About the service

Osborne House is a modern, purpose built nursing and residential care home. The service can support up to 74 people over three floors, each of which has separate facilities. The top floor specialises in providing residential care to people living with dementia. The service was providing personal and nursing care to 55 people aged 65 and over at the time of the inspection.

People’s experience of using this service

People told us they felt safe and well supported by the staff. The provider followed robust recruitment checks to employ suitable staff, and there were sufficient staff employed to ensure care was carried out in a timely way. People's medicines were managed safely.

Staff received appropriate training to give them the knowledge and skills they required to carry out their roles. This included training on the administration of medicines and on how to protect people from the risk of harm. Staff received regular supervision to fulfil their roles effectively and had yearly appraisals to monitor their work performance.

People had 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.

There was a planned programme of activities open to everyone living in the service. However, further development was needed to ensure people living with dementia were able to take part in suitable social activities and events.

Staff knew about people's individual care needs and care plans were person-centred and detailed. People and relatives gave us positive feedback about the staff and described them as "Excellent, caring and friendly." We were told the staff treated people with compassion, dignity and respect.

People told us that the service was well managed and organised. The registered manager assessed and monitored the quality of care provided to people. People and staff were asked for their views and their suggestions were used to continuously improve the service.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection and update - At the last inspection the service was rated requires improvement (published 26 May 2018).

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider is no longer in breach of regulations.

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This inspection took place on 6 and 13 March 2018 and was unannounced on day one.

Osborne House (the service) is registered to provide accommodation for up to 74 older people some of whom live with dementia. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and care for people living with dementia on the third floor. The home is set in private secure gardens. There is a car park for visitors.

People in care homes receive accommodation and personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection, the service was rated Good.

The provider is required to have a registered manager. A registered manager is a person who has registered with CQC to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The manager of the service had submitted an application to register with CQC and this was being processed.

The quality of the record keeping varied and some care records we looked at were not personalised and were inconsistent or incomplete. This meant staff did not have an up to date record of people’s care and treatment.

The manager of the service was not available to assist us on day one of inspection and the service was being managed by senior nurses and care staff. We found there was a lack of direction under their leadership which impacted on the care given to people. Care was task based although the staff were patient and kind with people. People were sat in the same position for hours at a time, with no interactions from staff. Meals were late going out at lunch time and people told us the meals were cold when they got them.

The regional manager dealt with our concerns on day one of the inspection and the manager took further action when they returned to work. People and relatives gave positive feedback about the service. They said the issues raised on day one of inspection were not reflective of their usual care and treatment when the manager was in post.

People told us they felt safe and were well cared for. The provider followed robust recruitment checks, to employ suitable people. There were sufficient staff employed and on duty that they should have been able to assist people in a timely way. Medicine management practices were reviewed by the manager and medicines were given safely and as prescribed by people’s GPs.

Staff had completed relevant training. We found that the nurses and care staff received regular supervision and yearly appraisals, to fulfil their roles effectively.

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 were able to talk to health care professionals about their care and treatment. People could see a GP when they needed to. They also received care and treatment from external health care professionals such as the district nursing team and speech and language therapists (SALT).

People were treated with respect and dignity by the staff. People and relatives said staff were caring and they were happy with the care they received and had been included in planning and agreeing the care provided.

People had access to community facilities and a range of activities provided in the service. People and relatives knew how to make a complaint and those who spoke with us were happy with the way any issues they had raised had been dealt with.

People told us that the manager was approachable, open and honest. People and staff were asked for their views and their suggestions were used to continuously improve the servi

This inspection took place on 26 and 27 April 2016 and was unannounced. At the last comprehensive inspection of this service on 18 and 19 of February 2015 shortfalls were identified in relation to record keeping and auditing. This was a breach of Regulation 17 HSCA (RA) Regulations 2014. Also shortfalls were identified in relation to medicines administration, and we made a recommendation about this. We carried out a focused inspection on 7 August 2015 to follow up on these concerns. We found that practice had improved in both areas but we did not change the rating as to do so required consistent good practice over time. At this comprehensive inspection, improvements in these areas had been maintained.

Osborne House is registered to provide accommodation for up to 74 older people some of whom lived with dementia. There were 51 people living at the service when we inspected. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and care for people living with dementia on the third floor. The home is set in private secure gardens. There is a car park for visitors. The home is situated in Selby close to local amenities.

The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Medicines were safely handled and risks were well assessed to protect people.

Staff were able to tell us what they would do to ensure people were safe and people told us they felt safe at the home. The home had sufficient suitable staff to care for people and staff were safely recruited. The environment of the home was safe for people and monitoring checks were regularly carried out. People were protected by the infection control procedures in the home.

Staff had received training to ensure that people received care appropriate for their needs. Training was up to date across a range of relevant areas.

Staff had received up to date training in Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff understood that people should be consulted about their care and they understood the principles of the MCA and DoLs. People were protected around their mental capacity.

People’s nutrition and hydration needs were met. People enjoyed the meals and they were of a good quality. The registered manager was completing some work with a small number of people who lived at the service and visitors about elements of dissatisfaction over the meals. Specialist advice around people’s health care was sought and followed.

