14 December 2021
During an inspection looking at part of the service
About the service
Osmaston Grange is registered to provide personal care, nursing care and accommodation for up to 80 people across two buildings. At the time of the inspection only one of the two buildings were open providing accommodation and residential care to people either on a permanent basis or for short-term care, as required. Nursing care is no longer provided at Osmaston Grange.
On the day of our visit 30 people were using the service aged 65 and over. The open building in use can support up to 40 people.
People’s experience of using this service and what we found
The provider had a process for monitoring the home which included audits, however we found these had not consistently picked up on areas which required improvement.
Medicines were not always managed safely, and some aspects of safety were not always managed to reduce the risks of harm or impact on people’s dignity.
Lessons in some areas had been learnt, however there was not a system or ongoing approach to ensure areas of concern did not reoccur.
Partnerships had been developed with health and social care professionals, however, there continues to be an inconsistent approach to ensuring peoples care needs were being met.
There was sufficient staff to meet people’s needs and they had received training for their role. However, training in managing behaviours which challenged had not been made available which would have supported some staff in this area.
Staff understood how to raise a safeguarding’s and we saw any concerns raised had been investigated. Relatives were overall positive about the experience their family members received.
The provider completed notifications and responded to any concerns we raised. There was a positive culture within the home and environmental improvements had contributed to making the home feel more welcoming.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update) The last rating for this service was requires improvement (published 20 April 2021) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made, however further improvements were required, and the rating remains requires improvement and the provider was still in breach of the regulations.
Why we inspected
We undertook this focused inspection to check whether the Warning Notice we previously served in relation to Regulation 12 and 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 had been met. These were in relation to concerns we had about infection control and the environment. We saw improvements had been made in these areas, however identified other areas which required further monitoring. The overall rating for the service has not changed following this targeted inspection and remains requires improvement. This report only covers our findings in relation to the key questions
safe and well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service remains requires improvement. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Osmaston Grange on our website at www.cqc.org.uk.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to safety and oversight relating to the governance at this inspection.
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 until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.