Archived: Olton Grange Residential Home

Updated 2 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 to follow up on two previously identified breaches in the regulations, and to make sure the required improvements had been undertaken. The inspection took place on 30 August 2017 and was unannounced. The inspection team consisted of two inspectors and an expert by experience. The expert by experience was a person who had personal experience of caring for someone who had similar care needs to people living at Olton Grange Residential Home.

Prior to our visit we reviewed information received about the service, for example the statutory notifications the provider had sent us. A statutory notification is information about important events which the provider is required to send to us by law.

We also spoke with local authority commissioners who funded the care some people received. They informed us had had visited the home in July 2017 and had made some recommendations to improve the care people received.

During the visit we spoke with five people who lived at the home and four relatives. We also spoke with the manager, one trustee, two senior care workers, three care assistants, the cook and one laundry assistant.

We looked at the records of four people and two staff records. We looked at other records related to people's care and how the home operated. This included checks the management team took to assure themselves that people received a good quality service.

Updated 2 November 2017

This comprehensive inspection took place on 30 August 2017 and was unannounced. Olton Grange Residential Home provides care and accommodation for up to 25 older people. There were 19 people living at the home when we carried out our visit. A number of people at the home lived with dementia.

A requirement of the provider's registration is that they have a registered manager. A registered manager is a person who had registered with the Care Quality Commission to manager the service. Like registered provider's 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. At the time of our inspection a registered manager had not been in post for over 12 months. The manager who was responsible for running the home was in the process of applying for registration.

The home was last inspected on 21 July 2016 when we found the provider was not meeting the required standards. We identified two breaches in the legal requirements and regulations associated with the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

These breaches were in relation to the safe care and treatment people received and the leadership of the service. Care and treatment was not provided in a safe way. Risks were not assessed and action had not been taken to reduce risks. Systems and processes were not established or effective. The quality and safety of the service was not assessed or monitored. Accurate records of people and their care and treatment were not maintained.

The provider sent us an action plan outlining how they would improve. During this inspection we checked whether the improvements had been made. We found some improvements had been made but action had not been sufficient in response to the breaches in regulation.

New audits and checks to monitor the quality and safety of the home had been implemented. However health and checks of the building safety were not effective. Also, the provider’s fire risk assessment was out of date and was not fit for purpose. This meant the provider could not always demonstrate how they ensured people and the staff would be kept as safe as possible.

At our previous inspection, we were told meetings where people who lived at the home could discuss any issues or concerns would commence. At this visit, they still had not taken place.

The provider had received a Provider information Return (PIR) as part of this inspection process but this had not been completed and returned to us as requested.

Some improvements had been made to manage the risks associated with people’s care. Risk assessments and management plans identified potential risks to people's health and wellbeing. However, information for staff to follow to reduce risks was not always recorded.

At our previous inspection people were not involved in reviewing their care and their care records had not been regularly reviewed. Reviews had commenced but had not identified when people's risk assessments did not contain sufficient information. However all of the people we spoke with told us they were involved in their care reviews and received their care and support in the way they preferred which met their needs.

Incident and accident records were completed. Since our previous inspection the manager had implemented a system to analyse the records and we saw action had been taken to reduce the likelihood of the incidents happening again.

Relatives confirmed they had opportunities to be involved in people’s care and people were encouraged to maintain relationships important to them.

People told us they felt safe living at Olton Grange. Procedures were in place to protect them from harm and staff had received safeguarding training. Staff were confident to challenge poor practice and share concerns with their manager.

Sufficient and experienced staff were on duty to meet people's needs. Most staff told us they had received an induction when they started working at the home. The provider's recruitment procedures minimised, as far as possible, the risks to people safety.

Since our previous inspection medicine audits had commenced to check they were given safely and effectively. Improvements had also been made to the way medicines were stored. People received their medicines when they needed them but staff had not consistently recorded when they had administered people’s prescribed creams.

People provided positive feedback about the food and dining experiences at the home. Staff demonstrated good knowledge of people's nutritional needs. People were supported to manage their health conditions and had access to health professionals when required.

Managers and staff understood the principles of the Mental Capacity Act 2005 (MCA) and the Depravation of Liberty Safeguards (DoLS). Consent to care was sought in line with legislation. People were supported to make choices and decisions about their everyday routines. This meant the rights of people were protected.

Staff were caring and knew the people who lived at Olton Grange well. We saw they quickly responded to people’s requests for assistance. People's right to privacy was respected and their dignity was maintained by staff who supported them to be as independent as possible.

People spoke positively about the social activities available to occupy their time. People and their relatives knew how to make a complaint and felt comfortable doing so. No complaints had been received in the last 12 months.

The manager spoke positively about the support they received to be effective in their role. People and their relatives were happy with how the home was run. Staff told us they enjoyed working at the home and spoke positively about the manager.

Some staff had not had their work performance monitored for over 12 months. Staff confirmed they had some the opportunities to attend and contribute to team meetings to share ideas and drive forward improvements.

Annual quality questionnaires were sent out to gather people's views on the service they received. The provider had an improvement action plan in place to improve the décor in the home to make the home a nicer place for people to live.

The manager told us which notifications they were required to send to us so we were able to monitor any changes or issues within the home.

We found two breaches of the Health and social care Act 2008 (Regulated activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.