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.
Osborne House is a residential care home providing personal and nursing care to up to 74 people. The service provides support to older and younger adults, some of whom may be living with dementia or physical disabilities. At the time of our inspection there were 44 people using the service.
Osborne House accommodates 74 people in one adapted building, across three floors. Each floor has separate facilities and specialises in providing care to people with varying needs. The second floor is a nursing unit, while the top floor specialises in providing care to people living with dementia.
People’s experience of using this service and what we found
People received their medication as prescribed, by trained and competent staff. The recording and storage of some medicines did not always meet best practice guidance however people were not harmed by this. We have made a recommendation about this.
People were supported by staff who knew them and who acted in their best interests. Care records were in place to help guide staff in providing safe care, however, these needed further development to ensure all areas were detailed and person centred. The registered manager was addressing this by implementing an improvement plan which was already underway.
Recent changes in the management of the service had a positive impact on the people and the staff. Staff felt supported and valued by a registered manager who listened to them. Action was being taken to review staff practice and provide greater opportunities for people.
People told us it was a nice place to live; One person said, “It’s a lovely place, the carers and the people who live here are lovely. I’d recommend it to anyone.” Relatives also told us they were satisfied with the standard of care, one relative said, “I’m very happy with Osbourne House, it’s a lovely home”.
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 25 August 2020) and there were breaches of regulations. 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.
Why we inspected
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key Questions safe, effective and well-led, which contain those requirements.
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. This is based on the findings at 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 made a recommendation around the providers recording and storage of some medicines. At the time of inspection best practice guidance had not been followed however, there was no evidence that this resulted in harm to people. The provider took action to amend practices when this was highlighted on inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Osborne House provides accommodation with personal and or nursing care for up to 74 people some of whom may be living with dementia or have physical disabilities. At the time of the inspection 50 people were receiving support.
People living on the ground floor of the service received residential care and those living on the first floor received nursing care. At the time of the inspection the second floor was not being used.
People’s experience of using this service and what we found
People were found to be safer at this inspection and changes to care plans, risk management and staff knowledge about the people they supported had led to these improvements. However, a full record of the care people received, and assessment of risks were not always kept and appropriately reviewed for the provider to assure themselves of quality and safety. In addition, the number of staff on shift did not always support people to receive care in a timely way and did not monitor people effectively. Some of the checks carried out did not identify areas for improvement, this had led for example to staff not receiving support to practice fire evacuations. We did not see full and sustained improvements in governance of the service.
The leadership of the service had improved since the last inspection and the registered manager and provider were committed to developing the service further. Positive leadership had led to the improvements already seen in the safety and quality of the service people received. We recognise that progress has been hampered by the Covid-19 pandemic and also that the registered managers efforts to lead the team during this time have been successful. We are confident that plans for making improvements that were already in place will continue and that our feedback was used constructively to aid developments.
People have benefited from the improvements that have been made since the last inspection. Their staff were more organised and confident. There was a positive culture in the staff team where they felt confident to speak up and knew they would be listened to. Staff were appreciative of the support they received. People and their families were listened to and involved in their care.
A positive recruitment process had led to a reduction in the use of agency workers. People were therefore supported by a consistent group of staff who knew them. This had enabled positive relationships to develop.
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 Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 10 December 2019) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.
This service has been in Special Measures since December 2019. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
We carried out an unannounced focused inspection of this service in August 2019. Breaches of legal requirements were found. We undertook this focused inspection to check the provider had followed their action plan and to assess if they now met legal requirements. The key questions of safe and well-led were reviewed at this inspection. All breaches of regulation were met except for good governance which remains a breach of regulation.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from inadequate to requires improvement. This is based on the findings at 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.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.
We have identified a continued breach in relation to governance of the service at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to communicate with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Osborne House is a modern, purpose built nursing and residential care home. The service was providing personal and nursing care to 52 people aged 65 and over at the time of the inspection.
The service can support up to 74 people over three floors, each of which has separate facilities. The top floor specialises in providing residential care to people living with dementia and nine people were on this floor. The middle floor provides nursing care and had 21 people receiving support. The ground floor provides general residential care and had 22 people living there at the time of the inspection.
