Oriel Care Home

Updated 6 April 2023

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 Health and Social Care Act 2008.

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 2 inspectors.

Service and service type

Oriel Care Home is a residential care home. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Oriel Care Home is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who were living at Oriel Care Home and 5 relatives of people residing there. We spoke with 12 staff including the owner of the service, the registered manager and deputy manager, the quality assurance lead, the activity coordinator, senior care staff, the care staff and the cook. We reviewed a range of records. These included 4 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. We reviewed a variety of records relating to the management of the service, including policies and procedures. We also contacted 2 professionals who work regularly with the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 6 April 2023

About the service

Oriel Care Home is a residential care home providing accommodation and personal care to up to 33 people. The service provides support to older adults, people living with dementia and people with mental health needs. At the time of our inspection there were 32 people using the service. The home is separated into 3 areas. One smaller building which accommodates 4 people, and a larger building separated into 2 areas. Each area has its own lounge and dining room.

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

Some staff had not practiced fire evacuation drills and did not know the emergency evacuation procedure. A lack of analysis of incidents for people experiencing distress linked to their mental health meant they were at risk of not receiving appropriate and effective care. People told us they felt safe. The home was clean and clutter free.

People gave mixed views about their meals, some felt they were not very varied, some were happy with their food. Some staff had not completed mandatory training which could impact on their ability to provide safe effective care.

Some records relating to people showing distress and confusion were not very caring. They showed a lack of understanding by some staff of how people’s conditions affected them. We did also see examples of kind and caring staff interactions. Relatives spoke positively about the staff team.

Relatives gave mixed views on whether there were enough events and activities to stimulate people. Some felt their loved ones seemed to have a lack of activities to occupy their time, others felt there was enough for them to do. Staff would have benefited from more guidance in some cases to support people with mental health needs and those living with dementia.

Systems to monitor the safety and effectiveness of care had not identified a number of the concerns we found during inspection. Relatives told us they felt consulted and involved in decisions about people’s care. Staff told us they felt supported by the management team.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.

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 21 August 2021)

Why we inspected

The inspection was prompted in part by notification of an incident following which a person using the service died. This incident is subject to further investigation by CQC as to whether any regulatory action should be taken. As a result, this inspection did not examine the circumstances of the incident. However, the information shared with CQC about the incident indicated potential concerns about the management of risks for people experiencing distress. This inspection examined those risks.

We found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report.

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 COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified a breach in relation to how the quality and safety of care is monitored at this inspection.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.