Ostley House

We found the following examples of good practice.

The home was supporting people infected with COVID-19 at the time of our inspection. The registered manager had followed guidance to manage the outbreak, including separate staff teams supporting people who had a positive COVID-19 test result and people who did not have a positive test result.

Staff were trained in infection prevention and control and using Personal Protective Equipment (PPE) safely.

The provider had ensured sufficient quantities of PPE were available.

The registered manager had ensured information about symptoms of COVID-19 was displayed at all entrances to the home with clear instructions for staff and visitors not to enter the premises if they were experiencing any symptoms of the virus.

The registered manager had followed government guidance about visiting. They had supported relatives to visit people who were at the end of life.

The registered manager had rearranged communal areas in the home to support social distancing.

The registered manager followed best practice around safe admissions when people moved into the home.

The registered manager had arranged for regular COVID-19 testing for staff and people who lived in the home.

The staff team kept the home clean and hygienic. Frequently touched surfaces were cleaned regularly throughout the day to reduce the risk of infection.

There was a well-established, experienced staff team working in the home. The staff had been responsive to the challenges caused by the pandemic and worked outside of their normal roles, where required, to maintain a safe environment for people.

The provider had acknowledged the staff team’s work during the pandemic and given the staff a bonus in recognition of their work.

Further information is in the detailed findings below.

Ostley House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection. The home provides permanent accommodation and short-term respite care for up to 44 people. Accommodation is mainly provided to older people and to people who have a sensory impairment. The home is a period property which has been adapted and extended for its present use.

There was a registered manager at the home. 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.

We found that Ostley House was constantly working to improve their service to people and to look for ways to move the service forward. People told us they felt safe living at the home and that it was a good place to live. The service had an appropriate safeguarding policy, staff had undertaken safeguarding training and were aware of their responsibilities.

The registered provider continued to improve the environment for the people who lived there, the building was well maintained and it was a clean and homely place for people to live. We saw that equipment in use was regularly cleaned and had been serviced and maintained. We noted that people shared slings for moving and handling needs. We have made a recommendation that the registered manager consider current guidance on infection control and update their practice accordingly.

Medicines administration was safe and staff had undertaken appropriate training in medicines administration. We raised with the registered and deputy manager the use of written plans or protocols that made clear when to administer extra, or as required, medication (PRN) and they addressed this on the day of the inspection.

Staffing levels were sufficient to meet the needs of the people who lived in the home and were monitored and adjusted when needed. Staff training was ongoing and staff had received a variety of training that enabled them to safely support and care for people. Staff recruitment processes were thorough and included all the relevant checks on suitability.

People were being 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. There was an appropriate complaints procedure which was displayed in the home.

People and/or their representatives were being included in their care planning and reviews and people told us the service was responsive to their needs and preferences. People had access to a range of organised and informal activities.

Health and safety records were maintained and regular checks undertaken on equipment in use. Accidents and incidents were recorded and there were individual and general risk assessments in place.

The service was well led by an experienced registered manager and management team. There were systems in place to monitor the quality of the service, seek people's views and make on-going improvements.

Further information is in the detailed findings below.

Ostley House is a residential care home providing accommodation and personal care for up to 44 people. The home provides permanent accommodation for people and short-term respite care. Accommodation is mainly provided to older people and to people who have a sensory impairment. The home is a period property which has been adapted and extended for its present use.

There was a registered manager employed at the home. 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 and associated Regulations about how the service is run.

People who lived in the home, the visitors and health care professionals we spoke with told us this was a good service and said they would recommend it. They told us, “This is an excellent home” and said, “This home has a really good reputation in the area”.

The staff were kind and caring. There were enough staff, with the appropriate skills and knowledge, to provide people with the support they required.

People were included in planning and agreeing to the support they received. The staff knew people well and provided their care as they preferred.

People were protected from harm. Risks to their safety had been identified and action taken to manage any hazards. People were protected from abuse and their rights were respected.

The home provided a range of activities that people enjoyed. Visitors were made welcome and people could maintain relationships that were important to them.

People received a choice of meals and drinks that they enjoyed. They were asked for their views of the home and were included in developing the service.

Medicines were managed safely. People were supported to see their doctor as they needed. This helped to maintain their health.

The premises were clean and free from unpleasant odour.

The management team and registered provider carried out checks on the service. They maintained oversight of the quality and safety of the home. Where areas were identified that required improvement these were actioned.

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 who lived at Ostley House were safe and protected from the risk of abuse. All the staff we spoke with showed that they had a good understanding of their responsibility to protect people. They told us they were confident people were safe and well cared for and showed that they knew how they could report any concerns about an individual. A visitor to the home told us, 'I have no concerns at all'.

Risk assessments had been carried out to identify hazards to individuals' safety and to reduce and manage risks. Where people had complex care needs additional risk assessments had been completed including around moving and handling, pressure area care and nutrition. The staff in the home knew the actions to take to protect people because this was recorded in their care records.

People were provided with nutritious meals, snacks and drinks which they told us they enjoyed. This ensured they were protected against the risk of malnutrition and dehydration.

Medicines were stored and managed safety to ensure people received their medication as their doctor had prescribed it.

