Archived: Osman House

At our last inspection we rated the service good overall. At this inspection we found the evidence continued to support the rating of good with responsive improving to good, and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The inspection took place on 27 June 2018 and was unannounced. At the last inspection on 29 January 2016 we found a breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) 2014 because the provider had not made sure people received care to meet their needs and which reflected their preferences.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question of responsive to at least good. We found that the provider had reviewed and changed the way in which care was planned and reviewed. The care planning and review process was more structured and ensured people’s current needs and preferences were reflected in the documentation.

People felt safe and staff had been trained and understood their responsibilities around safeguarding adults and reporting concerns.

Risks to people’s physical and mental health had been identified and guidance was available for staff to manage those risks. The environment and equipment was safely maintained.

Staff recruitment was robust and there were sufficient staff on duty to meet people’s needs. Staff were well trained in basic care and in specialist subjects giving them the knowledge they required to care for people who used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had access to a clinical team within the service and other healthcare professionals from the community such as their GP or community mental health team. They each had a health passport with details of their care needs, for those times they needed to visit other services such as hospitals.

Staff maintained positive relationships with people and showed care and compassion in their interactions.

Staff were caring maintaining positive relationships with people. They consulted people about the way in which they wished to receive their care and supported them through the rehabilitation process giving practical and emotional support.

There was a quality monitoring system in place which identified where improvements were needed. One medicine recording error had not been identified but the manager investigated and provided a report immediately following the inspection. Lessons were learned from this as measures were put in place to make sure this was not repeated. There had been no impact on people.

People and staff were invited to share their views and give feedback about the service. They attended regular meetings where they could discuss any issues related to the day to day running of the service.

Further details can be found in the main report.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

Is the service safe?

We looked at the systems in place for managing medicines in the service. We reviewed general storage and handling as well as a sample of Medication Administration Records (MARs), stock and other records. We also observed the administration of medicines. Overall we found appropriate arrangements for the ordering, recording, administration and safe handling of medicines were in place.

The provider responded appropriately to any allegation of abuse. Where concerns had been raised in the past, we found the provider had appropriately reported matters to the local authority safeguarding team and the Care Quality Commission (CQC). We found the provider had cooperated with investigations and had implemented actions to prevent reoccurrence or to maintain people's safety.

The provider had taken action to check if people who used the service were being deprived of their liberty under Deprivation of Liberty Safeguards (DoLS). We checked people's DoLS paperwork and found applications were in the process of being submitted.

Is the service effective?

We found people living at Osman House were involved in regular reviews of the care and support they received, both from the psychologists and the wider community health services. We were told by the assistant psychologist that everyone had an allocated session each week to discuss how things were going and to determine if people's programmes were effective and appropriate.

Is the service caring?

We observed the interaction between staff and people who used the service throughout our visit. It was clear staff knew people well. We saw the way staff approached people was tailored to meet the needs of the individual. Staff were both professional and caring in how they communicated with people.

A member of staff we spoke with said, "I believe people are happy living here, we promote independence and people live in comfortable surroundings."

Is the service responsive?

We saw information on making a complaint was displayed in the home. Staff told us they tried to resolve any issues people raised and people could approach the manager at any time. We looked at the complaints log and saw detailed records of the complaint, how the complaint had been investigated, feedback to the complainant and if the person was happy with the response.

Is the service well led?

The quality of the service was audited by senior managers of the organisation who undertook monthly 'provider visits', during which they talked with people who used the service, talked with staff and ensured the building was safe. We saw evidence of such internal quality monitoring. This included an action plan with actions and dates for completion.

Staff were generally appropriately supported. We saw the matrix for staff one to ones and 'personal development review' (PDR) we found one to one meetings had taken place, however, staff had not received their PDR. This had been identified in the 'provider visit' the action was 'to collate supervision/PDR data' and it had been noted during the June 2014 visit that 'most records had been gathered'.

Where people had no family or personal representative we saw the service provided information about advocacy services. This was on display on the notice boards and in individual care plans.

During our visit we observed people's experiences of living in the service and their interactions with each other and with staff. We saw people looked well-presented and seemed relaxed and well cared for. It was clear from observations of staff interactions with people living in the service that they knew people very well.

The people we spoke with said the environment was clean and in good repair. We looked at some of the communal areas of the service, bathrooms, some people's bedrooms and the laundry area. We found all the areas to be clean and satisfactorily maintained.

There were effective systems in place to reduce the risk and spread of infection. Staff told us that specific cleaning routines were in place to maintain hygiene standards.

Appropriate checks were undertaken before staff began work. There were effective recruitment and selection processes in place.

People spoken with said they had no concerns or complaints about Osman House at this time.

The service had a complaints policy and procedures were in place to provide staff and people who used the service with information on how to make a complaint and how this would be handled.