OSJCT Henlow Court

OSJCT Henlow Court is a residential care home providing personal and nursing care to up to 40 people. The service provides support to older people, some of whom have a diagnosis of dementia. At the time of our inspection there were 32 people using the service.

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

On the day of our inspection staff did not consistently follow safe infection prevention and control procedures which placed people at risk of harm.

People's care records were not always robust enough and did not always contain the necessary detail to evidence the care, support and treatment people received.

Whilst there were systems and processes to assess and manage risks to people, they had not been operated effectively and had not identified some of the shortfalls we found in relation to wound management and infection prevention and control.

The provider needed to make improvements to the way they recorded the action they had taken in response to information of concern. We have made a recommendation about the recording of investigations and information of concern.

We received mixed feedback relating to staffing levels at the home. The registered manager told us the measures they had put in place to cover staff absence.

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. However, there was not a clear record to show that consideration had been given to the principles of the MCA when there had been a change in a person’s mental capacity. The registered manager took immediate action to resolve this in response to our feedback.

People were protected against the risks of potential abuse and they told us they felt safe in the home. Staff knew about safeguarding people and told us they felt confident to report any concerns.

People using the service and their relatives were happy with the care they received. They spoke positively about the staff and told us they were treated with kindness and respect.

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

Rating at last inspection

The last rating for this service was good (published 8 November 2017).

Why we inspected

We received concerns in relation to wound care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

The provider took action to correct the issues we identified and also put in place systems to minimise any risk to people.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

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.

At the last inspection, the service was rated Good. At this inspection we found the service remained Good.

People were protected against the risks of potential abuse and they told us they felt safe in the home. Staff knew about safeguarding people and reported any concerns. Individual risks for people were minimised and risk assessments of the environment were completed to help ensure people lived in a safe home. There were sufficient staff who were recruited using thorough checks to ensure their suitability. Medicines were managed safely and reviewed. People were able to make their own choices and decisions about their care. They were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s needs were met by staff who had access to the training they needed and had regular updates to their training. Staff were supported in their role and had regular individual meetings where they could discuss their training and their progress with senior staff. People had a choice of meals and their nutritional needs were met. People told us they liked the meals provided.

People had positive interactions with staff who respected their privacy and dignity. We observed staff were kind and compassionate to people and encouraged them to be independent. People

received personalised care and had care plans that identified their needs and they were reviewed regularly. People were supported by health and social care professionals who visited when required. There was a programme of activities and links with the local community were established. There was a clear complaints procedure and people could use the suggestion box in the home.

The registered provider had quality assurance procedures to check the service was safe and people were supported to lead the life they wanted without restrictions. People and their supporters had opportunities to comment on the service and they were listened to. Staff felt well supported by the registered manager and were able to comment to help improve the service.

Further information is in the detailed findings below.

People's needs, including risks to their health and wellbeing, had been properly assessed and kept under review. Care plans were person centred and reflected people's life styles and preferences. The standard of record keeping had improved and provided evidence that people's needs were consistently met.

There were systems in place to prevent and control infection. The home was well maintained, clean and tidy, although we noticed a lingering smell of urine in some people's bedrooms.

There were effective recruitment and selection procedures in place so people could be assured that they were cared for by appropriately skilled and qualified staff.

People told us that 'the food is good and we can have what we want to eat, there is always a choice'. We witnessed conversations between members of staff and the people using the service and their relatives. People were frequently asked about their wellbeing. The atmosphere was lively and people were being attended to according to their needs. People told us that staff were 'very supportive' and helped them with 'whatever we need'. People had access to a number of clinical teams, which included nursing staff, podiatry, GPs and district nurses. There was a hairdresser who regularly visited to provide grooming sessions to the people who lived at Henlow Court. We looked at various records kept at the home including care records, training records and quality assurance records. We found that accurate records to provide staff with appropriate information to support people with their needs had not always been maintained.