Osmaston Grange

Updated 20 January 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 Care Act 2014.

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

This inspection was completed by one inspector, a nurse specialist and an Expert by Experience. A nurse specialist has nursing knowledge to review these areas of the service. 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

Osmaston Grange is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a registered manager registered with the Care Quality Commission in addition to a nominated individual and this means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We spoke with local commissioners and health care professionals and used all of this information to plan our inspection.

During the inspection

We spoke with two people who used the service about their experience of the care provided. We spoke with eleven members of staff including the provider, registered manager, senior care workers, care workers, domestic staff and the chef.

We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

Our Expert by Experience contacted relatives and representative of twelve people using the service. We continued to seek clarification from the provider to validate evidence found. We looked at training data and further quality assurance records. We requested policies and additional information from the provider.

Updated 20 January 2022

About the service

Osmaston Grange is registered to provide personal care, nursing care and accommodation for up to 80 people across two buildings. At the time of the inspection only one of the two buildings were open providing accommodation and residential care to people either on a permanent basis or for short-term care, as required. Nursing care is no longer provided at Osmaston Grange.

On the day of our visit 30 people were using the service aged 65 and over. The open building in use can support up to 40 people.

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

The provider had a process for monitoring the home which included audits, however we found these had not consistently picked up on areas which required improvement.

Medicines were not always managed safely, and some aspects of safety were not always managed to reduce the risks of harm or impact on people’s dignity.

Lessons in some areas had been learnt, however there was not a system or ongoing approach to ensure areas of concern did not reoccur.

Partnerships had been developed with health and social care professionals, however, there continues to be an inconsistent approach to ensuring peoples care needs were being met.

There was sufficient staff to meet people’s needs and they had received training for their role. However, training in managing behaviours which challenged had not been made available which would have supported some staff in this area.

Staff understood how to raise a safeguarding’s and we saw any concerns raised had been investigated. Relatives were overall positive about the experience their family members received.

The provider completed notifications and responded to any concerns we raised. There was a positive culture within the home and environmental improvements had contributed to making the home feel more welcoming.

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 20 April 2021) and there were two 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 improvements had been made, however further improvements were required, and the rating remains requires improvement and the provider was still in breach of the regulations.

Why we inspected

We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. These were in relation to concerns we had about infection control and the environment. We saw improvements had been made in these areas, however identified other areas which required further monitoring. The overall rating for the service has not changed following this targeted inspection and remains requires improvement. This report only covers our findings in relation to the key questions

safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.

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

Enforcement

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 continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safety and oversight relating to the 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 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.