This was an unannounced inspection carried out on 31 May 2018.

At the previous inspection in May 2017, we identified some improvements were required in two key areas we inspected; ‘Safe’ and 'Well-led'. This resulted in the service having an overall rating of 'Requires Improvement'. One breach of regulation was found, this was with regard to the Care Quality Commission (Registration) Regulations 2009, the registered provider had not notified us of information they were required to inform us about. The registered provider sent us information on how they intended to improve the rating to at least ‘good’. At this inspection we found some improvements had been made however some improvements were still required.

OSJCT Whitefriars is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single packages under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

OSJCT Whitefriars can accommodate up to 57 older people and people living with dementia. On the day of our inspection, 45 people were living at the service. The accommodation is a purpose built, single storey property. It is divided into five self-contained units or 'households' each of which has its own communal facilities and bedrooms. The households are called Fern, Poppy, Lavender and Primrose in each of which nine people can live. The other household is called Jasmine where 20 people can live. All of the households are intended to accommodate people who live with dementia, with Primrose and Jasmine being reserved for people who need the most support.

The service had a registered manager at the time of our inspection who had been in post since March 2018. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered provider had safeguarding policies and procedures and staff were aware of their responsibility to protect people from avoidable harm and abuse. However, a concern was identified in how the management team had responded to a recent allegation of abuse. Risks associated with people’s needs had been assessed. Whilst staff were aware of people’s needs, recorded information to instruct and guide staff of how to manage risks, lacked detail or was out of date. Risks associated with the environment and premises had been assessed and were monitored regularly.

Safe staff recruitment checks were completed before staff commenced employment. The registered provider used a dependency tool to assess people’s needs and staffing levels required. However, the deployment of staff required reviewing to ensure this was effective in meeting people’s needs.

Some shortfalls were identified in the management of some medicines and with some of the infection control measures in place.

People were not always supported to have maximum choice and control of their lives and staff did not always support them in the least restrictive way possible; the policies and systems in the service were not always followed. Where people lacked mental capacity to consent to their care and support, assessments to ensure decisions were made in their best interest had not always been consistently or fully completed. Where people had a Deprivation of Liberty Safeguards (DoLS) authorisation, staff were aware of this and the person was cared for effectively.

People’s nutritional needs had been assessed, but information to guide and instruct staff either lacked detail or was out of date. People received a choice of meals and drinks and support to eat and drink where required.

The registered provider had policies and procedures that were based on current legislation and best practice guidance. Staff

This was an unannounced inspection carried out on 30 May 2017 and 1 June 2017.

OSJCT Whitefriars can provide accommodation and personal care for 57 older people and people who live with dementia. There were 51 people living in the service at the time of our inspection. The accommodation is a purpose built, single storey property. It is divided into five self-contained units or ‘households’ each of which has its own communal facilities and bedrooms. The households are called Fern, Poppy, Lavender and Primrose in each of which nine people can live. The other household is called Jasmine where 20 people can live. All of the households are intended to accommodate people who live with dementia, with Primrose and Jasmine being reserved for people who need the most support and reassurance.

The service was run by a company who was the registered provider. At this inspection the company was represented by an assistant operations director. There was a registered manager in post. 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. In this report when we speak both about the company (as represented by the assistant operations director) and the registered manager we refer to them as being, ‘the registered persons’.

At our last inspection on 26 January 2015 we found that a number of improvements needed to be made to ensure that the service was well led so that people reliably received safe care. The improvements included making sure that medicines that had not been given were recorded correctly, other care records were accurate, people were promptly assisted to dine and robust security checks of the accommodation were completed. At this inspection we found that each of these particular concerns had been addressed.

However, at this inspection we also found that other shortfalls needed to be addressed. One of these was a breach of the Care Quality Commission (Registration) Regulations 2009. This was because the registered persons had not promptly informed us about a number of significant events that had occurred in the service. You can see what action we told the registered persons to take in relation to this breach of the regulations at the back of the full version of this report.

We also found that parts of the accommodation were not clean and that full background checks had not always been completed before new staff were employed. In addition, medicines had not always been managed safely. Furthermore, the registered persons had not always ensured that there were enough care staff on duty. However, people had been helped to avoid preventable accidents and care staff knew how to safeguard people from situations in which they might experience abuse.

Although some care staff had not received all of the training the registered persons considered to be necessary, in practice they had the knowledge and skills they needed. People were supported to eat and drink enough and care staff ensured that people received all of the healthcare they needed.

The registered persons had ensured that whenever possible people were helped to make decisions for themselves. When people lacked mental capacity the registered persons had ensured that decisions were taken in people’s best interests.

The Care Quality Commission is required by law to monitor how registered persons apply the Deprivation of Liberty Safeguards under the Mental Capacity Act 2005 and to report on what we find. These safeguards protect people when they are not able to make decisions for themselves and it is necessary to deprive them of their liberty in order to keep them safe. In relation to this, the registered persons had ensured that people only received lawful care.

Care staff were kind and compassi

We spoke with 11 people who used the service. They told us that they were happy living in the service. One person said, “I am very happy here.” Another person said, “It is absolutely wonderful." Another said, “Gold stars all round.” Another person said, "I couldn't wish for better."

We looked at the care records of six people who used the service and found that people experienced care, treatment and support that met their needs and protected their rights. Before people were provided with care, they were asked for their consent. We found that the service worked with other professionals involved in people's care which ensured that they were provided with a consistent service that met their needs.

We looked around the service and found that people were provided with a clean and hygienic environment to live in. Equipment used in the service was regularly checked and serviced to ensure that it was fit for purpose and safe to use.

We looked at four staff personnel records which showed that staff were trained and supported to meet the needs of the people who used the service. We saw that the appropriate checks were made on staff before they started to work in the service to ensure that they were able to work with vulnerable people.

Records seen, including people's care records and staff records were accurate and up to date.

We spoke with four members of staff. One told us, "The home is kept very, very clean and the residents really seem to enjoy it here." One person who lived at the home said, "What you're seeing today is what its like all the time. You never have to ask for anything more than once." We spoke with a person's relative who commented, "I like the cleanliness and ambience of the home as well as the staff enthusiasm from the moment you walk in."

The inspection took place on 26 January and 27 January 2015 and was unannounced.

OSJCT Whitefriars is registered to provide accommodation and personal care for up 57 older people or people living with dementia. There were 54 people living at the service on the day of our inspection. The service is divided into three areas, the main home that can accommodate 26 older people and two further areas, called Primrose and Jasmine where up to 28 people living with dementia are accommodated.

There was a registered manager in post at the time of our inspection. 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.

The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act, 2005 and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves or others. At the time of the inspection one person had their freedom restricted lawfully.

People felt safe and were cared for by kind and caring staff. Staff knew what action to take and who to report to if they were concerned about the safety and welfare of the people in their care. However, we saw that there were some areas where safety and security within the home could be improved.

People were supported to have nutritious and well-presented food. We found that there was choice and the availability of snacks and hot and cold drinks to ensure that people always had enough to eat and drink.

People were supported by designated activity coordinators to maintain their hobbies and interests. People told us that they were supported to maintain interests outside of the service and enjoyed trips out in the min-bus.

Staff were aware of people’s choices and preferences and had the knowledge and skills to undertake risk assessments to provide for people’s personal, physical, social and psychological care needs.

The provider had not identified that there were some weaknesses in the systems to monitor some aspects of the quality and safety of the service.

There was a positive culture in the home where staff enjoyed their work