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Osborne Lodge Rest Home Requires improvement

We are carrying out checks at Osborne Lodge Rest Home. We will publish a report when our check is complete.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 10 November 2017

Osborne Lodge offers accommodation for up to 24 people who require personal care, including those who are living with dementia. We carried out an unannounced inspection on 25 & 30 August and 1 September 2017.

At our inspection in August 2016 we identified the provider was not meeting four regulations. Risk assessments were not always completed and regularly reviewed and actions were not taken to mitigate risks. Staff recruitment procedures were not established and operated effectively to ensure safe recruitment decisions. Records in respect of service users, persons employed and the management of the regulated activity were not accurately maintained. Notifications were not submitted to the Commission when required. The provider had not maintained appropriate oversight of the service.

At our inspection in August and September 2017 we found improvements had been made and the providers now met the requirements of the regulations. Although there was still some work to do to ensure the effectiveness of record keeping which we found was sometimes conflicting or incomplete.

A registered manager was in place at the home. A registered manager is a person who has registered with the Care Quality Commission to manage the home. 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 home is run.

The registered manager managed two homes owned by the provider. They spent two and a half days each week at Osborne Lodge and were supported by a deputy manager. The deputy manager was unable to fully carry out their role as they were often needed to cover care shifts due to staffing issues.

Safe recruitment practices ensured that only suitable staff were employed. There were sufficient staff deployed to meet people’s needs during the day, however, during a number of evenings in August the staffing levels dropped below assessed requirements.

People were supported by staff, most of whom had received appropriate supervision and appraisal to enable them to meet people’s individual needs. Some training was overdue and plans were in place to ensure training for all staff was brought up to date.

The registered manager had a good understanding of their responsibilities in relation to meeting the Health and Social Care Act 2008 regulations. They had notified us appropriately of events required by law.

People and relatives told us they felt the home was safe. Staff understood how to identify abuse and explained the action they would take if they identified any concerns.

Systems to manage and administer medicines, including controlled drugs, were safe. Staff received training to administer medicines and were assessed for competency.

Individual and environmental risks relating to people’s health and welfare had been reviewed to identify, assess and reduce those risks. Incidents and accidents had been investigated and learning shared with staff.

The registered manager and staff understood and followed the principles of the Mental Capacity Act 2005 designed to protect people’s rights and ensure decisions were made in their best interests.

People were supported to maintain their health and well-being and had access to a range of healthcare services when they needed them.

People enjoyed a choice of freshly cooked foods, prepared in a way that met their specific dietary needs. People received support from staff, such as prompting or physical assistance to eat their meals, where required.

Staff interacted with people with kindness and care. Staff treated people with dignity and respect and ensured their privacy and independence was promoted.

Friends and family were able to visit their loved ones at any time and felt welcomed by staff.

Initial assessments were carried out before people moved into Osborne Lodge to ensure their needs could be met. The service was responsive to people’

Inspection areas

Safe

Requires improvement

Updated 10 November 2017

The service was not always safe.

There were not always sufficient staff deployed to meet people’s needs at all times. The registered manager was taking steps to address this.

Recruitment practices ensured that only staff who were suitable to work in social care were employed. Staff followed safeguarding procedures to identify and protect people from abuse or improper treatment.

Environmental and individual risks had been assessed and measures put in place to minimise risks. Fire safety checks were carried out and equipment was regularly serviced and maintained. The home was clean and tidy and staff were aware of infection prevention and control procedures.

Effective

Good

Updated 10 November 2017

The service was effective.

Some areas of training were overdue although the registered manager had put plans in place to address this. Staff received regular supervision and told us they felt well supported in their roles.

People’s rights were protected because the registered manager and staff had a good understanding of the MCA 2005 and best interest decisions were made appropriately.

People were supported to have enough to eat and drink in a way that met their specific dietary needs and preferences. People had access to appropriate health professionals and other specialists when needed.

Caring

Good

Updated 10 November 2017

The service was caring.

Staff were kind, caring and compassionate and reassured people when they were upset or unwell. Staff treated people with dignity and respected their privacy.

There was a good rapport between people and staff. Staff knew people well and encouraged their independence.

People were encouraged to maintain important relationships. Family members and friends were made welcome and could visit at any time.

Responsive

Good

Updated 10 November 2017

The service was responsive.

People’s care plans focused on their individual needs, rights, choices and preferences. People and their families were involved in planning their care.

A range of activities were available for people to participate in if they wished to do so, although this was to be reviewed by the registered manager to ensure people were not at risk of isolation.

An up to date complaints procedure was on display and people were confident if they had any concerns these would be listened to and addressed.

Well-led

Requires improvement

Updated 10 November 2017

The service was not always well-led.

Record keeping and monitoring of the quality of the service had improved significantly since our previous inspection, although there was still work to do. The management structure was not yet fully embedded due to staffing issues.

Staff felt well supported by the registered manager who was approachable and provided clear leadership and direction. The providers maintained oversight of the home and kept people and relatives informed of any changes. Notifications were submitted appropriately.

People, their families, healthcare professionals and staff had opportunities to feedback their views about the home and quality of the service being provided.