People’s experience of using this service and what we found
We looked at the whole service during the inspection; the care and support given to people on the ground floor and top floor was sufficient to meet people’s needs. The outcomes of our report mainly reflect the care and support practices of the nursing unit on the middle floor. Throughout the report we have referenced where our judgement is specific to the nursing unit. All other judgements relate to the whole service.
Nursing unit
Insufficient numbers of experienced and competent staff had impacted on all aspects of the care being delivered. There was a lack of effective organisation amongst the senior staff, which meant new and inexperienced staff were working without sufficient guidance and support.
Care records were not completed in a consistent manner. Some records were not up to date and documentation was not fully completed. Staff said they did not have time to read the care records.
People’s privacy and dignity was not promoted through staff practice. The care and support delivered to people were task based and did not meet their needs. People were not being supported to wash or bathe on a regular basis which meant their skin integrity was put at risk and they appeared unkempt.
Staff lacked the knowledge and skills to effectively manage the behaviours of people living with dementia. This put people and others at risk of harm.
All three units
The recording and administration of medicines was not managed appropriately in the service. People did not always receive their medicines as prescribed by their GP.
The induction, supervision and training programme for staff was not robust and did not adequately enable them to carry out the duties they were employed to perform. The provider did not monitor this which meant people were at risk of being cared for by staff who lacked the knowledge, competency and skills to meet their needs.
The lack of effective leadership, oversight and management meant the quality assurance and monitoring processes within the service were not used to drive improvement. The assessment, monitoring and mitigation of risk for people with regard to basic care needs such as medicine management, bowel care, personal hygiene and pressure care was not carried out effectively. This meant people's health and safety was put at risk.
We received positive feedback from people and relatives on the residential and dementia units about their care and support. People on these two units were treated with dignity and respect.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 29 May 2019).
Why we inspected
The inspection was prompted in part by notification of a specific incident. During which poor care practices were observed. This incident is subject to a criminal investigation. As a result, this inspection did not examine the circumstances of the incident.
The information CQC received about the incident indicated concerns about the management of risks to people who may experience distress or anxiety and staff approach to safety during personal care. As a result we undertook a focused inspection to review the Key Questions of Safe and Well-Led only.
We reviewed the information we held about the service. No areas of concern were identified in the other Key Questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.
The overall rating for the service has changed from good to inadequate. This is based on the findings at this inspection.
We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this report.
During and after our inspection we found that the provider took action to improve the quality of the service. The manager worked with the staff to stop institutionalised practices and improve the quality of life for people who used the service.
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.
Enforcement
We have identified breaches in relation to the provision of safe care and treatment, safeguarding people from harm and abuse, staffing and good governance at this inspection. Please find the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions of the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it, and it is no longer rated as inadequate for any of the five key questions, it will no longer be in special measures.
Osborne House is a modern, purpose built nursing and residential care home. The service can support up to 74 people over three floors, each of which has separate facilities. The top floor specialises in providing residential care to people living with dementia. The service was providing personal and nursing care to 55 people aged 65 and over at the time of the inspection.
People’s experience of using this service
People told us they felt safe and well supported by the staff. The provider followed robust recruitment checks to employ suitable staff, and there were sufficient staff employed to ensure care was carried out in a timely way. People's medicines were managed safely.
Staff received appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm. Staff received regular supervision to fulfil their roles effectively and had yearly appraisals to monitor their work performance.
People had choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
There was a planned programme of activities open to everyone living in the service. However, further development was needed to ensure people living with dementia were able to take part in suitable social activities and events.
Staff knew about people's individual care needs and care plans were person-centred and detailed. People and relatives gave us positive feedback about the staff and described them as "Excellent, caring and friendly." We were told the staff treated people with compassion, dignity and respect.
People told us that the service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to continuously improve the service.
For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.
Rating at last inspection and update - At the last inspection the service was rated requires improvement (published 26 May 2018).
Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.
Osborne House (the service) is registered to provide accommodation for up to 74 older people some of whom live with dementia. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and care for people living with dementia on the third floor. The home is set in private secure gardens. There is a car park for visitors.
