Little Oyster Residential Home

Updated 2 November 2023

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 3 inspectors.

Service and service type

Little Oyster Residential Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Little Oyster Residential Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

A manager had applied to become a registered manager, we started the inspection of the service on 21 September 2023, they became registered with CQC on 25 September 2023.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, which included monthly reports that the provider had sent CQC as part of their conditions of registration. We sought feedback from the local authority and other professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) since the last inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 9 people who use the service about their experience of the care provided. We spoke with 14 members of staff including the registered manager, general manager, deputy managers, team leaders, head of care, support workers and ancillary staff. We observed staff interactions with people and observed care and support in communal areas. We reviewed a range of records, including 8 people's care records, everyone’s medicine records and risk assessments. A variety of records relating to the management of the service were reviewed including staff files, audits, action plans and meeting notes.

Updated 2 November 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Little Oyster Residential Home is a residential care home providing accommodation and personal care for up to 64 people. The service supports people with learning disabilities, autism, physical disabilities and mental health conditions. The main building is arranged across 2 floors with lift access and the service has an annex, bungalows and flats on the same site. Only 1 of the flats was occupied. At the time of our inspection there were 15 people using the service.

People's experience of using this service and what we found

Right Support:

The service had systems and processes in place to safely administer and record medicines use. There was a robust auditing process in place that helped to identify areas for improvement and minimise impact on people’s care and safety. However, there was no process in place to record why PRN (as and when required) medicines were being used or if these had been effective and national guidance wasn’t always being followed when disposing of certain medicines. We made a recommendation about this.

Staff supported people to take part in activities of their choice. People were supported to pursue interests in their local area. People's rooms were personalised and they were supported to move to another part of the service if they wanted to and if it was appropriate. Staff supported people in a clean and well-equipped environment. The service had an ongoing programme of redecoration in progress.

Right Care:

People were protected from poor care and abuse. The provider had policies in place and staff had been trained. Safeguarding concerns were reported to the appropriate authorities and the manager worked with the local safeguarding teams to ensure any issues were fully investigated.

Risk assessments had improved since our last inspection and these gave staff enough information to provide safe care. Care plans were detailed and people's preferences and choices were documented. There were enough staff deployed to provide support for people. Staff knew people well and understood how to provide safe care. People told us, “A lot of things changed here since January 2023. This is the first week with no agency [staff] which is better” and “I am happy with my care.”

Right Culture:

Since the last inspection a new manager had joined Little Oyster Residential Home. The manager had continued working with the wider management team to embed the quality monitoring and audit processes. The new care system gave the management team better oversight of the care and support provided, handover records were utilised in this system to give staff clear information about people’s care and support. These quality monitoring processes were embedded and were continuously reviewed to ensure they gave a good oversight of the service.

The management team met with staff daily to share information and ensure staff had the most up to date information. Other meetings were held regularly, including a clinical risk meeting. Staff told us the management were supportive and approachable.

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.

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 7 August 2023) and there were breaches of regulation. This was a focused inspection of safe and well-led. Effective, caring and responsive were also rated requires improvement at a previous inspection (published 24 March 2023) and there were 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. However, there were some areas for improvement.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last 2 inspections.

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.

Recommendations

We have made a recommendation about the management of some medicines.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.