Overdene House

Updated 11 October 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and a specialist nurse advisor.

Service and service type

Overdene House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Overdene House is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection and sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and 2 visiting relatives about their experience of the care provided. We spoke with 15 members of staff including the registered manager and deputy manager, area manager, nurses, care and ancillary staff.

We reviewed a range of records. This included 15 people's care records and several medication records. We looked at 3 staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Updated 11 October 2023

About the service

Overdene House is a residential care home providing personal and nursing care for to up to 70 people. The service provides support to older people. At the time of our inspection there were 54 people using the service. Overdene House accommodates people across two separate floors, each of which has separate adapted facilities.

People’s experience of using this service and what we found

Risks to people were not always fully assessed or managed robustly. Whilst some assessment and management plans were in place, records did not fully demonstrate staff had taken sufficient action to assess and mitigate all risks to people.

Systems and processes to maintain oversight of the quality and safety of care were not effective. Improvements were required to ensure that any concerns about people were appropriately identified and reported or reviewed, and that all staff had received appropriate training and supervision. Records were not always complete and accurate.

The management team were open and honest about areas being addressed and acknowledged they were on a journey to develop and improve the service. There was a home improvement plan in place. Some shortfalls in relation to staff training, had been identified prior to our inspection, and some specific training was in progress.

Overall, there were enough staff to meet people's needs. However, staff were less flexible to respond to people’s personal care needs during the morning breakfast period. We have made a recommendation about this.

The provider followed safe procedures for the recruitment of staff and all appropriate checks had been completed before new staff were employed in the home.

Overall medicines were managed safely, and people received these as prescribed. However, some improvements were required in relation to the application and recording of topical creams and ointments.

Systems were in place to prevent and control the risks of infection. However, not all staff fully followed procedures for donning and doffing of PPE. More robust cleaning was required in certain areas.

We received some positive feedback from people and their relatives about the care provided. People told us they felt safe and were happy with the way they were treated. People were positive about the food available. They were supported to have enough to eat and drink and staff monitored for any unexpected weight loss.

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. The management team had undertaken some focused work to ensure all Deprivation of Liberty Safeguards (DoLS) authorisations were in place where required.

The management team had made some positive changes to the environment, however areas remained in need of redecoration. The provider had a planned refurbishment programme; however no dates were available yet for completion.

Staff were positive about the support they received. Managers were accessible, knew people well and understood their needs. The provider sought people’s feedback about the service through various means. They were working with the local authority, and various health and social care professionals, to ensure people received appropriate care and support.

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 6 December 2022).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding. A decision was made for us to inspect and examine those risks. We undertook a focused inspection to review the key questions of safe, effective and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to the safe management of risk and oversight of the service, including training and record keeping. We have also made a recommendation in relation to staffing.

Follow up

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.