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Otterbourne House Requires improvement

Reports


Inspection carried out on 29 March 2019

During a routine inspection

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 www.cqc.org.uk

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 carried out on 8 November 2016

During a routine inspection

This inspection was unannounced and took place on the 8 and 9 November 2016.

Otterbourne House, to be referred to as the home throughout this report, is a care home which provides residential care for up to nine younger and older adults with learning disabilities. People receiving the service also live with complex emotional and behavioural needs including autism. Some people living at the service also had additional health conditions such as epilepsy and cerebral palsy.

The care home comprises of single floor accommodation consisting of seven en-suite bedrooms in the main home which also had a main lounge and a smaller quieter lounge, dining area, laundry room and social area which had facilities including a juke box and pool table. The home was situated with its own communally accessed secure rear garden. Each person living in the main home also had patio doors which led from their bedrooms to a small fenced patio area allowing each individual their own outdoor space. Two annexes were situated in the grounds of the home, both of which comprised of a living room, bathroom, kitchen and a bedroom area. The home was situated on the outskirts of the village of Otterbourne. At the time of the inspection nine people were using the service.

The home has a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Most relatives of those using the service told us they felt their family members were kept safe. Staff understood and followed the provider’s guidance to enable them to recognise and address any safeguarding concerns about people.

People’s safety was promoted because risks that may cause them harm had been identified and guidance provided to manage these appropriately. People were assisted by staff who encouraged them to remain independent. Appropriate risk assessments were in place to keep people safe.

People were kept safe as the provider ensured sufficient numbers of staff were deployed in order to meet people’s needs in a timely fashion. In the event of unplanned staff sickness the provider sought to use existing staff including the registered manager to deliver people’s care or used regular agency staff to ensure familiarity for people living in the home.

Contingency plans were in place to ensure the safe delivery of people’s care in the event of adverse situations such as large scale staff sickness or accommodation loss due to fire or floods.

People were protected from the unsafe administration of medicines. Staff responsible for administering people’s medicines had received additional training to ensure medicines were administered, stored and disposed of correctly. Staff skills in medicines management were regularly reviewed by other staff including managerial staff to ensure staff remained competent to administer people’s medicines safely.

The provider used robust recruitment processes to ensure people were protected from the employment of unsuitable staff.

New staff induction training was followed by a period of time when they worked with experienced colleagues to ensure they had the skills and confidence required to support people safely.

People were supported by staff who had up the most relevant up to date training available which was regularly reviewed to ensure staff had the skills to proactively meet people’s individual needs.

People, where possible, were supported by staff to make their own decisions. Staff were able to demonstrate that they complied with the requirements of the Mental Capacity Act 2005 when supporting people during their daily interactions. This involved making decisions on behalf of people who lacked the capacity to make a specific decision for themselves. The home pr