29 June 2023
During an inspection looking at part of the service
Ormsby Lodge is a care home. It is registered to provide accommodation and personal care for up to 10 people. It predominantly supports people living with a learning disability, autism or mental health needs. At the time of the inspection there were 8 people living at the service. The service is a large house in the heart of Southsea, close to local amenities. It has been adapted to suit the needs of the people living there.
People’s experience of using this service and what we found
People and their relatives told us they felt staff provided safe care and support. We found improvements had been made, which meant people received safe care from a staff team that knew them well.
Medicines were managed safely by trained staff. Medication administration records (MARs) were completed and regularly audited to identify any areas for development and improvement. Staff had access to medicines policies and procedures as well as best practice guidelines. Although the registered manager regularly observed staff administering medicines, formal records to check staff were competent were not being made. We have made a recommendation about this.
The provider and registered manager had systems and processes to monitor quality within the home. They were working to further improve the effectiveness of the monitoring systems to ensure they were robust in identifying where action was required.
Staff had received training in safeguarding and understood their responsibilities. People were protected from abuse and there was an open culture, where staff supported people to have regular conversations where they could express any concerns.
Recruitment processes were safe to ensure only suitable staff were employed. Where agency staff were used, these were regular and knew people well. There were enough staff to meet people’s needs and support them with activities of their choice.
Infection, prevention and control processes and up to date policies were in place and people’s friends and relatives could visit them when they wished to.
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.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
The size of the service had not been designed in line with the principles and values that underpin Right support, right care, right culture, as the number of people living at the home exceeded the recommended number of six. However, people were supported to live as full a life as possible and achieve the best possible outcomes. The outcomes for people using the service promoted choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible to be involved in decisions about their own lives and gain new skills.
Right Support: People were supported to make choices about how they lived their life and had the right support to achieve this. People had lived in the service for many years and were a close group of people who knew each other well and were happy living together.
Right Care: Staff clearly knew people well. Although recruitment was ongoing, where agency staff were used, they were supported to get to understand people’s needs and how to meet them. This meant people received person-centred support from staff who knew them well and respected their privacy and dignity.
Right Culture: The values of the registered manager and provider were embedded in the staff team. This meant the values, attitudes and behaviours of care staff supported people to be confident and empowered in living in the community.
The registered manager understood their regulatory responsibilities and shared information with stakeholders in a timely way. There was a complaints procedure and people were supported to express their views.
The staff team were positive about their roles and felt supported by the registered manager.
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 11 December 2019). We found breaches in regulations in relation to safe care and treatment, duty of candour and governance. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 31 October 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment and governance. We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements.
This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements. For those key questions not inspected, we used the ratings awarded at the last full comprehensive inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Ormsby Lodge on our website at www.cqc.org.uk.
Recommendations
We have made a recommendation about following best practice to assess staff competency to safely administer medicines.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.