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Otterbourne House Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 4 July 2019

About the service:

Otterbourne House is a ‘care home’. People in care homes receive accommodation and personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided. Both were looked at during this inspection. At the time of our inspection there were nine people living in the service.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

For more details, please see the full report which is on the CQC website at

People’s experience of using this service:

People’s relatives told us that their family members received inconsistent care.

There had been a large turnover of care staff which had resulted in the provider using agency staff, who did not always have the training or knowledge about people to provide effective care.

Relatives told us improvements were needed in the support people received around their nutrition to ensure they followed a healthy and balanced diet.

There had been a large turnover of management staff which had a negative effect on communication and working partnership between the provider and families.

The provider’s quality assurance systems were not always effective in identifying shortfalls in the quality of care.

The manager had recently joined the service and had made some initial improvements to the quality and safety of the service.

The positive changes at the service were not fully imbedded and the manager required more time to demonstrate that the improvements were sustained.

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to good governance. Details of action we have asked the provider to take can be found at the end of this report.

Rating at last inspection:

At our last inspection, we rated the service good (13 December 2016).

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We have asked the provider to send us an action plan telling us what steps they are to take to make the improvements needed. We will continue to monitor information and intelligence we receive about the service to ensure good quality is provided to people. We will return to re-inspect in line with our inspection timescales for Requires Improvement services.

Inspection areas



Updated 4 July 2019

The service was safe.

Details are in our safe findings below.


Requires improvement

Updated 4 July 2019

The service was not always effective.

Details are in our effective findings below.


Requires improvement

Updated 4 July 2019

The service was not always caring.

Details are in our caring findings below.



Updated 4 July 2019

The service was responsive.

Details are in our responsive findings below.


Requires improvement

Updated 4 July 2019

The service was not always well led.

Details are in our well led findings below.