23 February 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 11 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.
23 February 2022
We inspected this service on 2 July 2018 and returned on 3 July 2018. On the first day of our inspection we arrived at the home during the afternoon, we stayed throughout the evening to get a better view of the service during the evening and when the staff changed to the night shift. The inspection was unannounced on 2 July 2018, and we told the registered manager that we would return on 3 July 2018.
Overslade House is a 'care home' operated by Barchester Healthcare Homes Limited, who are a large provider of care services. Overslade House is a purpose-built home which provides accommodation with personal and nursing care for up to 89 adults, including people living with dementia and physical disabilities. End of life care is provided at the 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.
Of the 89 beds, 15 are contracted by the local Clinical Commissioning Group (CCG) for people discharged from hospital and in need of personal and nursing care. Ten of these beds are offered on a ‘Discharge to Assess’ basis; for an initial six-week assessment period. The home is split into three units. At the time of our visit, there were 79 people living at the home.
A requirement of the services’ registration with us is that they have 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. There was a registered manager in post at the time of our inspection visit.
We last inspected this service on 4 January 2018 to undertake a planned comprehensive inspection. We then returned on 16 February 2018 because we were made aware of a serious incident which had taken place in the home. At that inspection, we rated the safety of the service as Requires Improvement because there was an on-going external investigation into the serious incident that had occurred. We gave the service an overall rating of Good.
We undertook this inspection following further information of concern received. This inspection focused on two key areas; the safety and governance of the service. At the time of this inspection, the investigation into the serious incident remained on-going.
Overall, staff knew how to keep people safe because risks were assessed and actions implemented to mitigate risks of harm or injury. However, staff did not always recognise when people's behaviours or their own practice created risks that could compromise people's safety. This meant some risks were not assessed which could put people at risk of harm or injury.
People had their prescribed medicines available to them. Medicines were given to people by trained staff.
Staff understood their responsibilities to protect people from the risks of abuse. Staff had been trained in what constituted abuse and would raise concerns under the provider’s safeguarding policies. The provider checked staff’s suitability to deliver care and support during the recruitment process. Staff received training and, overall, used their skills, knowledge and experience to provide safe care to people.
People and their relatives had no complaints about the service. However, some people and relatives felt more staff were needed because at times staff took over five minutes to answer call bells.
Staff on shift met people’s individual needs, however, staff were very busy and rushed. This had been recognised by the provider who was recruiting to an additional nurse post for day shifts.
The registered manager and provider had systems in place to monitor the quality of the service people received. Increased spot checks had been implemented following a serious incident that had occurred so the provider could be assured there was a more robust quality assurance process within the home.
Further information is in the detailed findings below.