People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
At the last inspection, the service was rated Good.
The provider is required to have a registered manager. A registered manager is a person who has registered with CQC 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. The manager of the service had submitted an application to register with CQC and this was being processed.
The quality of the record keeping varied and some care records we looked at were not personalised and were inconsistent or incomplete. This meant staff did not have an up to date record of people’s care and treatment.
The manager of the service was not available to assist us on day one of inspection and the service was being managed by senior nurses and care staff. We found there was a lack of direction under their leadership which impacted on the care given to people. Care was task based although the staff were patient and kind with people. People were sat in the same position for hours at a time, with no interactions from staff. Meals were late going out at lunch time and people told us the meals were cold when they got them.
The regional manager dealt with our concerns on day one of the inspection and the manager took further action when they returned to work. People and relatives gave positive feedback about the service. They said the issues raised on day one of inspection were not reflective of their usual care and treatment when the manager was in post.
People told us they felt safe and were well cared for. The provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed and on duty that they should have been able to assist people in a timely way. Medicine management practices were reviewed by the manager and medicines were given safely and as prescribed by people’s GPs.
Staff had completed relevant training. We found that the nurses and care staff received regular supervision and yearly appraisals, to fulfil their roles effectively.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People were able to talk to health care professionals about their care and treatment. People could see a GP when they needed to. They also received care and treatment from external health care professionals such as the district nursing team and speech and language therapists (SALT).
People were treated with respect and dignity by the staff. People and relatives said staff were caring and they were happy with the care they received and had been included in planning and agreeing the care provided.
People had access to community facilities and a range of activities provided in the service. People and relatives knew how to make a complaint and those who spoke with us were happy with the way any issues they had raised had been dealt with.
People told us that the manager was approachable, open and honest. People and staff were asked for their views and their suggestions were used to continuously improve the service.
At this inspection we have identified a breach of regulation 17 with regard to poor record keeping.
You can see what action we told the provider to take at the back of the full version of this report.
This is the first time the service has been rated as Requires Improvement.
Osborne House is registered to provide accommodation for up to 74 older people some of whom lived with dementia. There were 51 people living at the service when we inspected. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and care for people living with dementia on the third floor. The home is set in private secure gardens. There is a car park for visitors. The home is situated in Selby close to local amenities.
The home had a registered manager. 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.
Medicines were safely handled and risks were well assessed to protect people.
Staff were able to tell us what they would do to ensure people were safe and people told us they felt safe at the home. The home had sufficient suitable staff to care for people and staff were safely recruited. The environment of the home was safe for people and monitoring checks were regularly carried out. People were protected by the infection control procedures in the home.
Staff had received training to ensure that people received care appropriate for their needs. Training was up to date across a range of relevant areas.
Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and they understood the principles of the MCA and DoLs. People were protected around their mental capacity.
People’s nutrition and hydration needs were met. People enjoyed the meals and they were of a good quality. The registered manager was completing some work with a small number of people who lived at the service and visitors about elements of dissatisfaction over the meals. Specialist advice around people’s health care was sought and followed.
People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with dignity and respect. Staff had a knowledge and understanding of people’s needs and worked together well as a team. Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were treated in a way which encouraged them to feel valued and cared about.
People were supported to engage in daily activities they enjoyed and which were in line with their preferences and interests. Staff were responsive to people’s wishes and understood people’s personal histories and social networks so that they could support them in the way they preferred. Care plans were kept up to date when needs changed, and people were encouraged to take part in drawing up their care plans, their reviews and to give their views which were acted upon.
People told us their complaints were responded to and the results of complaint investigations were clearly recorded. Everyone we spoke with told us that if they had concerns they were always addressed by the registered manager who responded quickly and with courtesy.
The service had an effective quality assurance system in place. Osborne House was well managed, and staff were well supported in their role. The registered manager had a clear understanding of their role. They consulted appropriately with people who lived at the service, people who mattered to them, staff and health care professionals, in order to identify required improvements and put these in place. Records around good governance were clear and accurate and led to planned improvements.
