Overseal Residential Care Home

About the service

Overseal Residential Care Home provides accommodation and personal care for older people who may have dementia. Nursing care was not provided. The service is registered for 30 beds. However, 5 of the 25 bedrooms had initially been used as double rooms. All bedrooms were now used as single rooms due to people’s preferences. At the time of our inspection there were 25 people using the service.

People’s experience of the service and what we found:

People were protected from the risk of harm as staff knew the procedure to follow to report concerns. Assessments were completed and followed, staff had guidance to support people safely and records were up to date. The home was cleaned to a good standard. Medicines were managed safely, and people received their medicines as prescribed. Staff were recruited safely, and sufficient staff were available to meet people’s needs.

People were supported by trained staff and supported to access health care services. People were supported to eat and drink and those at risk of risk of malnutrition and dehydration were monitored, and referrals made to the relevant healthcare professionals.

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.

People’s equality and diversity was fully respected. People were supported by kind and compassionate staff who understood what was important to them. People said staff were kind and respectful to them. People were encouraged and supported to express their views.

People's support was tailored to meet their needs and preferences and they were supported to engage in activities of their preference. Complaints were used to improve people’s experience of care and support. People were supported in a sensitive way to share their wishes in regard to end of life care and support.

People, relatives, and staff were encouraged to feedback into the running of the service. The provider and registered manager worked alongside partner agencies to enhance the support provided to people.

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 1 December 2018.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We found the following examples of good practice.

There was a restriction on visiting the service. There were safe procedures in place for visitors to the service, including healthcare professionals and relatives to reduce and prevent the spread of infection. There was a clear system to ensure visitors followed the current guidance on the use of personal protective equipment (PPE) and social distancing. Although we found data was not always recorded to ensure visitors were not a potential risk of COVID-19. The registered manager said they would address this.

The provider ensured people maintained contact with relatives by staff supporting them with telephone calls. The registered manager was looking at planning for visits for the winter once they had reviewed current guidance.

There was a clear regular programme for staff and people living in the home to be tested for COVID -19. This meant swift action could be taken if or when positive tests were received.

Staff followed procedures for don and doffing PPE and how to dispose of it safely, in line with government guidelines. All staff wore appropriate PPE, which was in good supply. Posters and information about COVID-19 were visual throughout the service. However, we found concerns that the area used for staff don and doffing process was not suitably placed. We spoke with the registered manager and they addressed this before we left and confirmed the new area being used.

A robust contingency plan was in place and used for when positive testing or isolation for staff or people arose. The provider also used a COVID-19 planning document, this was to assist with any reduction in staff numbers. There were arrangements to deploy staff across the service to reduce the risk of cross infection. Agency staff were used to cover shortfalls in staffing, due to staff testing positive for COVID-19.

Handover meetings were completed in line with safe distancing guidelines and a minimum staff team. Then shared with the rest of the staff team appropriately to make sure people’s needs were met.

General risk assessments were in place for people in high risk groups, but not individual to identify personal risks. The registered manager gave an example of vulnerability in the staff team. They noted the risk but had not recorded it to ensure the staff member did not enter high risk areas of the home. The registered manager told us they would address this. They assured us that adjustments, if required to staff working practices would be put in place as and when required to keep them safe.

People using the service self-isolated in their own rooms if they tested positive for COVID-19. Anyone not in isolation and free from infection appropriate arrangements were in place to reduce the spread of infection. This meant peoples individual needs were considered to ensure everyone was kept safe.

The home was very clean and tidy. Housekeeping staff told us they had increased the cleaning regime and stepped up their use of cleaning solution. The cleaning schedules had been consistently completed for the weekly and monthly tasks around the home environment. Staff told us they try to deep clean every other day. We found some gaps in the daily cleaning schedules. From speaking with staff, we were assured the cleaning was being completed however this was not always recorded. The registered manager had identified a training issue and told us they were in the process of addressing this.

Further information is in the detailed findings below.

Overseal Residential Care Home residential is care home that provides residential care for up to 30 older people. Bedrooms are provided over two floors with three communal seating areas and a dining area on the ground floor. A patio and garden area is available at the front of the home.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. At this inspection we found the service remained Good.

