CQC report explained · a nursing home
What the CQC found at Osborne House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. There were enough staff, risks were monitored, infection controls were in place, and medicines were given as prescribed, although some medicines records and storage checks did not follow best practice.
- Effective?
- Good
- Staff had suitable training and supported people with food, drinks, healthcare and specialist needs. The home worked with other professionals and followed the Mental Capacity Act.
- Caring?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Responsive?
- Good
- This question was not inspected during this focused visit. Its previous rating was used when calculating the overall rating.
- Well-led?
- Good
- Management systems had improved, audits were in place, and people, relatives and staff were involved in developing the service. Staff described an open culture and felt supported by management.
What inspectors found, September 2022
Rated Good; inspectors found safe, effective and well-led care, although some medicines records and care plans needed improvement.
This was an unannounced focused inspection on 11 August 2022. Inspectors checked whether the home had acted on its previous improvement plan. They spoke with people, relatives and staff, and reviewed care records, medicines records, staff files and management records.
The home was rated Good overall. Safe, Effective and Well-led were also rated Good. People received medicines as prescribed, there were enough trained staff, risks were monitored, and staff worked with health professionals. People and relatives said they were happy with the care.
Some medicines recording and storage did not follow best practice, although inspectors found no harm. Care records also needed more detail and a more personal approach. The home acted on the medicines concerns and was no longer in breach of the regulation found at the previous inspection.
Staffing and safety
Inspectors found enough staff to provide safe care. Staff had the training and recruitment checks needed for their roles.
“There were enough staff to provide safe care.” from the report
Healthcare support
Staff made appropriate referrals and followed advice from health professionals. Relatives said people received medical help when needed.
“Staff worked with other agencies to provide effective care.” from the report
Food and drink
People had choices about meals and drinks. Menus considered cultural and religious needs, and extra support was available for people with complex dietary needs.
“People were supported appropriately to maintain a balanced diet.” from the report
Improved management
Management systems and quality checks had improved since the previous inspection. Staff, people and relatives were invited to share concerns and ideas.
“The systems in place to monitor the quality and safety of the service had been developed since the last inspection.” from the report
Medicines records and storage
needs fixingSome handwritten medicines records were not checked and signed by two staff members as recommended. Temperature checks for medicine storage were also not always completed correctly, although there was no evidence of harm.
“The recording and storage of some medicines did not always meet best practice guidance however people were not harmed by this.” from the report
Care plan detail
needs fixingCare records guided staff but did not yet describe all areas of support in enough detail or in a fully personal way. An improvement plan was underway.
“Care records were in place to help guide staff in providing safe care, however, these needed further development to ensure all areas were detailed and person centred.” from the report
Some repairs and decoration
minorInspectors noted torn wallpaper and stained carpets in places. The provider was addressing these issues and inspectors said they did not affect people living in the home.
“Improvements were needed in places, such as repairs to torn wallpaper and staining to some carpets however this was being addressed by the provider and did not affect the people in the service.” from the report
- 01How are handwritten medicines records checked and signed, and what changes have been made since the inspection?
- 02How are medicine storage temperatures recorded each day, and who reviews these records?
- 03How will you make care plans more detailed and person centred for my relative?
- 04What progress has been made with the repairs to torn wallpaper and stained carpets?
- 05Which ratings for Caring and Responsive were carried forward from the previous inspection?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings carried over into the overall rating. This explanation was written from the published report of 28 September 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, August 2020
Osborne House is rated Requires Improvement; inspectors found major progress after an Inadequate rating, but record-keeping, monitoring and staffing still needed improvement.
Inspectors visited on 30 July and 6 August 2020. This was an announced, focused inspection of safe and well-led care. They spoke with people, relatives, staff and a visiting professional, and reviewed care, medicines, staff and management records.
The home was safer than at the previous inspection. Care plans, risk guidance, medicines systems, safeguarding and staff recruitment had improved. People and relatives said care and communication had improved, and staff knew people better.
Important problems remained. Records did not always show the care given or whether risks were reviewed. Audits did not always find shortfalls, staffing did not always support timely care or effective monitoring, and some staff had not practised fire evacuation.
The overall rating improved from Inadequate to Requires Improvement. The home is no longer in Special Measures, but it still breached Regulation 17 about good governance. The other three question ratings were carried over because they were not reviewed during this inspection.
Improved safety
Care plans and guidance for risks and distress had improved. Accidents and incidents were recorded better, with action taken to reduce future risks.
“People living on the ground floor of the service received residential care and those living on the first floor received nursing care.” from the report
More consistent staff team
Recruitment had reduced reliance on agency workers. This helped people build relationships with staff who knew them.
“A positive recruitment process had led to a reduction in the use of agency workers.” from the report
Open leadership and communication
Staff said they felt supported and able to raise concerns. Relatives were involved and communication during the pandemic was described positively.
“A positive and open culture had developed.” from the report
Weak quality checks
seriousAudits did not always identify problems with staffing, monitoring or fire drill participation. This was the continuing breach of Regulation 17.
“This was a continued breach of regulation 17 (Good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.” from the report
Staffing and monitoring
needs fixingThere were enough staff overall, but staffing levels did not always allow timely care or effective monitoring in communal areas. The provider increased staffing after inspectors raised this.
“However, staffing levels did not always ensure people received responsive care in a timely way or that they were monitored when in communal areas.” from the report
Fire safety practice
needs fixingNot all staff had taken part in regular fire drills. The manager provided an action plan during the inspection.
“Not all staff had attended regular fire drills to practice the safe way to respond in a fire situation.” from the report
Infection control practice
needs fixingInspectors were not assured that social distancing and personal protective equipment were being used safely and that infection control policies were up to date. The home later confirmed that actions had been completed.
“We were not assured that the provider was meeting social distancing rules and using PPE effectively and safely or that their policy for infection prevention and control and practices were up to date.” from the report
- 01How do you now make sure every person's care is recorded fully and checked?
- 02How often are risk assessments reviewed, and how would you show me that this is happening?
- 03What staffing levels are in place on each shift, and how do you make sure people receive timely care and are monitored in communal areas?
- 04Have all staff completed fire drills, and how do you check their participation?
- 05What changes have been made to infection control since the inspection, including the use of PPE and social distancing?
This was a focused inspection of Safe and Well-led only; the ratings for Effective, Caring and Responsive were carried forward from the previous comprehensive inspection. This explanation was written from the published report of 26 August 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Osborne House Care Home
8 rated inspections over 7 years: the service has improved, from Requires improvement to Good.
- September 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2020Requires improvementup from InadequateSafe: Requires improvementWell-led: Requires improvement
- December 2019Inadequatedown from GoodSafe: InadequateWell-led: Inadequate
- May 2019Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- May 2018Requires improvementdown from GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- May 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- December 2013
Registered with the Care Quality Commission on 11 December 2013.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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