We carried out a review of the data available to us about OSJCT Gregory House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about OSJCT Gregory House, you can give feedback on this service.
We found the following examples of good practice.
A recent outbreak of COVID- 19 at the service has had a devastating effect on the home. A large number of staff were tested positive and a number of people using the service tragically died during the outbreak. The registered manager and her team were supported by the provider and staff from other services were brought in to ensure people were provided with safe care.
The plans in place to support people had been utilised safely. People who tested positive for COVID- 19 were isolated in line with government guidelines. The protocols in place gave staff clear guidance on how to effectively support people living with dementia who may not be compliant with social distancing and isolation.
Staff who tested positive or had displayed symptoms of COVID- 19 had shielded in line with the government guidance and were symptom free before returning to work. The registered manager told us staff had been offered bereavement councelling as they had been affected by the sudden loss of people who they cared for. One member of staff told us they had found the support helpful.
Information and guidance on COVID- 19 restrictions and infection control measures in place was available and visible for staff, people and visitors. Visitors were required to have their temperature taken and wear personal protective equipment (PPE) before entering the service, following the provider’s infection prevention and control procedures.
The registered manager had a clear communication programme in place for people, staff and relatives to keep them updated with issues related to COVID- 19.
Staff received training about good practice for infection prevention and control. This included up to date training on infection control and how to safely put on and remove PPE, and was followed up with regular observation of practice.
The service had sufficient stocks of PPE and were supported by the provider to maintain these stocks. This included masks, gloves, aprons and visors. There were also sufficient stocks of hand sanitiser and cleaning materials.
People who lived at the service and staff underwent regular COVID- 19 testing in line with government guidance. This ensured anyone who had contracted COVID- 19 could be identified in a timely way.
Housekeeping staff maintained enhanced cleaning schedules and the environment was kept clean and hygienic.
People admitted to the service were supported in line with government guidance on managing new admissions during the COVID- 19 pandemic.
People were supported to keep in touch with their relatives and friends through telephone calls and video calls. At the time of the inspection the home was still closed to visitors due to the outbreak. However, a specially adapted room had been used prior to the COVID- 19 outbreak to allow socially distanced face to face visits with relatives. The registered manager told us it would be used again once they were allowed visitors. This enable people to receive their visitors in a comfortable and safe way.
At the last inspection in December 2014 this service was rated as good.
At this inspection the service was rated overall outstanding.
There was a registered manager in post at the time of our inspection. A registered manager is a person who has registered with the Care Quality Commission 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.
The service demonstrated an excellent commitment to providing outstanding care which was embedded into the practices of the staff and the management team. The service put people's views at the forefront of the service and designed the service around their needs. Staff were encouraged and enabled to work creatively which achieved consistently outstanding outcomes for the people receiving care and support. There was a strong system of quality assurance led by the provider and manager that ensured people consistently received exceptional care and support.
The registered manager was inspiring and dedicated to providing care which met the highest of standards. They strived for excellence through consultation, research and reflective practice. They were passionate and dedicated to providing an outstanding service to people. They led with a dynamic approach and continually reflected on how to improve the service further. They demonstrated a strong and supportive leadership style, seeking feedback in order to further improve what was offered. The provider's vision and values were understood and shared across the staff team.
The service was exemplary in responding to people's needs and preferences. People were supported by a service that was devoted to getting to know the people they supported. Relatives told us the service was responsive and well managed. The service sought people's views and opinions and acted upon them.
People were supported with care and compassion and there was an ethos of care which was person centred and valued people as individuals. People received a personalised service which was responsive to their individual needs and there was an emphasis on each person's identity and what was important to them from the moment they moved into the service.
There were sufficient staff to meet people's needs. Staff were not rushed in their duties and had time to chat with people. Throughout the inspection there was a calm atmosphere and staff responded promptly to people who needed support. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their role.
