OSJCT Foxby Court

Foxby court is a residential care home providing accommodation and personal care to up to 46 people. The service provides support to older people. At the time of our inspection there were 35 people using the service.

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

The risks to people’s safety were not always well managed. This included managing the risks to people’s skin integrity and some aspects of people’s medicines. Information in people’s care plans required improvement along with some areas of cleanliness at the service.

A lack of oversight had impacted on the effectiveness of quality assurance processes at the service, this included the lack of recognition of trends affecting people’s skin care, oversight of cleaning, medicines and care plans. This lack of oversight put people at risk of not receiving care to meet their needs.

However there was a new registered manager and head of care at the service who were responsive to the issues we raised with them. The service had a staff group who received appropriate training for their roles and understood their responsibilities in relation to safeguarding people from abuse.

The provider maintained their established staffing levels to meet people’s needs and had safe recruitment processes in place.

Staff worked to maintain a person centred approach to people’s care and showed good knowledge of people’s needs. People were supported in a caring way and the management team worked in an open and inclusive way with people and their relatives.

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.

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 18 December 2017.

Why we inspected

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

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for Foxby Court on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to Governance and Safe Care and Treatment at the service.

Please see the action we have told the provider to take at the end of this report.

Follow Up

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

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

OSJCT Foxby Court is registered to provide accommodation and personal care for 46 older people. There were 46 people living in the service at the time of our inspection visit.

The service was run by a charitable body who was the registered provider. 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. In this report when we speak about both the charitable body and the registered manager we refer to them as being, ‘the registered persons’.

At the last inspection on 15 April 2015 the service was rated, ‘Good’.

At this inspection we found the service remained, ‘Good’.

In more detail, there were systems, processes and practices to safeguard people from situations in which they may experience abuse. Risks to people’s safety had been assessed, monitored and managed so they were supported to stay safe while their freedom was respected. In addition, medicines were managed safely. Suitable arrangements had been made to ensure that sufficient numbers of suitable staff were deployed in the service and background checks had been completed before new care staff had been appointed. People were protected by their being arrangements to prevent and control infection and lessons had been learnt when things had gone wrong.

Care staff had been supported to deliver care in line with current best practice guidance. People enjoyed their meals and were supported to eat and drink enough to maintain a balanced diet. In addition, suitable steps had been taken to ensure that people received coordinated and person-centred care when they used or moved between different services. People had been supported to live healthier lives by having suitable access to healthcare services so that they received on-going healthcare support. Furthermore, people had benefited from the accommodation being adapted, designed and decorated in a way that met their needs and expectations.

Suitable arrangements had been made to obtain consent to care and treatment in line with legislation and guidance.

People were treated with kindness, respect and compassion and they were given emotional support when needed. They were also supported to express their views and be actively involved in making decisions about their care as far as possible. This included having access to lay advocates if necessary. Confidential information was kept private.

People received personalised care that was responsive to their needs. This included offering people the opportunity to pursue their hobbies and interests. People’s concerns and complaints were listened and responded to in order to improve the quality of care. In addition, suitable provision had been made to support people at the end of their life to have a comfortable, dignified and pain-free death.

There was a positive culture in the service that was open, inclusive and focused upon achieving good outcomes for people. People benefited from there being a management framework to ensure that staff understood their responsibilities so that risks and regulatory requirements were met. The views of people who lived in the service, relatives and staff had been gathered and acted on to shape any improvements that were made. Quality checks had been completed to ensure people benefited from the service being able to quickly put problems right and to innovate so that people could consistently receive safe care.

Good team work was promoted and staff were supported to speak out if they had any concerns about people not being treated in the right way. In addition, the registered persons worked in partnership with other agencies to support the development of joined-up care.

People were asked for their consent before care support was given, and for their views about the running of the home. One person said, 'We have a resident's association meeting to regularly discuss and decide important things about how the home is run.'

We found that people were supported using records that were maintained, checked and reviewed regularly in order to make any changes that were needed to ensure people were cared for safely.

There was a range of balanced, nutritious meals and drinks available throughout the day that people had chosen and enjoyed. One person said, 'I love the food here, it is always good quality and there is plenty of it.' Another person said, 'There are drinks whenever we want them, with plenty of water, tea and juices to drink.'

We found where people had concerns or complaints there was a clear policy and process in place to acknowledge, respond to and resolve them.

We knew that the acting manager had been appointed to provide cover since 01 April 2013 for a period of planned absence for the manager. In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.