Archived: Owston View

Owston View is a purpose built care home with accommodation on two floors. The home is situated in Carcroft, Doncaster and is registered to accommodate up to 36 people. On the day of our inspection there were 24 people living in the home.

There was a registered manager employed at the service. 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.

Our last inspection at Owston View took place on 14 December 2016. The home was rated as ‘Requires Improvement’ overall, with the ‘Caring’ domain rated as ‘Good’.

At this inspection we found improvements had been made and have rated the service ‘Good’ overall.

Some people who used the service and their relatives felt there were not always a sufficient number of staff on duty. However the registered manager kept this monitored and made sure numbers were above the minimum required. The senior managers reassured us they would continue to keep staffing numbers under close review and increase them as and when required.

The premises were effectively maintained and safety checks undertaken on a regular basis, including checks with regard to fire safety. Risk assessments were in place related to the environment and the delivery of care.

The registered provider's recruitment processes minimised the risk of unsuitable staff being employed.

Staff received mandatory training in a number of areas, which assisted them to support people effectively. The registered manager had a plan in place to ensure staff supervisions and appraisals were completed in line with the registered providers policy.

The service was meeting the requirements of the Deprivation of Liberty Safeguards. Staff had an understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported to maintain a healthy diet and had access to healthcare professionals to help maintain their wellbeing. Staff responded promptly when they were made aware of anyone with a health concern.

People and their relatives spoke positively about the staff at the service, describing them as kind and caring. In the main staff treated people with dignity and respect, although we did observe some practice which did not fully promote people’s dignity.

Staff knew the people they were supporting well, and throughout our inspection we saw all staff, including the senior manager’s, having friendly and meaningful conversations with people.

The planning and delivery of activities would benefit from being enhanced and improved to make sure it meets the needs of all people who use the service.

The service had a complaints policy, which was publicly advertised and accessible to people. People and their relatives told us they knew how to complain and would be confident to do so.

People, relatives and staff spoke positively about the registered manager saying they were accessible and included them in the running of the service. The registered provider’s representatives carried out a number of quality assurance checks to monitor and improve standards at the service.

Further information is in the detailed findings below.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We carried out this comprehensive inspection on the 16 November 2016 to check that they had followed their plan and to confirm that they now met all of the legal requirements. This was the second rated inspection for this service. The service had been rated inadequate at the inspection in July 2016 and had been placed into Special Measures.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Owston View’ on our website at www.cqc.org.uk’

Owston View is a care home situated in Carcroft, Doncaster which is registered to accommodate up to 36 people. The service had bedrooms on both the ground and first floor. There was a secure garden area and parking at the front and rear of the home. The service is provided by Runwood Homes Limited. At the time of the inspection the home was providing care for 21 people, some of whom had a diagnosis of dementia.

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.

At this inspection we found that the provider had followed their action plan which they had told us would be completed by the 31October 2016. During this inspection we checked to see if improvements had been made since our last inspection in July 2016. The service has now been taken out of Special Measures as we found improvements had been made across all aspects of the service and it was evident further improvements were in the process or were planned to be implemented. The systems in place to maintain the improvements had not yet been embedded into practice as they were new. Further improvements are required to ensure that these have been fully embedded into practice so that improvements made will be sustained over time.

We found the registered manager had a good understanding of the legal requirements as required under the Mental Capacity Act (2005) Code of Practice. The Mental Capacity Act 2005 sets out how to act to support people who do not have the capacity to make a specific decision.

People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms, so appropriate referrals to health professionals could be made. The home involved dietician and tissue viability nurses to support people’s health and wellbeing.

We found the home had a much friendlier relaxed atmosphere. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. People we spoke with told us that they were encouraged to make decisions about their care and how staff were to support them to meet their needs. Feedback from the relatives we spoke with was positive.

We noted improvements in people’s dining experience. Staff were actively offering choice during the lunch time meal we observed.

Medication systems had improved so that the administration of medicine was safe. However, minor amendments were required when hand written entries were made on the medication administration record.

There were robust recruitment procedures in place; most staff had received formal supervision since the manager had been in post. Annual appraisals had been scheduled. These ensured development and training to support staff to fulfil their roles and responsibilities was identified. There were adequate members of staff working throughout the day and night and this should be kept under review as the numbers of people who used the service increased.

Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it.

The provider had introduced new systems to monitor the quality of the service provided. We saw these were more effective. Although improvements were now taking place the provider needs time to ensure the systems are embedded and sustainable.

There was a new manager at the home who became registered shortly after our inspection on 26 June 2016. The manager is also registered at another Runwood Homes Limited service in Doncaster and we were informed that they will be based at Owston View until further notice. 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.

Owston View is a care home situated in Carcroft, Doncaster which is registered to accommodate up to 36 people. The service was split into two units the Croft unit which cared for people living with dementia and Willow unit which had bedrooms on both the ground and first floor. This was classed as the residential unit. The service is provided by Runwood Homes Limited. At the time of the inspection the home was providing care for 21 people, some of whom had a diagnosis of dementia.

Concerns had been raised to us before the inspection in relation to staffing levels and an incident involving one person whose care needs had not been appropriately met. This was still being investigated at the time of the inspection.

At the time of our inspection we found there were not enough staff on duty to ensure people’s care needs could be met in a timely manner. The system to alert staff when people needed assistance was not working effectively.

People cared for in bed did not receive appropriate care and treatment. Some issues identified on the first day of the inspection had not been addressed when we returned on the second day. Some

people were at risk of being socially isolated due to their high dependency needs, the only interaction with staff was when staff were assisting with personal care tasks.

Care records were not always fit for purpose. Some lacked detail, were out of date or contradictory. When care records were reviewed, the reviews did not always result in relevant changes being made to people’s care plans or risk assessments. We identified instances where care was not being provided in accordance with people’s assessed needs.

Safeguarding arrangements in the home were in place. Staff we spoke with appeared to be knowledgeable and were trained in this area, and appropriate procedures had been followed when abuse or suspected abuse had occurred. However, during the inspection we identified safeguarding concerns which had not been recognised and we have report these to the local authority.

The manager was aware of the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS). There were policies and procedures in place and key staff had been trained. This helped to make sure people were safeguarded from excessive or unnecessary restrictions being place on them. We found some improvements were still required to ensure mental capacity assessments and best interest decision records were more detailed and decision specific.

Health professionals told us that communication within the home was poor. They told us their instructions were not always followed which meant people’s care needs were not always met.

We found staff approached people in a kind and caring way. However, most of the interactions we observed were task orientated. People could not access activities. Staff told us they did not have time to arrange activities. Signage around the home was not dementia friendly. Notice boards were not kept up to date and menus were not always displayed.

The secure garden area was not safe for people to use. Old broken furniture, no shade and overgrown bushes meant people would be at risk of injury. People accessed the garden through fire doors which could not be opened from the outside, therefore people had to wait until staff were available to let them back in.

The provider told us systems were in place to guide staff on safe administration of medicines. However, we identified these were not followed and people did not always receive their medication as prescribed. Medication was not stored at the recommended temperature. Protocols for the administration of ‘as required’ medications were generic which meant they were not effective.

We identified that inadequate staff were on duty to meet people needs, although the provider did review this during our inspection. We observed people had to wait for assistance and staff were not always present in communal areas to ensure people’s safety. Staff and relatives we spoke with told us they could do with more staff to ensure people’s needs were met in a timely way and maintain their safety.

People were not always supported to eat and drink sufficient to maintain a balanced diet and adequate hydration. We found the meal time experience did not meet the standards expected by the provider.

Infection prevention and control policies were not always adhered to; therefore safe procedures were not always followed.

We saw the provider followed safe recruitment procedures to ensure people employed to work with vulnerable people were fit to do so. However, we found staff induction was not completed and staff had not received supervision in line with the provider’s policies. Staff told us morale was very low which was impacting on the people who used the service.

The systems and processes in place to monitor the quality and safety of the services provided were not effective. There was a complaints procedure; however relatives told us that they were not satisfied with the standards of care. One relative told us they were not satisfied with how their complaint had been handled.

The overall rating for this service is 'Inadequate' and the service is therefore in 'Special measures'.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider's registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe. If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action.

Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their 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.

You can see what action we told the provider to take at the back of the full version of the report.