There was a registered manager in post. 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 oversaw the running of the home and was supported by a deputy manager, senior support workers and support workers.

People continued to receive safe support. Sufficient staff who understood their role in protecting people from the risk of harm were available to support people. People were supported to keep safe because risks were identified and minimised to maintain their safety. Assistive technology was in place to support people to keep safe. People received their medicines in a safe way. The staff’s suitability to work with people was checked before they commenced employment. People were protected by the systems in place for the prevention and control of infection.

People continued to receive effective support. People were supported by staff who received the right training and support to meet their needs. People were supported to have maximum choice and control of their lives. People were supported by staff who understood the importance of gaining their consent regarding the support they received. People were supported in the least restrictive way possible; the policies and systems in the service supported this practice. People were encouraged to eat a balanced diet that met their preferences and assessed needs and were supported to access healthcare services. People received coordinated support that met their needs and preferences because the registered manager worked with other organisations and healthcare professionals to achieve this.

People continued to receive caring support. There was a good relationship between people using the service and the staff team and their independence, privacy and dignity were respected. People’s visitors were made welcome which supported people to maintain relationships with those who were important to them.

People continued to receive responsive support. People were supported to develop and maintain interests and be part of the local community. People were enabled to received support in their preferred way because they were involved in assessment and reviews of their care. There were processes in place for people to raise any complaints and express their views and opinions about the service provided.

People continued to receive well led support. A warm and friendly culture was in place that promoted good outcomes for people. People and their representatives were encouraged to give their views of the service; which promoted an open and inclusive culture. Staff understood their roles and responsibilities and were encouraged by registered manager to develop their skills. The registered manager and provider understood their legal responsibilities and kept up to date with relevant changes. There were systems in place to monitor the quality of the service to enable the registered manager and provider to drive improvement.

Further information is in the detailed findings below.

We inspected this service on 24 August 2016. This was an unannounced inspection. At our previous visit on the 28 May 2014 the service was meeting the regulations that we checked.

Overseal Residential Care Home provides residential care for up to 30 people. At the time of our inspection there were 25 people using the service.

The service had a registered manager in post. 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.

People told us and we saw there were sufficient staff available to support them. Staff had knowledge about people’s care and support needs to enable support to be provided in a safe way. Staff understood what constituted abuse or poor practice and systems were in place to protect people from the risk of harm. Medicines were managed safely and people were given their medicine as and when needed. The registered manager had undertaken thorough recruitment checks to ensure the staff employed were suitable to support people.

Staff understood people’s needs and preferences and were provided with training and supervision, to support and develop their skills. Staff gained people’s verbal consent before supporting them with any care tasks and helped people to make their own decisions when possible. Where people were unable to make decisions independently they were supported in their best interests and in accordance with the Mental Capacity Act. People received food and drink that met their nutritional needs and preferences, and were referred to healthcare professionals to maintain their health and wellbeing.

Staff were caring in their approach and supported people to maintain their dignity and privacy. People were supported to maintain relationships that were important to them and develop their social interests. The provider sought people’s opinions to bring about changes. People knew who the registered manager was and they understood their responsibilities around registration with us. Staff felt listened to and were happy to raise concerns. People knew how to complain and we saw when complaints were made they were addressed. Quality monitoring checks were completed by the provider and when needed action was taken to make improvements.

Is the service safe?

In April 2014 we received information of concern. We were told that medicines were not being given out in a safe manner because they were being dispensed by one member of staff and given by a different staff member. We were informed they were being left in people's bedrooms and not taken.

The information suggested there were people at the home whose personal care needs were not being met and they were being left unattended between the shift changeovers until staff were able to care for them.

We made two inspection visits to the home. During the evening inspection we arrived at the home at 8.10pm to meet the day and night staff. Staff informed the manager that we were present and the manager and her deputy returned to the home during our inspection. The second day inspection took place on date 5 June 2014.

At both inspection visits we saw that people were cared for in a clean, hygienic and safe environment. During the evening inspection we saw that people were in the lounge and one person walked around the room freely. We found people to be clean and presentable and having their needs met. One person told us, 'Staff are very nice, they come when I press the buzzer. They talk nicely to me. I feel safe here. They always remember to give me my medicine'. Another person told us 'It's marvellous, staff are nice to me they come when I press my buzzer. It feels safe here. Everything is alright.'

