Archived: Ogilvy Court

Ogilvy Court is a care home that provides personal and nursing care for up to 56 people. At the time of the inspection there were 50 people using the service. Most people using the service were older people, some of whom were living with dementia. There were also a small number of people who had a learning disability, living in the home. Accommodation was provided across two floors, with communal areas located on each floor.

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

People’s care plans had been reviewed and improved since the last inspection. They were more detailed and personalised. Comprehensive guidance helped staff ensure people’s individual needs were met.

People’s mobility needs were understood by staff. People had the equipment and tools they needed to be as active and independent as possible.

People’s mealtime experience had improved, and their choices were included in the menu.

Staff received the training, guidance and support they needed to do their job well and to effectively meet people's needs.

Improvements and developments had been made to the quality monitoring systems. These were effective in monitoring the service and making improvements when needed.

We saw positive engagement between staff and people. Systems were in place to ensure people were protected from abuse and treated with respect and dignity.

Staff, people and relatives told us that suitable staffing levels provided people with the care and support they needed.

Risks to people's safety in a range of areas including the COVID-19 pandemic were assessed and understood by staff.

Suitable infection prevention and control measures and practices were in place to keep people safe and prevent people, staff and visitors catching and spreading infection.

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.

The registered manager was approachable and provided staff with leadership, support and direction.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance the Care Quality Commission (CQC) follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. The eight people living with learning disabilities and nursing needs received care and support in small unit sharing communal facilities with other people using the service. The home was welcoming and calm. It was within easy access of local amenities which people had been supported to access. The registered manager understood the principles of what constitutes good quality personalised care for people with a learning disability. People had been supported to personalise their rooms. Accessible information was used to support people's understanding and engagement.

Since the last inspection staff have received training and coaching about learning disabilities. People’s care plans have been developed and improved. They included the personalised information and guidance that staff required to provide people with personalised care. A registered learning disability nurse was employed by the care home. They provided staff with support and guidance in meeting the needs of people living with learning disabilities.

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 requires improvement (published 23 July 2019). There was one breach of regulation. We told the provider to make improvements. 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 improvements had been made in the areas where there had been shortfalls, and the provider was no longer in breach of regulation.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led.

The rating from the previous comprehensive inspection for the key question not looked at on this occasion was used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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 coronavirus and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service:

At the time of the inspection there were six people with learning disabilities who were receiving care and support at Ogilvy Court. The service had provided a service to a small number of people with learning disabilities for several years, many of whom had other needs including dementia. The care home had been registered before Registering the Right Support and other best practice guidance had been developed. Registering the Right Support guidance focuses on values that include choice, inclusion and the promotion of people’s independence so that people living with learning disabilities and/or autism can live a life as ordinary as any other citizen.

The service is larger than current best practice guidance. However, the people living with learning disabilities received care and support in small unit sharing communal facilities with other people using the service. The registered manager informed us they were aware of the principles of what constitutes good quality care for all people with a learning disability and/or autism and would not admit anyone to the service if it was not suitable for them. They told us people were supported by staff who knew them well. A registered learning disability nurse was employed by the service. They provided staff with support in meeting the needs of people living with learning disabilities.

Some people’s specific needs including personalised mental health needs were not detailed in their care plans. Staff had also not received training in those areas. Therefore, staff might not have the information and knowledge they needed to provide people with effective and responsive personalised care and support.

Several people spent long periods in bed, some not getting out of bed. Some people’s care plans did not include details about why people remained in bed. There was little that indicated the service had a culture of rehabilitation in supporting people to maintain and develop their mobility.

Systems were in place to assess and monitor the safety of the environment. Risks to the health and wellbeing of people were regularly assessed. Guidance to minimise these risks and keep people safe was in place. Regular health and safety audits including fire safety checks were carried out. However, we found on two occasions staff did not follow safe moving and handling practice.

People’s nutritional needs were assessed and monitored. People were offered a choice of two main meals. The menu did not include details of the alternative options such as vegetarian and cultural meals. Some people waited sometime for their meals.

Staff knew how to recognise and report any concerns they had about people's welfare. The home was clean and safely maintained.

People were supported to have the relationships that they wanted with family and friends.

People had access to a range of healthcare services.

The provider recruited staff carefully to ensure that staff were suitable for their role. Staffing numbers and skill mix were flexible to ensure that people’s needs were met by the service.

People 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. Staff knew that when people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) needed to be followed.

Systems were in place to assess and monitor the quality and delivery of care to people and drive improvement. However, the shortfalls we identified had not been found by the service.

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

We identified one breach of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to shortfalls in the identification and provision of some aspects of personalised care. Details of action we have asked the provider to take can be found at the end of this report.

We also made two recommendations. The first recommendation was in relation to improving people's dining experience. The second was in relation to strengthening the auditing processes.

Rating at last inspection: Good. The report was published in April 2017.

Why we inspected: This was a planned inspection based on the previous rating .

We have found evidence that the provider needs to make improvement. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Follow up. We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Ogilvy Court is registered to provide accommodation for up to 57 people who require nursing and personal care. The service is provided to mainly older people some of whom may be living with dementia. It also provides a service for people with physical disabilities, learning disabilities and mental health needs.

The service has a registered manager. 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.

People were treated with respect. Staff engaged with people in a friendly and courteous manner. Staff respected people’s privacy and dignity and understood the importance of confidentiality.

People and their relatives told us people were safe living in the home. There were procedures for safeguarding people. Staff knew how to recognise and report potential abuse of the people they supported and cared for.

Risks to people in relation to their care needs had been assessed and guidance was in place for staff to follow to minimise the risk of people being harmed and to keep people safe. Accidents and incidents were addressed appropriately and learning took place to minimise similar incidents reoccurring. We have made a recommendation about the management and safe use of bedrails.

Arrangements were in place to make sure sufficient numbers of skilled staff were deployed at all times to provide people with the care and support they required. However, some people’s relatives told us they felt there were times when the service would benefit from more staff being on duty. The provider had carried out appropriate checks to ensure staff were suitable and fit to support people. People were supported to take part in some activities.

We found that the home was clean and well maintained and records we looked at showed that required health and safety checks were carried out.

Care plans were in place which reflected people's needs and their individual choices and preferences for how they received care. Feedback from people and their relatives was positive about the care provided by the service. Arrangements were in place to make sure people received the medicines they were prescribed, however there were some areas of medicines administration which could be improved.

People had access to appropriate healthcare services including specialist advice when needed. People were registered with a GP who regularly visited the service. People’s nutritional needs were assessed and their dietary needs and preferences met.

Staff were appropriately recruited and supported to provide people with individualised care and support. Staff received a range of training to enable them to be skilled and competent to carry out their roles and responsibilities. They had a good understanding of people's needs and how these should be met. There was an on-going programme of training and development for staff.

Staff understood the legal requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). People were encouraged and supported to make decisions for themselves whenever possible. Some staff were a little vague when asked to describe the principles of the MCA and DoLS. However, staff knew about the systems in place for making decisions in people’s best interest when they were unable to make one or more decisions about their care, treatment and/or other aspects of their lives.

The registered manager encouraged an open, inclusive culture within the home. People’s relatives told us they felt welcomed when visiting the home and comfortable raising issues to do with the service with the registered manager. There were arrangements in place to deal appropriately and promptly with people's complaints and other issues.

There were effective systems in place to regularly assess, monitor and improve the quality of the services provided for people. These included unannounced checks of the service carried out by the registered manager and regional director during the night.