People were treated with kindness and compassion. We saw staff had a good rapport with people whilst treating them with dignity and respect. Staff had a knowledge and understanding of people’s needs and worked together well as a team. Care plans provided detailed information about people’s individual needs and preferences. Records and observations provided evidence that people were treated in a way which encouraged them to feel valued and cared about.

People were supported to engage in daily activities they enjoyed and which were in line with their preferences and interests. Staff were responsive to people’s wishes and understood people’s personal histories and social networks so that they could support them in the way they preferred. Care plans were kept up to date when needs changed, and people were encouraged to take part in drawing up their care plans, their reviews and to give their views which were acted upon.

People told us their complaints were responded to and the results of complaint investigations were clearly recorded. Everyone we spoke with told us that if they had concerns they were always addressed by the registered manager w

We carried out an unannounced comprehensive inspection of this service on 18 and 19 February 2015. At this inspection we found a breach of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. This was in relation to Regulation 17 HSCA (RA) Regulations 2014 Good Governance.

The provider had failed to ensure there was a system in place to assess and monitor the quality of the service. This meant people were at risk of receiving unsafe care, treatment and risks associated with unsafe care and treatment. We asked the provider to make improvements in those areas following our inspection of the service.

We also recommended the provider ensure that monitoring and the corrective action implemented, in relation to the management of medicines, be maintained to ensure that the services policies and procedures were followed.

After the comprehensive inspection, the provider wrote to us with an action plan to say what they would do to meet legal requirements in relation to the breach and the recommendation.

We undertook this focused inspection on 7 August 2015, to check that the provider had followed their plan and to confirm that they now met with the legal requirements. This inspection was unannounced. This report only covers our findings in relation to that requirement. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Osborne House on our website at www.cqc.org.uk.

Osborne House is registered to provide accommodation for up to 74 older people some of whom live with dementia. There were 50 people living at the service during our inspection. The service was purpose built; there were various communal areas for people to access. Each bedroom had ensuite facilities, in addition to communal bathrooms.

Accommodation was provided over three floors; residential care was provided on the ground floor, nursing care on the first floor and residential dementia care on the third floor. The home was set in private secure gardens. There was a car park for visitors. The home was situated in Selby close to local amenities.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Improvements had been made to the management of medication. The service had developed effective systems to audit medication, they had provided additional training and competency checks for staff who administered medication. This meant people were protected from the risks associated with poor management of medicines.

Improvements had been made to the management systems at the home in making sure the service was operating safely and effectively. The processes for monitoring and reviewing improvement now provided clear instruction for staff.

The provider completed monthly management reviews to assure themselves the service was adhering to the organisations policies and procedures.

The registered manager was approachable and had developed strategies to ensure people, and their relatives, had the opportunity to give feedback on the service. They demonstrated a willingness to learn from feedback. They were keen to develop the service to ensure people received a good standard of care.

This inspection took place over two days, 18 and 19 February 2015 and was unannounced. This was our first inspection of this service since it registered with us.

This service is registered to provide accommodation for up to 74 older people some of whom lived with dementia. There were 48 people residing at the service during our inspection. Accommodation is provided over three floors; residential care is provided on the ground floor, nursing care on the first floor and dementia care on the third floor. The home is set in private secure gardens. There is a car park for visitors. The home is situated in Selby close to local amenities. Staff are available 24 hours a day to support people.

The home has a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have the legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People who used the service were cared for by staff who understood they had a duty to protect people from harm. Staff knew how to report abuse and said they felt able to raise any issues, which helped to keep people safe.

People received the care and support they needed to receive. However, we found there were some minor issues with the medication systems in some areas of the home. We have made a recommendation regarding this.

We observed there were enough staff available to support people. Staff knew people’s care needs and risks to their health and wellbeing which enabled them to support people appropriately. Training was provided to all staff to help them to develop and maintain their skills.

People lived in a well maintained, clean environment. Bedrooms were personalised with memory boxes placed outside people’s bedroom doors to help them find their bedroom. Pictorial signage was provided to help guide people to bathrooms, toilets and lounge areas.

People were offered home cooked food with appropriate fluids to maintain their nutrition. Those who required prompting or support to eat were assisted by patient and attentive staff. People’s dietary intake was recorded and staff gained help and advice if people were losing weight. This ensured that people’s nutritional needs were met.

Visiting health care professionals we spoke with informed us they had no concerns about the service people received and they were positive about the help and support provided to people by staff. They confirmed staff acted upon their advice to promote people’s health and wellbeing.

People were involved in making decisions about their care. Staff supported people to make decisions for themselves. People’s privacy and dignity was respected.

A complaints procedure was in place, anyone wishing to make a complaint could do so. We saw two complaints had been received. There were systems in place to deal with complaints in a timely manner. Some relatives told us they would like to see more activities taking place.

People living at the home and their relatives were asked for their opinions about the service provided. The registered manager undertook regular audits which helped them to monitor and maintain the quality of the service. However, we have made some recommendations throughout the report for the registered provider to consider.