good.
Why we inspected
We inspected the service in order to review the improvements made since the last inspection.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Osborne House on our website at www.cqc.org.uk.
Recommendations
We have made one recommendation in relation to recording of mental capacity act assessments and decisions.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Osborne House accommodates up to 32 older people. At the time of the inspection 26 people were living at the home.
People’s experience of using this service and what we found
During this inspection we did not speak directly with people at the service due to the increased risks associated with the COVID-19 pandemic. People appeared relaxed and had a good rapport with staff and were undertaking activities.
People’s medicines were administered and managed safely. There were effective audits in place. The service was clean and infection control procedures were in place for visiting, cleaning and to support effective handwashing however procedures relating to the safe storage of laundry required improving.
The provider had improved the auditing of the safe handling of medicines, hot water temperatures and overall governance systems. We recommend the provider seeks guidance from a reputable source to ensure their policies relating to the management of medicines remain current and up to date and laundry is being handled within current care home guidance.
Rating at last inspection and update
The last rating for this service was Requires improvement (published August 2019), there were two 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 either regulation however we have made some recommendations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on the 1 and 2 August 2019. Two breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve in regard to Regulation 12 (Safe Care and Treatment) and Regulation 17 (Good Governance).
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We undertook this targeted inspection to check they now met the legal requirements. This report only covers our findings in relation to the breaches within Key Questions of Safe and Well-led.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to coronavirus and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Osborne House on our website at www.cqc.org.uk.
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.
Osbourne House accommodates up to 30 older people. At the time of the inspection 26 people were living there.
People’s experience of using this service:
Medicines were not being administered safely and records were not accurate and up to date. The providers medicines policy required updating.
People, staff and visitors could be at risk due to poor handling of soiled laundry, hot water that posed a risk of scalding and the stair case being uneven. The provider’s quality assurance systems had failed to identify shortfalls found during the inspection relating to the environment, infection control and medicines management.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff received supervision, training and an annual appraisal.
People felt supported by staff who were kind and caring and who knew them well. Although staff were not always quick enough to respond when incidents occurred which on occasions meant people become upset. People were supported by staff who had checks undertaken prior to starting within the service.
Care plans were personalised and contained important information relating to likes and dislikes. People felt about to raise a complaint should they need to.
Staff were happy and felt well supported. People felt the manager was approachable and friendly. People were supported to access medical appointments and health professionals when required. People could attend various activities and be part of daily routines within the service.
Incidents and accidents were recorded, and an overview held so that any trends and themes could be identified. People had end of life wishes recorded within the care plan.
Rating at last inspection: Outstanding (published January 2017).
Why we inspected: This was a planned inspection based on the previous rating. At this inspection we found the overall rating had changed from Outstanding to Requires Improvement.
Follow up: We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We will continue to monitor the service through the information we receive. We will visit the service in line with our inspection schedule, or sooner if required.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Osborne House is registered to provide accommodation and personal care to up to 30 people. The home specialises in providing care to older people living with dementia. At the time of this inspection there were 27 people living at the home.
The last inspection of the home was carried out in August 2014. No concerns were identified at that inspection.
There is 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.
People were supported by a registered manager and staff team who were passionate about their work and committed to providing a high standard of care. The registered manager and provider had a clear philosophy for the home which was to promote a positive environment for people where they were able to make choices about all aspects of their lives. They aimed to constantly up date and improve the service.
A high emphasis was placed on ensuring people had access to activities and social stimulation. During the inspection all staff engaged with people in a positive and pro-active manner. There was an excellent programme of activities which catered for people’s individual interests and abilities. There was equipment in the communal areas of the home which encouraged occupation even when people did not choose to join in with organised activities. Staff spent time with people encouraging them with their hobbies and promoting their sense of well-being. People were animated and happy.
People were able to make choices about their day to day lives. People could choose when they got up, when they went to bed and how they spent their days. There were good links with local community groups which increased people’s opportunities to attend social events and take part in leisure activities. Staff supported people to continue to pursue their interests and maintain contact with family and friends.
