Oliver House

Oliver House is a nursing care home providing personal and nursing care to up to 26 people. The service provides support to younger adults and older people, including those with dementia. At the time of our inspection there were 22 people using the service. People are cared for over 2 floors, with communal spaces and a secure outdoor space.

People’s experience of the service and what we found

Since our last inspection, the provider had made significant improvements to the service. Medicines were now safely managed. Risk assessments were up to date and provided clear guidance on how to safely support people’s identified risks, such as diabetes or skin integrity concerns. The home was clean and well-maintained and checks were in place to ensure specialist equipment was fit for purpose. People felt safe using the service and able to raise concerns with staff. The registered manager and staff understood how to recognise, report and investigate potential abuse. There were enough staff to meet people’s needs. Accidents and incidents were reviewed and analysed so lessons could be learned when things went wrong.

Assessments of people’s needs were informed by nationally recognised tools and explored people’s diverse needs. Staff were suitably trained to carry out their roles and received ongoing support to remain skilled and competent. Staff worked well as a team and alongside relevant healthcare professionals, referring and following recommendations appropriately meaning people achieved good outcomes in relation to their health and well-being.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were kind and caring and considerate of people’s diverse needs. People’s needs, preferences and choices were well understood, and their privacy and dignity respected.

People received person-centred care, and staff knew people well. There were a variety of activities and engagements with the local community for people to get involved in. People and relatives felt able to raise complaints and that they would be dealt with by the provider. People were supported to make decisions about their preferences for end-of-life care.

Improvements had been made to the overall governance and quality assurance systems. The registered manager had effective oversight of risk within the home, completing regular audits and taking action to improve safety where identified. Feedback was encouraged and people, relatives and staff could share their views through surveys and meetings. There was an open and inclusive culture at the service which meant people received personalised care and good outcomes. The service had positive working relationships with a range of key stakeholders.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 19 July 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvement had been made and the provider was no longer in breach of regulations.

Why we inspected

When we last inspected Oliver House on 3 May 2022 breaches of legal requirements were found. We undertook this inspection to check whether the warning notices we previously served in relation to regulation 12 (safe care and treatment) and regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. We also checked whether the provider had followed their action plan and to confirm they now met legal requirements.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Oliver House is a nursing and residential care home providing regulated activities for personal and nursing care to up to 26 people. At the time of our inspection there were 26 people using the service. Care is provided on two floors, with bedrooms on each floor and communal areas on the ground floor.

People’s experience of using this service and what we found

The provider lacked oversight and governance arrangements to ensure improvements were made and quality of care maintained. Policies were out of date and the governance in respect of the use of CCTV was not in line with best practice.

Audits were in place, however had not been used to make the required changes or to drive changes to keep people safe or maintain the environment.

Medicines were not managed safely. Risk assessments had not been completed consistently for all health conditions. Behaviours plans were not in place to support staff with the guidance they required to safely meet people’s needs.

We found some areas of the environment required repairs and refurbishments. Some aspects of infection prevention and control had not been followed to reduce the risk of infection.

There were enough staff to support people’s needs and they had been recruited appropriately. However, staff had not received the required training for their role and nurses had not received the required clinical supervision for revalidation of their profession.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always supported this practice. We have made a recommendation about following best practice guidance in relation to the Mental Capacity Act.

People’s dignity was not always considered. Relatives shared with us their thoughts on kind and caring staff. Relatives views had been obtained and overall, these were positive, however the less positive comments had not been reviewed to consider how improvements could be made.

Relatives enjoyed visiting the home and had opportunities to use technology if they were unable to visit in person.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

This service was registered with us on 20 May 2020 and this is the first inspection.

The last rating for the service under the previous provider was rated good published on 6 December 2019.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risks being managed, medicine management, infection, prevention and control, person centred care, staff training and governance at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.