Other comments included, 'I think the care is very good and I am happy to be here because I feel safe'. A family member also confirmed how much better they saw their relative was doing, since being at the home. They told us their relative had company and could ask for help whenever they needed it.

People who used the service were protected from the risk of abuse, because risk assessments were in place that raised staff awareness and people told us they were safe at the home.

We saw people were supported to receive their medicines safely and in the way they preferred although there were some practice issues. We spoke with staff who told us one staff member sometimes administered the medicine and another staff member then gave the medicine. Both staff members were senior care workers on the shift who were trained to give medicines to people. This meant people may be at risk of not having their prescribed medicines administered correctly. The information of concern suggested staff were leaving medicines in people's bedrooms. We did not find evidence of this at the time(s) of our inspection. This meant people were not placed at risk of finding and taking other people's medicines.

The Mental Capacity Act 2005 (MCA) is a law providing a system of assessment and decision making to protect people who do not have capacity to give consent themselves. We were told by the manager there was one person who needed a Deprivation of Liberty Safeguard. This is where a person is restricted of their freedom and considerations are made in the person's best interest. This was being appropriately managed and involved the appropriate authorities to manage this. A Deprivation of Liberty Safeguard was being put into place in the person's best interest. This has been completed and the information has been sent to us.

Is the service caring?

Over the two visits, we looked at two people's care records and spoke with five people, two relatives, one health care professional and a student nurse, four staff, a deputy manager, the registered manager and the provider.

We observed people at the home as they continued with their daily activities. We observed people's routines at different times of the day. We saw they were given choices with their meals and were provided with a choice of suitable and nutritious food and drink. We saw people took part in the activities provided.

Is the service responsive?

There was an effective complaints system available. We saw comments and complaints people made were responded to appropriately. This meant results were used to improve care at the home as people's concerns were acted on by the provider.

In the records we looked at, people's health care needs were recorded and monitored on a regular basis. Records demonstrated that people accessed health care professionals as and when needed. People we spoke with told us that if they were unwell staff contacted the doctor for them. This meant that people's health care needs were met.

Is it effective?

We saw that effective recruitment processes were in place. This ensured people received care from staff who were safe to be with them and had received sufficient training to meet their needs. We saw risks were managed through effective employment checks for staff.

People we spoke with and the relatives who spoke with us did not express any concerns regarding the competency of the staff team. People were complimentary about staff who they received care and support from. Visitors told us they were happy with the way staff supported their relatives. Comments included, 'The staff are very good' and, 'They are helpful to my parent'.

Is the service well led?

We saw the provider made regular health and safety checks including fire safety, hoist checks and electrical safety checks. This ensured they provided a safe environment for people to use. The registered manager was in daily charge of the service supported by sufficient staff.

People's relatives confirmed they were informed and involved in the lives of their family members. We found people were able to have their say and the provider acted on their comments.

One person who spoke with us told us, 'the food is very good and we are given a choice of food. There is always something that you will like'.

We observed people to have their medicines in the way they preferred. People who spoke withus told us they were happy at the home. We found the atmosphere to be pleasant and relaxing.

We noted that when staff supported people they generally did this is in a respectful and dignified manner and were able to promote people's independence.

People told us they were being invited to take part in more activities within the home since our last inspection. We observed people being assisted during the day and this was dignified and respectful manner. We spoke with four people, they told us they were happy at the home.

Care and treatment was delivered in a way that ensured people's welfare. We saw people needed encouragement and help from staff to preserve their dignity. When we spoke with four staff they told us they understood people's needs as they had been working at the service for a while. People told us they would like to have more activities on a daily basis in the home to make their days more interesting.

We spoke with a small group of seven people in the lounge. They told us they felt safe at the home. Two people told us they thought the home was kept clean and tidy.

Although the manager stated she felt there was enough staff, one person told us 'we have to wait for two hours before we can be taken to the toilet as there are no staff around when we need them'. Two people told us there were times when they had to wait for staff to attend to their needs.