Staff had the skills and knowledge needed to provide a specialist service to people living with dementia. Throughout the inspection the staff displayed extreme kindness and understanding of people’s needs and wishes.
The registered manager kept their knowledge up to date and shared their knowledge with the staff team. Staff felt well supported and were well motivated and happy in their work. This all helped to create a warm and welcoming atmosphere for people and their families.
People we spoke with were positive about the service they received and told us they felt well cared for. People spoke very highly of the staff who supported them with some saying it felt like a big family. Comments included; “Staff are always happy, never miserable,” “Staff are very kind. They are like family really” and “They are very, very caring people.”
People had their needs assessed and care was planned in accordance with people’s needs and wishes. People, or their representatives, were involved in decisions about how their care was provided. Staff monitored people’s mental and physical health and ensured they received treatment from healthcare professionals according to their individual needs.
There were policies and procedures to make sure only suitable staff were employed in the home. All staff knew how to report any suspicions of abuse or poor practice and all were confident action would be taken to make sure people were safe. People felt safe at the home and with the staff who supported them. One person said “The staff are kind, I’m safe here.”
People were supported by staff who were aware of their responsibilities to safeguard them from harm and to report any concerns.
Where people had identified risks, for example with their mobility and falls, we saw that an appropriate assessment had been completed and a support plan to guide staff on how to support the person safely was in place. In addition, we saw that where people needed support due to their dementia, for example if they forgot what their family looked like, a support plan was in place.
The provider operated a safe and appropriate recruitment procedure to help protect people from harm. We saw that appropriate pre-employment checks had been completed.
Is the service effective?
We saw that the service involved other healthcare professionals as required. For example, every person in the home was registered with the same local GP surgery. A GP from that surgery attended the home a minimum of once a week to see people who may require medical assistance. We saw from people's care records that appropriate referrals had been made following a specific event, for example if a person had fallen.
The home had ensured that where a risk had been identified, action had been taken. For example, we saw that when a person's weight had decreased, the home had responded to their needs by involving a healthcare professional and monitoring the person's food and fluids.
Is the service caring?
People who lived at Osborne House and their relatives spoke highly about their experiences of the home. All praised the staff at the home, with one person describing the staff as their 'family' and one person's relative telling us the staff were 'Absolutely delightful.' We observed staff treated people with dignity and kindness.
People's relative's spoke highly of the registered manager and staff employed at Osborne House. The registered manager held support groups for people's families to form a support network with other relatives of people living in the home that were suffering from dementia. One person's relative told us the home provided 'A really supportive network.' Another told us the support groups were 'Excellent.'
We made observations where people received the support they needed and people told us their needs were met by staff. For example, where people needed specific mobility equipment to move around the home, this was available or nearby if the person was seated.
Is the service responsive?
People's relatives told us they were involved in people's care planning and decisions about care. The care people received reflected the needs of each individual. The provider had an appropriate system to ensure person centred information was recorded to meet people's individual needs. We saw the home completed care reviews and that people and the relatives were involved in these reviews.
People and their relatives were happy with the care provided at Osborne House and positive comments were received. One person said, 'It's really nice here, the staff are my friends.' One person's relative told us, 'I would certainly recommend them, they (the staff) always ask if there I anything they can do for you.' Another person's relative said, 'It's a lovely atmosphere, the staff are absolutely amazing.'
Is the service well led?
Staff at the home told us they felt well supported by the registered manager.
We saw that there were systems in place to monitor the quality and safety of the service provided. This included, for example, care reviews with people's relatives and comment cards to gather the views of the people who lived at the home and their relatives.
The home had a suitable auditing system to manage the health, safety and welfare of people living at the home. These audits included, for example, the medication used in the home, the home cleanliness and the safety of the environment.
Any accidents and incidents that occurred in the home were recorded and analysed to establish any trends.