Archived: Oakmere

At the last inspection the service was rated good. At this inspection we found the service remained good.

People continued to be safe from the potential harm of abuse or ill-treatment as staff knew how to recognise and respond to such concerns. People were supported by enough staff to meet their needs. People were assisted with their medicines safely.

The provider followed safe recruitment procedures when employing new staff members.

Staff members had the training and skills to meet people’s individual needs. Staff members were supported by a management team in order to complete their job.

People had care and support plans that were personal to them and reflected their individual needs and preferences. Staff members knew the people they supported well.

People were supported to have choice and control over their lives. Staff were aware of current guidance which directed their practice and people’s individual rights were protected by the staff who supported them.

People received support that continued to be caring and kind. People had their privacy and dignity respected by those supporting them. People were supported by staff members when they felt upset or worried.

Staff members knew people’s support needs and assisted them in the manner they preferred. People and their relatives were encouraged to raise any concerns or complaints. The provider had systems in place to address any issues raised with them.

The management team were approachable and supportive. People receiving services from SOS Homecare felt involved and their suggestions were valued by the provider.

Staff members felt valued as employees and their opinions and ideas were listened to by the provider. The provider had systems in place to monitor the quality of service and where necessary made changes to drive improvements.

Further information is in the detailed findings below.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

Staff felt they were up to date with their training in safeguarding, Staff told us they wouldn't hesitate to report any concerns to their line managers and were aware of their duty of care to protect vulnerable adults.

We noted some improvements in the management of safeguarding in that they now had the local authority safeguarding policy and that all staff were updated in safeguarding training.

We found continued risks and weaknesses with the overall support and management of medications for service users. People were at serious risk of medication errors which may affect their health and well-being.

Some people made comments that indicated that whilst the attitude of staff was good, there were issues relating to the numbers of staff available, their punctuality and the consistency of the service

Is the service effective?

Seventeen people living at Oakmere and three relatives told us they were mostly happy with the care that had been provided to them and their relatives. Staff were positive about the changes made to the service and the positive impact of having a deputy manager. Overall the majority of people using the service were positive about the staff.

Each person living at the service had a support plan in place to help to show how their needs were being met by the staff team. These records had been reviewed since our last visit. Out of date information have been removed.

Care records had consent forms that some people had signed regarding the management of their records. People told us they had discussed their care plans with staff and they had recently been included in discussions about their care plan.

There were various gaps in staff training needs in topics such as the Mental Capacity Act; infection control and food hygiene. The service had no overall plan to show what actions and dates were being planned to ensure all staff were fully trained and up to date in all other topics necessary for their role.

Is the service caring?

People living at Oakmere made general positive comments about the staff such as,

"I would trust most of the care staff with my life"; 'All very nice, feel safe here, like old friends'; 'They are a fine set of girls, cannot fault them'; 'Its fine' and 'Carers are alright, I know them all."

Two relatives and one person using the service were unhappy with various aspects of care provided. We have referred them to the provider to review their concerns. We have also discussed their concerns with the local authority commissioning team.

Is the service responsive?

We noted that some comments and concerns had been recently captured within the surveys sent out to everyone in August by the provider. However they had not analysed the results of the surveys as senior managers advised they were waiting for more to be submitted. There was no evidence that each person's concern had been dealt with and we noted similar comments shared with the inspection team during our visit by a small number of relatives and people using the service.

We spoke with two relatives who raised concerns about their family members care. Their concerns had not been documented as complaints. Their concerns had not been followed up or acknowledged by the manager.

Is the service well-led?

Staff told us they felt well supported by the managers from SOS Home care. A lot of people responded positively to the deputy in post who now worked 40 hours a week supernumerary.

The manager and provider quality checks at the service required further development. Improvements were needed in the present arrangements for monitoring of the service, specifically with the management arrangements and engagement with people using the service; safeguarding; complaints; medications and training and supervisions of staff. Both service users and relatives took the opportunity to express their opinions and suggestions for improvements to the service.

We noted continued concerns with the management, non-reporting and lack of transparency in notifications regarding safeguarding and incidents involving the police. The service had not reported a number of incidents to the Care Quality Commission (CQC) which is a legal requirement to ensure transparency of the management of the service.

' Is the service safe?

' Is the service effective?

' Is the service caring?

' Is the service responsive?

' Is the service well-led?

This is a summary of what we found-

Is the service safe?

People living at Oakmere told us that staff were always rushing and often late for their visits and in their opinion they felt the staffing levels were too low and they needed more staff. The staff team were short staffed as they had one staff member less than stated on the duty rota as a staff member did not arrive for duty on the day of our visit. This impacted on the workload and quality of care provided and correlated to the opinions of people who received support from the service. We noted two complaints during our inspection, one related to a drop in the standard of care provided and another related to the lack of choice provided in the gender of staff providing personal care.

Staff were confident they would be listened to by the provider and supported with reporting procedures to safeguard people living at Oakmere. However, some staff had not received updated training in safeguarding which put the management of maintaining people's safety at risk. The overview and management of risks was poorly managed and lacked any evidence of risk assessments to show effective actions to keep people safe. The service had not reported a number of incidents to the Care Quality Commission (CQC) which is a legal requirement to ensure transparency of the management of the service. Following our visit we have met with the provider and they have told us they do have risks assessments in place.

Is the service effective?

Seven people living at Oakmere and two relatives told us they were mostly happy with the care that had been provided to them and their relatives. However they did not want to express any more details about a small minority of staff who they felt were, "just ok."

Staff described the support they provided on a day to day basis and felt it was difficult when they were working with lower than usual numbers. They felt they tried their best to get all of the work done and wished they could bring in agency staff to help when their staffing levels were lower than usual.

Is the service caring?

People living at the service made general positive comments about the staff such as:

"The staff have been ok, they are caring"; "The care is fantastic" and "The staff are mostly very caring".

Relatives were positive about staff but they told us they were unhappy in having to repeatedly raise concerns about the standards of care offered by some staff and the lack of choice in the gender of staff providing personal care. There had been no effective review of their comments and concerns. The manager agreed to review their concerns following our inspection.

Is the service responsive?

Each person living at the service had a support plan in place to help to show how their needs were being met by the staff team. These records were regularly reviewed, however most care files still stored documentation relating to the previous provider. This meant that some people had out of date information about the service relating to the providers complaints procedure and information about SOS Homecare.

Is the service well-led?

Prior to our inspection we had received an anonymous complaint about the staffing levels, the lack of training and the administration of medications. We used this information to help us plan our inspection. We found that these areas needed reviewing by the provider to produce improved compliance and standards in the management of staffing; training and the management of medications.

Staff told us they felt well supported by the managers from SOS Home care. However, they believed improvements could be made in relation to: Managing staffing levels and training and facilities for staff to work in.

People living at Oakmere also shared their views about how they would like the service to be improved. They wanted staffing levels reviewed and a simpler way to raise issues and conversations about the service. They also wanted their comments about service users acting inappropriately while living at Oakmere be reviewed.

There was limited evidence of engagement with people living at the service and the provider. Both service users and relatives took the opportunity to express their opinions and suggestions for improvements to the service. Following our visit we met with the provider and they advised that they do regularly visit the service and that the manager held 'surgeries' and coffee mornings for people to attend.

A range of policies were in place and accessible by all staff. However, some policies were in need of review. These policies created risks to the staff team who needed updated information to ensure the safe management of the service.

The manager and provider quality checks at the service required development. Improvements were needed in the present arrangements for monitoring of the service, specifically with the management arrangements and engagement with people using the service; safeguarding; complaints; medications; training and supervisions; staffing levels and general incidents.