Background to this inspection
Updated
7 October 2015
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider was meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
The inspection took place on 06 July and 17 August 2015 and was unannounced.
The inspection was undertaken by two adult social care inspectors, a specialist pharmacy adviser 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, in this case of older people.
Before the inspection the provider completed a Provider Information Return which we reviewed in order to prepare for the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
We also looked at all of the information which the Care Quality Commission already held on the service. This included previous inspections and any information the provider had to notify us about. Furthermore, we invited the local authority and Clinical Commissioning Group to provide us with any information they held about St Oswalds. We took any information they provided into account.
During the visit we talked with 13 people who used the service, six relatives, four care support workers, three nursing staff, an activities coordinator and a member of the catering team.
Furthermore, we met with the registered manager, deputy manager and regional manager. We also spent time with people in the communal lounges and in their bedrooms with their consent. The expert by experience joined one group of people for lunch.
We undertook a Short Observational Framework for Inspection (SOFI) during lunch time. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.
We looked at a range of records including four care plans; four staff files; staff training records; minutes of meetings; rotas; complaint and safeguarding records; medication; maintenance and audit documents.
Updated
7 October 2015
This inspection was unannounced and took place on 6 July and 17 August 2015.
The home was previously inspected in June 2014. A breach of legal requirements was noted in regard to notification of incidents. We followed this up during August 2014 and found that improvements had been made to address the breach.
St Oswalds is a residential care home providing accommodation, personal and nursing care for up to 42 older people. The service is provided by Four Seasons (No 9) Limited.
The home was first registered in 1987 and consists of a two storey Victorian building and a single storey extension. All rooms are single occupancy and eighteen are equipped with en-suite facilities.
On the day of our inspection the service was accommodating 38 people with different levels of need.
At the time of the inspection there was a registered manager at St Oswalds. 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 registered manager was present during the two days of our inspection and engaged positively in the inspection process together with her regional manager. The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors.
We found a number of breaches related to medicine management which included a failure to ensure there were sufficient quantities of medication to ensure the safety of service users and to meet their needs. You can see what action we told the provider to take at the back of the full version of the report.
People living at St Oswalds were observed to be comfortable and relaxed in their home environment and in the presence of staff. People spoken with were generally complimentary about the care provided at St Oswalds.
For example, comments received included: “Staff are very nice. They treat me well”; “If I feel I need help I get it”; “They treat me kindly. They’re very good and patient”; “Thanks be to God we’re looked after well. Staff are wonderful” and “Staff look after me well.”
Likewise, relatives reported; “Although they’re busy staff always make time for a chat. They have all the time in the world for relatives too”; “Staff are wonderful with her” and “Staff are definitely caring, even the reception staff.”
We observed people’s choices were respected and that staff communicated and engaged with people in a polite, dignified and courteous manner. We also noted that interactions between staff and people were professional; unhurried; kind, friendly; caring and personalised. Staff were also seen to be attentive to the individual needs of the people they cared for and demonstrated a good awareness of the preferred routines of the people living at St Oswalds.
People using the service had access to a range of individualised and group activities and a choice of wholesome and nutritious meals. Records showed that people also had access to GPs, chiropodists and other health care professionals (subject to individual need).
Systems had been developed by the provider to assess the needs and dependency of people using the service; to obtain feedback on the standard of care provided and to respond to safeguarding concerns and complaints.
Staff spoken with confirmed they were supported in their role and had access to induction, ongoing training and formal supervision and appraisal.