Safe systems were used when recruiting new staff. People were only employed at Ostley House if they were suitable to work in a care service.

The home had appropriate policies and procedures regarding The Mental Capacity Act 2005 deprivation of liberty safeguards. The manager of the home was knowledgeable about the Mental Capacity Act 2005 and the Mental Capacity Act Codes of Practice. This meant people could be confident that their rights would be protected.

Is the service effective?

People we spoke with told us they were happy living at Ostley House. One person said, 'It's nice here' and another person told us, 'I'm very happy, it's very good'.

People told us that the staff in the home were knowledgeable about the support they needed and how they wanted this to be provided. They said, 'The staff know what I want, I'm very independent and they respect that'. They told us that they made choices about their lives and the staff respected the decisions they made.

From our observations we saw that there were enough staff, with the appropriate skills, to meet people's needs. The staff told us they had completed a range of training to give them the skills to provide the support people required.

Throughout our inspection we found the home was clean and free from odour. The domestic staff we spoke with showed that they understood this was important in maintaining the dignity of people who lived in the home.

People who lived in the home and their families had been included in making decisions about the support they received. People were asked for their views about the service and we saw that action was taken in response to their comments.

Is the service caring?

Everyone we spoke with told us that people were well cared for in this home. One person told us, 'We're well looked after' and another person said, 'The staff are all very kind'. The staff we spoke with told us they were confident that people who lived in the home were well cared for.

We saw that the staff were attentive to individuals' needs and identified when people required support. People were provided with the support they needed promptly and discreetly.

We saw that the staff in the home had developed supportive relationships with the people who lived there. We observed friendly and respectful interactions and saw that people who used the service were confident with the staff working in the home. One person, who liked to spent time in their own room, told us, 'The staff are very good, they pop in to check I'm alright and to have a chat'.

Is the service responsive?

People told us that they made choices about their lives in Ostley House and said the staff in the home respected the choices they made. One person told us, 'They always ask if I want to take my medicines' and another person said, 'I like my breakfast in my room but come to the dining room at dinner time'. During our observations we saw that people were treated with respect and given choices about their daily lives.

A visitor to the home told us that they thought there were enough staff to provide the support people needed. They said, 'There are always staff around and you can find someone quickly if you need to'. They told us they could visit 'any time' and said the staff in the home made them welcome. People were supported to maintain relationships with their families and other people who were important to them.

We looked at a sample of the records the home held about people. We saw that people and their families had been asked about their preferences about their lives and care. The staff on duty were knowledgeable about individuals' preferences and ensured people received support as they wanted it.

Where people were at risk due to having complex health care needs we saw that appropriate specialist support had been taken to ensure their health and welfare were protected

Is the service well-led?

People told us they were asked for their views about the quality of the service provided at Ostley House. The records we looked at showed that people had made suggestions about changes they wanted in how the service was provided and that action that had been taken in response to their comments.

A visitor told us that they felt the management team in the home were 'visible' and said they were able to speak to a senior person in the home if they wanted to. They told us that they had never needed to raise a concern about the service provided to their relative but would be confident speaking to the manager if they needed to do so. They told us, 'The office staff are really helpful'.

The registered manager held regular meetings with staff in the home. Any concerns identified by the registered manager were discussed with the staff and staff team were given opportunities to raise concerns or suggestions about how the service could be further improved.

All the staff said they felt the manager set high standards. They said that people who lived in the home were placed at the centre of their care and the service was focused on providing good quality care. All the staff said they felt well supported and said they would be confident speaking to a member of the management team if they had any concerns about the care provided.

A number of people who lived at Ostley House had some level of dementia. The registered manager and senior staff had attended specialist training in the best practice in supporting people who have dementia. The registered manager had also developed links with other charities which carried on homes for people who had visual impairment to share best practice.

The registered provider and registered manager of the home were committed to providing people with a good service, which met their needs. They had developed a plan for further improvements to the service, including improvements to the environment and furnishings.

People made many positive comments about the staff employed at the home. They said the staff were knowledgeable about the support they needed and were able to provide this.

A number of people told us about activities which they had enjoyed in the home and about other activities which they were looking forward to. They said they were looking forward to Christmas and the activities which were planned to celebrate the festive season. One person told us, 'The staff make a lot of effort for Christmas, they really put themselves out for us'.

When we inspected this service in July 2013 we found that areas of the home were not maintained in a clean and hygienic condition and staff had not received appropriate support in relation to their responsibilities. We also found that the systems used to monitor the quality and safety of the service had not ensured people were protected from the risk of harm.

At our inspection in November 2013 we looked around the home and found all areas were clean and free from odour. We saw that staff had received appropriate training and support to ensure they had the skills and knowledge to provide the care individuals needed. We found the systems to monitor the quality of the service had been improved to ensure people received a safe service which met their needs.

People told us,

'We have good dinners',

'I'm looked after better here than at home',

And said, 'The staff are very caring'.

During our inspection we found areas of the home were not maintained in a clean and hygienic condition and staff had not received appropriate support in relation to their responsibilities. The systems used to monitor the quality and safety of the service had not ensured people were protected from the risk of harm.