Ormsby Lodge

Updated 24 August 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 conducted by one inspector.

Service and service type

Ormsby Lodge 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. Ormsby Lodge is a care home without 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.

Inspection activity started on 29 June 2023 and ended on 14 August 2023. We visited the service on 29 June 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection, including notifications. Notifications are information about specific important events the service is legally required to send to us. We received feedback from the local authority who work with the service. 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 3 people during the inspection and carried out observations of other people who were unable to have conversations with us. 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.

We spoke with 4 members of staff including care staff, and the registered manager. We reviewed a range of records. This included 4 people's care records and medicines records. We looked at 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including accident and incident records, audits and policies and procedures were reviewed. We received feedback from 3 people’s relatives and 1 external professional.

Updated 24 August 2023

About 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.