Archived: OSJCT Fosse House

OSJCT Fosse House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

OSJCT Fosse House provides accommodation for up to 42 older people with care needs including physical frailty and dementia. It is situated on the outskirts of Lincoln and provides accommodation over two floors. On the day of our inspection there were 39 people staying at the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good overall. At this inspection our rating for the responsive domain changed to requires improvement as care records did not always reflect people’s current care needs and some social activities could be improved. However, this did not affect the overall rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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.

Systems and processes were in place to keep people safe. Staff understood their responsibilities for safeguarding the people they cared for and assessed risks to their health and safety. Measures were in place to reduce these risks and people were supported to stay safe, whilst not unnecessarily restricting their freedom. However, documentation in this area was not always fully reflective of the steps being taken by staff. Recruitment processes ensured appropriate staff were recruited to work in the home. Accidents and incidents were recorded, investigated and learning identified. Safety checks of the premises and equipment were completed and processes were in place to prevent and control infection. People’s medicines continued to be managed safely.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills. People’s needs were assessed and care was delivered in line with national guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, documentation of mental capacity assessments and decision making in people’s best interests was not always fully completed. People were supported to access their GP and other healthcare professionals when it was necessary.

Staff were knowledgeable about the people they cared for and treated them with kindness. They respected people’s privacy and dignity. People were involved in planning and reviewing their care.

Care was generally responsive to people’s individual needs, but care plans were not always fully updated in response to changes in people’s requirements. Information about people’s personal preferences in relation to their care and their life history was available. Some activities were available for people in the form of entertainment, external visits and one to one and group activities at the home. However, people we spoke with and their relatives told us they would like more activities to be provided. The service had not fully embedded the accessible information standard which ensures that provisions are made for people to have information about their care in ways which are meaningful to them.

Staff felt supported by the leadership and management team and had the opportunity to raise issues and concerns. Relatives told us that when they identified a concern, it was listened to and addressed. The provider and the registered manager monitored the quality of the services provided and action plans were completed to bring about improvements when required. The registered manager carried out their role in line with their registration with the CQC.

People told us they liked living at Fosse house and felt safe and well supported. One person said 'I've been happy since moving here.' Another said 'Nothing is too much for the staff.'

One person's relative who was visiting said 'I'm chuffed to bits with the care.' They told us, 'They could sleep at night' because they knew their relative was safe and happy.

We saw people were involved in deciding how their care would be provided. We noted written plans of care were signed as agreed by people and staff regularly discussed and reviewed their wishes, feelings and care needs with them.

People told us they received support when required with medical appointments. We saw people received prompt and effective support from doctors and other health professionals at the care home and in community surgeries.

People we spoke with said they enjoyed the food provided and a wide range of social and leisure activities including trips shopping and visits to places of local interest.

We saw medication was managed safely and effectively by staff with appropriate training. Discussions with staff and our review of records showed workers were recruited, trained and managed in a way that ensured people were cared for safely and effectively.

The people we spoke with told us they all took part in a variety of activities details of which were displayed in one of the communal areas. One person said, 'There's something going on each day and we're encouraged to take part.'

We looked at the menus and saw they offered a wide range of hot and cold meals. One person who lived at the home commented, 'The food is very good I never go hungry, they keep a real good eye on us.' We saw each care plan contained a monthly assessment of each person's nutritional needs.

We looked around the home and observed a good overall standard of cleanliness. We saw people's rooms were clean and communal areas were clean and tidy. One relative told us, 'The home is kept spotless.'

People looked relaxed in the company of the staff. One person told us, 'They look after us really well, nothing to complain about at all. Another person commented, 'The staff are lovely, they go out of their way for you.'

We found that people were cared for in a clean, well presented home. One person commented, 'My room's ever so nice and clean.' People's care was based on their individual needs. The staff provided care in a pleasant and professional manner.

We saw staff had time to interact with people. The home had two activity coordinators who organised a wide range of activities.

The home had a resident's committee which acted as an advocate for people who wanted to express concerns. One committee member told us, 'They always try to put things right.'

We saw the cook provided a choice of hot and cold foods at each mealtime and snacks throughout the day. There was also a cooked breakfast available each day.