We carried out an unannounced comprehensive inspection of this service on 18 and 19 February 2015. At this inspection we found a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to Regulation 17 HSCA (RA) Regulations 2014 Good Governance.
The provider had failed to ensure there was a system in place to assess and monitor the quality of the service. This meant people were at risk of receiving unsafe care, treatment and risks associated with unsafe care and treatment. We asked the provider to make improvements in those areas following our inspection of the service.
We also recommended the provider ensure that monitoring and the corrective action implemented, in relation to the management of medicines, be maintained to ensure that the services policies and procedures were followed.
After the comprehensive inspection, the provider wrote to us with an action plan to say what they would do to meet legal requirements in relation to the breach and the recommendation.
We undertook this focused inspection on 7 August 2015, to check that the provider had followed their plan and to confirm that they now met with the legal requirements. This inspection was unannounced. This report only covers our findings in relation to that requirement. 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.
Osborne House is registered to provide accommodation for up to 74 older people some of whom live with dementia. There were 50 people living at the service during our inspection. The service was purpose built; there were various communal areas for people to access. Each bedroom had ensuite facilities, in addition to communal bathrooms.
Accommodation was provided over three floors; residential care was provided on the ground floor, nursing care on the first floor and residential dementia care on the third floor. The home was set in private secure gardens. There was a car park for visitors. The home was situated in Selby close to local amenities.
The service had a registered manager. 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.
Improvements had been made to the management of medication. The service had developed effective systems to audit medication, they had provided additional training and competency checks for staff who administered medication. This meant people were protected from the risks associated with poor management of medicines.
Improvements had been made to the management systems at the home in making sure the service was operating safely and effectively. The processes for monitoring and reviewing improvement now provided clear instruction for staff.
The provider completed monthly management reviews to assure themselves the service was adhering to the organisations policies and procedures.
The registered manager was approachable and had developed strategies to ensure people, and their relatives, had the opportunity to give feedback on the service. They demonstrated a willingness to learn from feedback. They were keen to develop the service to ensure people received a good standard of care.
This inspection took place over two days, 18 and 19 February 2015 and was unannounced. This was our first inspection of this service since it registered with us.
This service is registered to provide accommodation for up to 74 older people some of whom lived with dementia. There were 48 people residing at the service during our inspection. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and dementia care on the third floor. The home is set in private secure gardens. There is a car park for visitors. The home is situated in Selby close to local amenities. Staff are available 24 hours a day to support people.
The home has a registered manager. 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 the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
People who used the service were cared for by staff who understood they had a duty to protect people from harm. Staff knew how to report abuse and said they felt able to raise any issues, which helped to keep people safe.
People received the care and support they needed to receive. However, we found there were some minor issues with the medication systems in some areas of the home. We have made a recommendation regarding this.
We observed there were enough staff available to support people. Staff knew people’s care needs and risks to their health and wellbeing which enabled them to support people appropriately. Training was provided to all staff to help them to develop and maintain their skills.
People lived in a well maintained, clean environment. Bedrooms were personalised with memory boxes placed outside people’s bedroom doors to help them find their bedroom. Pictorial signage was provided to help guide people to bathrooms, toilets and lounge areas.
People were offered home cooked food with appropriate fluids to maintain their nutrition. Those who required prompting or support to eat were assisted by patient and attentive staff. People’s dietary intake was recorded and staff gained help and advice if people were losing weight. This ensured that people’s nutritional needs were met.
Visiting health care professionals we spoke with informed us they had no concerns about the service people received and they were positive about the help and support provided to people by staff. They confirmed staff acted upon their advice to promote people’s health and wellbeing.
People were involved in making decisions about their care. Staff supported people to make decisions for themselves. People’s privacy and dignity was respected.
A complaints procedure was in place, anyone wishing to make a complaint could do so. We saw two complaints had been received. There were systems in place to deal with complaints in a timely manner. Some relatives told us they would like to see more activities taking place.
People living at the home and their relatives were asked for their opinions about the service provided. The registered manager undertook regular audits which helped them to monitor and maintain the quality of the service. However, we have made some recommendations throughout the report for the registered provider to consider.