About the service:

St Oswald’s is ‘care home’ and was providing personal care providing personal and nursing care for up to 41 people. At the time of the inspection there were 36 people living at the home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Accommodation was provided on two levels with access between by lift or stairs.

People’s experience of using this service:

Systems were in place to ensure that people were protected from abuse and avoidable harm. People told us they felt safe living at St Oswald’s. There were sufficient staff to meet people’s needs and safe recruitment procedures were followed. People’s medicines were managed and administered safely and staff followed best practice to prevent and control the spread of infection. Health and safety checks were carried out to ensure the environment was a safe place for people to live.

People’s needs were assessed and regularly reviewed to ensure they received care that was effective, achieving good outcomes in line with legislation and best practice. Care was delivered by a consistent and well-trained staff group who knew people well. There was a choice of nutritious food available which was freshly prepared on the premise and catered for people’s individual dietary needs. People were supported to have maximum choice and control of their lives and the service followed the principles of the Mental Capacity Act 2005 (MCA).

People were cared for by staff who were kind, caring and respectful and their privacy was respected. There was a warm and friendly atmosphere and people were at ease in staff’s company. People were supported to maintain their independence.

The service was responsive to people’s changing needs. Care and support plans were person-centred and included information about people’s likes, dislikes and interests. There was a varied programme of activities available which considered people’s individual needs and wishes. People knew who to speak with if they had a concern or complaint, but were keen to tell us that they did not have any.

The service was well-led. People, staff and visitors were complimentary about the difference the current registered manager had made since their arrival. Systems were in place to assess and monitor the quality of the service. The registered manager was pro-active in seeking opportunities to develop and improve the service to provide outstanding care. Staff felt well supported and had opportunities to develop their skills. Staff demonstrated a clear understanding of the provider’s values which were at the heart of service delivery.

Rating at last inspection: At the last inspection the service was rated Requires Improvement. (5 April 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 the key questions Safe, Responsive and Well-led to at least Good. At this inspection we found that the service had improved and all key questions were rated Good.

Why we inspected: This was a planned inspection based on the previous rating.

Follow up: We will continue our on-going monitoring of the service and all information we receive. We will use this information to determine when we next inspect the service.

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

The inspection took place on the 18 and 19 December 2017 and was unannounced.

St Oswalds was previously inspected in January 2017. During the inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We found that the registered person had failed to undertake a Mental Capacity Assessment before seeking authorisation to deprive people of their liberty. Furthermore, we found that the registered person had failed to clearly demonstrate that staff employed by the service had received training appropriate to the work they perform.

At this inspection we found that the registered provider had taken action to address the breaches identified at the last inspection.

During the inspection we found a breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 related to: governance. You can see what action we told the provider to take at the back of the full version of this report

St Oswalds is a ‘care home’ operated by brighterkind (Domo) Limited (the provider). People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.

St Oswalds is a two storey Victorian building with a single storey extension that is situated in the centre of Winwick. A range of shops and other local facilities are within walking distance of the home and the village is supported by good public transport services.

The care home accommodates up to 41 people in one adapted building. All rooms are for single occupancy and 18 are equipped with en-suite facilities. Communal bathing and toilet facilities are located throughout the home. At the time of our inspection, the service was accommodating 36 older people with a diverse range of needs.

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.

During our two-day inspection, we spoke with relatives, staff and people living in the care home. We also undertook direct observations of the standard of care provided.

Throughout our inspection we observed that staff treated people with dignity and respect and were attentive and responsive to their individual needs. People living in the care home were seen to be relaxed in the presence of staff, comfortable in their home environment and presented as well-groomed and content.

We found that assessment, care planning and risk management systems were in place that confirmed the holistic needs of people using the service were identified, planned for and kept under review. This helped staff to be aware of the support needs of people living in the care home and to understand how best to support them.

Staff had access to induction, mandatory and service specific training to help them understand their roles and responsibilities. Policies and procedures relating to the Mental Capacity Act and Deprivation of Liberty Safeguards had also been developed to provide guidance to staff.

Staff spoken with demonstrated a good understanding of this protective legislation and the need to protect the rights of vulnerable people who may lack capacity. 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 range of health care professionals to help maintain their health and wellbeing. Likewise, people were provided with a range of wholesome and nutritious meals and alternative choices were available if people did not like the meals that were on offer.

Systems had been

This inspection was unannounced and took place on 12 and 13 January 2017.

This was the first inspection of St Oswalds following a change of service provider.

St Oswalds is a residential care home providing accommodation, personal and nursing care for up to 42 older people, some of whom are living with dementia. The service is provided by brighterkind (Domo) Limited.

The home was first registered in 1987 and consists of a two storey Victorian building and a single storey extension. All rooms are single occupancy and eighteen are equipped with en-suite facilities.

During our two-day inspection the service was accommodating 35 people.

At the time of the inspection there was no registered manager at St Oswalds. 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 provider had appointed a new manager following the recent resignation of a registered manager, who was in the process of applying for registration with the Care Quality Commission.

The manager was present during the two days of our inspection and engaged positively in the inspection process together with her regional manager. The manager was observed to be friendly and approachable and operated an open door policy to people using the service, staff and visitors.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of need for consent and staff training. You can see what action we told the provider to take at the back of the full version of this report.

During our inspection we spent time talking with people and undertaking observations within the home. We noted that people received care and support in a timely manner, which was also responsive to their individual needs. We noted that staff were attentive to people and communicated and engaged with them in a kind, caring and compassionate manner. We also saw that people were encouraged to maintain their independence and to follow their preferred routines and lifestyle.

The provider had developed a corporate care planning system and we found that people had undergone an assessment of their needs and that care plans had been developed for them to, ensure staff understood how to respond to individual needs and risks.

People had access to health care professionals subject to their individual needs and medication was ordered, stored, administered and disposed of safely.

People had access to a choice of menu which offered a varied, balanced and wholesome diet.

Audits had been established to monitor service operations and systems were in place to safeguard people from abuse and to respond to complaints.