Archived: OSJCT Fosse House

Updated 19 May 2018

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 is 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.

This comprehensive inspection took place on 12 April 2018 and was unannounced. The inspection team consisted of two inspectors 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. Their area of expertise was dementia care.

Before the inspection we reviewed information the provider sent us in the Provider Information Return. This is information we require providers to send to us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information we held about the home including notifications they had sent us. A notification is information about important events which the provider is required to send us by law. We also contacted County Council commissioners of adult social care services and Healthwatch and asked them for their views of the service provided. Healthwatch is the local consumer champion for people using adult social care services

During the inspection we spoke with six people using the service and five relatives. We spoke with the area operations manager, registered manager, three care staff, an assistant cook, two housekeepers and two visiting health professionals.

We observed staff providing support to people in the communal areas of the service. This was so we could understand people's experiences. By observing the care received, we could determine whether or not they were comfortable with the support they were provided with.

We reviewed a range of records about people's care and how the service was managed. This included looking at all or part of five people's care records and associated documents. We reviewed records of meetings, recruitment checks carried out for three staff, staff rotas, staff training records and maintenance and safety logs. We also reviewed the quality assurance audits the management team had completed.

Updated 19 May 2018

We carried out an unannounced inspection on 12 April 2018.

OSJCT Fosse House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

OSJCT Fosse House provides accommodation for up to 42 older people with care needs including physical frailty and dementia. It is situated on the outskirts of Lincoln and provides accommodation over two floors. On the day of our inspection there were 39 people staying at 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 overall. At this inspection our rating for the responsive domain changed to requires improvement as care records did not always reflect people’s current care needs and some social activities could be improved. However, this did not affect the overall rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

There was a registered manager in place. 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.

Systems and processes were in place to keep people safe. Staff understood their responsibilities for safeguarding the people they cared for and assessed risks to their health and safety. Measures were in place to reduce these risks and people were supported to stay safe, whilst not unnecessarily restricting their freedom. However, documentation in this area was not always fully reflective of the steps being taken by staff. Recruitment processes ensured appropriate staff were recruited to work in the home. Accidents and incidents were recorded, investigated and learning identified. Safety checks of the premises and equipment were completed and processes were in place to prevent and control infection. People’s medicines continued to be managed safely.

Staff received appropriate training for their role and they were supported to further develop their knowledge and skills. People’s needs were assessed and care was delivered in line with national guidance. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, documentation of mental capacity assessments and decision making in people’s best interests was not always fully completed. People were supported to access their GP and other healthcare professionals when it was necessary.

Staff were knowledgeable about the people they cared for and treated them with kindness. They respected people’s privacy and dignity. People were involved in planning and reviewing their care.

Care was generally responsive to people’s individual needs, but care plans were not always fully updated in response to changes in people’s requirements. Information about people’s personal preferences in relation to their care and their life history was available. Some activities were available for people in the form of entertainment, external visits and one to one and group activities at the home. However, people we spoke with and their relatives told us they would like more activities to be provided. The service had not fully embedded the accessible information standard which ensures that provisions are made for people to have information about their care in ways which are meaningful to them.

Staff felt supported by the leadership and management team and had the opportunity to raise issues and concerns. Relatives told us that when they identified a concern, it was listened to and addressed. The provider and the registered manager monitored the quality of the services provided and action plans were completed to bring about improvements when required. The registered manager carried out their role in line with their registration with the CQC.