Oak Trees Care Home

We found the following examples of good practice.

All staff and people living at the service received regular COVID-19 testing. Appropriate processes were in place and followed should anyone display symptoms of COVID-19.

The service was transparent in sharing information with people and their families keeping them updated with any changes and expectations regarding government guidance and the COVID-19 pandemic.

Visits were facilitated in line with current guidance, to support people's emotional well-being. Appropriate screening and testing were completed, and visitors had access to handwashing facilities and Personal Protective Equipment (PPE).

Risk assessments had been developed for any person belonging to high risk groups and actions had been implemented where needed to help reduce risk.

Staff were seen to use PPE effectively and had undertaken the appropriate training in infection prevention and control, which included putting on and taking off PPE.

The service was clean, and cleaning of frequent touch surfaces was in place and recorded regularly by housekeeping staff.

Audits were completed and used to ensure the service was providing safe care and to promote improvement. There was an up to day Infection control policy and any changes to this policy or government guidance was cascaded to the team via daily huddle meetings.

Oak Trees is a care home providing personal and nursing care to 26 people aged 65 and over at the time of the inspection. The service can support up to 40 people.

The service accommodates people in one adapted building, which has an extension to the rear of the property. There are two floors and people can access the first floor by use of a lift or stairs.

People’s experience of using this service and what we found

Staff knew about people’s individual care needs and people said they received good support. However, care plans were not always up to date, person-centred and detailed. We have made a recommendation in the report about this.

People’s medicines were administered safely, and people said these were given on time and when needed. However, recording in the medicine administration charts and topical medicine charts was inconsistent. We have made a recommendation in the report about this.

People told us they felt safe and well supported. The provider followed robust recruitment checks, and sufficient staff were employed to ensure people’s needs were met.

Staff followed good infection protection and control standards and people said the service was clean and smelt fresh.

Communication was effective. 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 ate nutritious, well cooked food, and said they enjoyed their meals. Their health needs were identified, and staff worked with other professionals, to ensure these needs were met.

People participated in a wide range of activities within the service and in the community, they also enjoyed the company of others in the service.

People were able to see their families as they wanted. There were no restrictions on when people could visit the service. People were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.

People and relatives said the service was well-led and they were satisfied with their communication with the registered manager. Complaints were responded to thoroughly and the culture of the service was open and friendly.

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

The last rating for this service was good (published March 2017).

Why we inspected

This was a planned inspection based on the previous rating. We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Oak Trees Care Home is registered to provide nursing and personal care and accommodation for up to 40 people. The home focuses on providing care to older people. At the time of this inspection the home was providing care to 32 people.

Oak Trees Care 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.

Our previous inspection of Oak Trees Care Home took place in October 2014, when the service was given an overall rating of good. There was one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 identified at that time, relating to the safety and suitability of the premises. During this visit we found that improvements had been made and the registered provider was no longer in breach of this regulation.

Medicines were generally administered safely and as prescribed. There was a lack of clarity about some medicines that were being given ‘as required’ and the policies and procedures relating to medicines would benefit from updating. We have recommended that the registered provider consults and implements current best practice guidelines on managing medicines in care homes.

People felt safe at Oak Trees Care Home and relatives told us they thought their relations were safe and cared for.

The registered provider’s recruitment process reduced the risk of unsuitable staff being employed. Staff knew what to do if they had concerns or suspicions of abuse and felt able to raise any concerns they might have with the registered manager or provider. There were enough staff on duty to support people safely, although people acknowledged that staff were sometimes very busy.

Staff received the training and support relevant to their roles. This included encouragement to complete formal qualifications and regular supervision and appraisal of staff performance.

Staff worked within the principles of the Mental Capacity Act 2005, although the policy and procedure relating to Deprivation of Liberty Safeguards (DoLS) would benefit from review. The manager knew how to seek authorisation under the DoLS to legally deprive people of their liberty when required. However, at the time of our inspection no one living at the home was subject to a DoLS authorisation.

People received a varied choice of meals, snacks and drinks throughout the day. Food was homemade and of good quality. Nutritional needs were assessed and people’s weight was monitored.

Staff supported people to access other healthcare professionals to maintain and improve their health. Healthcare professionals we spoke with said that staff involved them appropriately in people’s care and that their advice and instructions were followed through.

People living at Oak Trees and their relatives spoke positively about the care people received. Staff were described as kind and caring. Staff knew people well and maintained people’s privacy and dignity.

An activities coordinator was employed by the home. They organised a range of activities and events and people living at Oak Trees spoke highly of their approach and input.

A complaints procedure and comments box was in place. People told us they would feel able to discuss any issues or concerns with staff.

The home was part way through transferring to a new person centred software package, which provided a comprehensive assessment, care planning and monitoring records system. Staff were being supported to implement the system with training and scheduled time to transfer people’s records onto the new system, but a formal plan with clear timescales for implementation would be beneficial in ensuring that the system was fully implemented with minimum delay or disruption.

People using the service, relatives, staff and visiting professionals spoke positively about the registered manager. There was a pleasant atmosphere at the home and people told us they were satisfied with the care provided.

Audits and checks took place and there were plans for further improvements to the environment. People had been consulted and asked for feedback about the service.

The registered provider and manager had informed CQC of certain events and displayed their inspection rating in line with legal requirements.

People told us that they were well cared for and liked living at the home. They told us that standards of care were good. People looked well cared for. We observed staff interacting with people in a polite and pleasant manner.

The home was clean and smelt pleasant throughout. There were good systems in place to monitor and control the spread of infection.

We looked at staffing arrangements. We found there were enough staff to care for people and all of the people we spoke with during our visit spoke positively of the staff.

We looked at quality monitoring sytems and found that the home had good quality monitoring systems in place.

Staff told us they felt settled and happy in their jobs, and were well supported by their manager. Comments included 'It's the best home I have ever worked in. I would not be here other wise".

People told us they felt safe living at the home and would raise any concerns they had with any of the staff. They told us that they had confidence that any issues would be rectified immediately and to their satisfaction.