Care records contained risk assessments and risk management plans to protect people from identified risks and helped to keep them safe. They gave information for staff on the identified risk and informed staff on the measures to take to minimise any risks. People were supported to take their medicines as prescribed and medicines were obtained, stored, administered and disposed of safely. People received care from staff that were supported to carry out their roles to meet the assessed needs of people living at the home. Staff received training in areas that enabled them to understand and meet the care needs of each person and people were actively involved in decisions about their care and support needs.
Staff had received training in the Mental Capacity Act 2005 (MCA) to make sure they understood how to protect people's rights. There was guidance in relation to the MCA and people were asked for their consent before staff carried out any care or treatment. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. The registered manager, registered provider and staff ensured that people were supported in ways that did not restrict their freedom and were supported appropriately to uphold their rights.
A variety of choices of food and drinks were offered at the home. Staff supported people to eat and drink with patience and dignity. People told us they had good access to their GP, dentist and optician. Staff at the service had good links with healthcare services and people told us they were involved in decisions about their healthcare. People who used the service were supported to obtain the appropriate health and social care that they needed.
Care plans were written in a person centred manner and focussed on giving people choices and opportunities to receive their care how they liked it to be. They detailed how people wished to be supported and people were fully involved in making decisions about their care. People participated in a range of activities and received the support they needed to help them do this. People were able to raise complaints and there was an easy read guide to support people through the process.
Robust quality assurance reports had been developed, incorporating all elements of requirements relating to legislation, Care Quality Commission guidance, best practice guidelines, along with evidence of how each area was being met. Continual auditing was carried out to ensure the safety and quality of care that was provided, using information from the audits to drive continual improvement.
We inspected Gregory House on 02 December 2014. This was an unannounced inspection. Gregory House provides accommodation for up to 32 older people who require nursing or personal care. There were 31 people living in the home when we carried out our inspection some of whom lived with dementia related needs and complex care needs.
There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission 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.
The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is to protect them. At the time of the inspection no people had their freedom restricted.
People who lived in the home told us that they were happy with the care they received. They felt safe living in the home and said that staff treated them with kindness and respected their privacy and dignity.
On the day of our inspection there were enough staff on duty to meet people’s needs. We found that there were additional senior staff to assist staff when required during busy periods. We found that action had been taken by the registered manager and the provider to increase the staffing levels to reflect the needs of people who lived in the service.
Staff understood people’s needs, wishes and preferences and they had been trained to provide effective and safe care which met people’s individual needs.
People and their relatives were able to raise any issues or concerns and action was taken to address them.
Robust arrangements for ordering, storing, administering and disposing of medicines were in place.
We found that people were provided with a choice of nutritious meals. When necessary, people were given extra help to make sure that they had enough to eat and drink.
People had access to a range of healthcare professionals when they required specialist help.
The home had a dedicated staff member to provide social activities for people and assist people in enjoying their hobbies and interests.
The registered manager assessed and monitored the quality of the service provided for people.
The home had established strong links with local community groups which benefited people who lived in the home.
One person told us 'It's lovely, we had a lovely Christmas.' A relative said, 'In a really good place here.'
Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.
We observed care and saw staff were responsive to people's needs.
We saw from the care plans and observations people received care which was appropriate to their needs.
People told us the staff were caring and looked after them well. When we looked at the records we found they detailed the care people required and care was delivered safely to meet people's needs.
We saw people received appropriate nutrition in order to meet their needs.
We looked at the process for administering medicines and saw it was safe and effective.
The provider had a responsive complaints process in place which effectively dealt with and resolved complaints.
Overall we observed that people were supported by skilled and experienced staff who understood their roles and responsibilities.
We saw people were treated with dignity and respect and supported to make decisions about their care. The quality assurance systems in place enabled people to express their views about the services and care they received.
People told us they liked living at the home.
People said the food was good and were given a choice of two dishes at mealtimes.They said, 'Food very good' and 'Spoilt for choice.'
One person told us about their care they had, "No complaints."
People told us they could usually get help when they needed it. One person said, "I have a call bell,I sometimes get frustrated as can't get to the toilet as quick as I want." We observed people using their call bells and saw staff responded promptly.