Background to this inspection
Updated
12 January 2024
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection team consisted of 2 inspectors and an Expert by Experience who made calls to relatives after the inspection to ask them for feedback. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 4 months and had submitted an application to register. We are currently assessing this application.
Notice of inspection
This inspection was unannounced.
Inspection activity started on 19 October 2023 and finished on 3 November 2023.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
We used all this information to plan our inspection.
During the inspection
During our visit to the office, we met and spoke to the manager and the head of operations. We reviewed a range of records which related to people's care and the running of the service. These records included 10 people's care records, 14 staff personnel records and policies and procedures relating to the management and quality monitoring of the service. We spoke to 10 relatives and 8 people who use the service. We continued to seek clarification from the provider to validate evidence found. We requested additional evidence to be sent to us after our inspection. We received the information which was used as part of our inspection.
Updated
12 January 2024
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Oasis Care and Training Agency (OCTA) is a domiciliary care agency. It provides personal care to people living with dementia and people with learning disabilities living in their own homes. At the time of our inspection the agency was providing a service of personal care to 210 people.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.
Right Support
People's mental capacity assessments were not always clear as to whether the assessment and decision was in the person's best interest and if this was the least restrictive measure. Staff respected people's choices and supported them to make decisions about their day-to-day care.
Right Care
Risk assessment and care plans required further development to be clear on individual support needs. There were examples where in places they were not coordinated, this meant that people may not get the most effective support. People received kind and compassionate care.
Positive risk taking was not always encouraged or enabled. Risk assessments were undertaken but these were sometimes basic and lacked individual detail.
Staff protected and respected people's privacy and dignity. They understood and responded to their individual needs.
Right Culture
The provider's systems for monitoring and improving the service were not always implemented effectively. They had failed to identify and plan for risks people were exposed to. The staff did not always have relevant training and supervision.
Staff had received training but did not have a good understanding of best practice models of care. This meant people did not always receive tailored support that empowered them as an individual.
People using the service and their relatives liked their individual care.
For more details, please see the full report which is on the CQC website at
The last rating for this service was good (published 23 January 2021).
Why we inspected
The inspection was prompted in part due to concerns received about staffing. A decision was made for us to inspect and examine those risks.
The overall rating for the service has changed from good to inadequate based on the findings of this inspection.
Enforcement and Recommendations
We have identified breaches in relation to the safe care and treatment, the lack of robust recruitment and staff levels, training and supervisions. We have also identified breaches in relation to the lack of care planning, lack of understanding of capacity assessments and lack of effective audits and risk assessments.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.