Ocean Hill Lodge Residential Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. This is the first assessment for this newly registered service. We identified 2 breaches of the regulations; safe care and treatment and governance. Initial assessments were not always fully completed and some people did not have care plans. Care plans did not always accurately reflect people’s needs or guide staff on how they should support people. Systems for sharing information were not robust.

This service scored 38 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

On the first day of our on-site visits 4 people who had been admitted to the service from hospital did not have care plans. This meant staff did not have access to information about their needs or how they preferred to be supported.

Staff told us they usually received basic information about people when they first moved in. However, they said there were occasions when this did not happen. One told us, “We find a lot of the time the information we get does not reflect what they are like. We just get to know them ourselves.”

Care plans had not been kept up to date to ensure they reflected people’s current needs.

Information in one person’s care plan contained advice from external professionals. There was no evidence this advice was being followed. This meant they were not protected from identified risk. We observed people being supported to mobilise in ways which were not in line with best practice.

Staff had not received practical moving and handling training. One member of staff had recently completed on-line training for moving and handling. They told us; “I was doing it wrong, but I didn’t know.”

The service worked with district nurses to help ensure people received care in line with evidence based good practice. However, medical concerns were not consistently escalated to other agencies for advice and guidance.

Staff told us they were working together to make sure people were not affected by the changes in the service.

Staff comments included, “Staff are all chipping in. It’s a good team, we help each other out.” However, staff did not have confidence in the registered manager. One commented, “[Registered manager] is trying their hardest but it’s not really their line.”

An external professional said they had not had any concerns about the service. They commented, “Staff seem to be pulling together in what seems to be a crisis. It’s all hands on deck trying to keep things going.”

Staff had handovers when coming on shift to make them aware of any changes or areas of concern. However, there was no protected time set aside for this and staff told us they did not always have in depth information. Daily notes and handover sheets were completed but they lacked detail. The information was not consistently shared with other agencies.

There was a lack of activities available for people to engage with. People were frequently unoccupied.

Staff told us they encouraged people with gentle exercise if they had time but this was limited and they had not had training in this area. One commented, “We did some arm stretches in the lounge and they enjoyed it. We could spend more time doing things like that if we had more staff. We don’t normally have time to do it.”

Records for monitoring people’s health had not been completed in the month preceding the onsite assessment visit. This meant there was a risk any decline in people’s health would not be identified.

One person had conditions attached to their DoLS authorisation requiring the service to record when the person had been offered an activity and what the outcome was. This was not being completed.

Some staff told us they had not read the care plans. One said, “I have never read a care plan here. You get to know the residents from working with them rather than reading about them.” This meant staff might not be aware of people’s individual needs.”

Records for monitoring people’s health were sometimes contradictory. Handover records for one person recorded they had pressure damage to their skin. Their skin integrity records for the same dates recorded there was no damage. The conflicting information had not been reviewed and there was no evidence available to demonstrate action had been taken in response to the risk identified in the handover record. Staff were not always recording important observations about changes in people’s needs. For example, we heard an agency worker ask if they should record that one person was anxious. A permanent member of staff advised this was not necessary. This meant information about changes in people's mental state was not being recorded.

People’s opportunities to make daily choices was limited. However, we saw people making choices about what they ate.

Due to the low staffing levels, we saw staff discouraging people from walking around. One member of staff told us, “People do want to get up and walk around but for their safety we do try to encourage them to stay sat down.”

Some people had been assessed as lacking capacity to make specific decisions. Capacity assessment records did not evidence how people had been supported to take part in the assessment process.