Background to this inspection
Updated
20 December 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
Obelisk House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Obelisk House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
During the inspection
We spoke to 4 people and 6 relatives about their experience of the care provided. We spoke with 14 members of staff including the registered manager, team leaders, senior care staff, care staff and kitchen staff.
We reviewed a range of records. This included 4 people's care plans, risk assessments and daily care records including pressure care and food and fluid support. We looked at recruitment of staff, maintenance records and medication administration. A variety of records relating to the management of the service including auditing and monitoring were also reviewed.
Updated
20 December 2022
About the service
Obelisk House is a residential care home providing accommodation and personal care to up to 44 older and younger people living with dementia, physical disability and/or sensory impairment. At the time of our inspection there were 30 people using the service.
Obelisk House accommodates people across four separate units, each with its own lounge, dining area and kitchenette.
People’s experience of using this service and what we found
Systems and processes to assess, monitor and improve the service were in place. However, these required further development. Quality assurance systems had not identified the shortfalls found during the inspection in relation to repositioning charts and equipment. People and their relatives told us that they would speak to the management team should they wish to raise any concerns or complaints.
Not all care staff had received additional training to ensure they had the necessary skills to meet the needs of the people they supported. This included training in end of life and catheter care. The registered manager advised they will ensure staff will receive this training to enhance their skills and knowledge.
There were not always enough staff to ensure people received the care they needed in a timely manner. We recommend the provider considers the layout of the service and the deployment of staff when assessing staffing levels.
People and their relatives told us that there were limited activities. Staff told us they wished they had more time to spend with people doing activities or one-to-one interaction. People were supported to maintain relationships with loved ones and were supported by staff to access the community.
Staff had received training on the safe and effective use of personal protective equipment (PPE). However, during the inspection staff were seen to be wearing their face masks below their noses on several occasions.
People told us they felt safe at Obelisk House. Staff received training in safeguarding and understood the signs of abuse and how to report any concerns. Medicines were safely managed. Staff administering medicines had received the appropriate training.
Risks associated with people's care had been identified and plans were in place to mitigate these. Falls were analysed on a monthly basis to identify themes and/or trends and to ensure appropriate action was taken to reduce the risk of reoccurrence.
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 demonstrated they knew people well and spoke to them kindly. Staff communicated well with people and supported people with their wellbeing.
There was information in people’s care records about their dietary needs and people were weighed regularly to ensure they maintained a healthy weight. Staff worked in partnership with health and social care professionals to maintain people's health.
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 1 April 2021 and this is the first inspection under a new provider.
The last rating for the service under the previous provider was Good, published on 24 May 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.
We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Obelisk House on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.