OSJCT Ermine House

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care. The service was in breach of the legal regulation in relation to governance at the service.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Shared direction and culture during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Capable, compassionate and inclusive leaders during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Freedom to speak up during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Workforce equality, diversity and inclusion during this assessment. The score for this quality statement is based on the previous rating for Well-led.

Risks regarding window safety had not been sufficiently assessed to keep people safe. Smaller windows on the ground and first floor had not been effectively assessed to ensure there was not a risk to people who could potentially climb out or fall from height if left unrestricted. The provider had completed a risk assessment, however there was no consideration for the cognition of the people who used the service or furniture that may have enabled access to the windows. The efficiency of the risk assessment had been highlighted at a recent inspection for another of the provider’s services; however, actions were not taken at this service to ensure risks had been properly assessed. Care plans did not always contain clear guidance for staff to ensure they knew how to support people in line with their assessed needs. Some people’s medicine care plans contained very limited or no information. For example, there was no information about risks associated with high-risk medicines and drug toxicity. Diabetes care plans were inconsistent in quality and information contained in them. For example, information was not included for people who required insulin to control their diabetes to ensure staff knew what their normal blood glucose levels were and what to do if they were out of range. Audits had not been effective in ensuring records were made appropriately by staff. Daily notes contained minimal information and did not evidence people were being supported in line with their assessed needs. For example, there were only 2 records made in 2 weeks to show staff had supported a person with their continence when their care plan stated they required full support. Care plans contained information about ongoing treatment people required with no evidence this had been carried out. For example, when a person had been falling more regularly, a blood test was requested to investigate possible causes. However, it was not clear if this had been carried out as records had not been updated.

We did not look at Partnerships and communities during this assessment. The score for this quality statement is based on the previous rating for Well-led.

We did not look at Learning, improvement and innovation during this assessment. The score for this quality statement is based on the previous rating for Well-led.