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Archived: Oakleigh House Nursing Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 11 October 2018

This inspection took place on 21, 25 and 26 June 2018. We arrived on the 21 June 2018 early in the morning and did not announce our inspection. We told the registered provider that we would need to visit again on 25 and 26 June 2018.

During our previous inspection on 14 & 15 June 2017 we rated Oakleigh House Nursing Home as ‘Requires Improvement’ and found five breaches of the Health and Social Care Act (HSCA) 2008 (Regulated Activities) Regulations 2014. We found that the premises and equipment used was not secure, clean and suitable for carrying out the regulated activities, Regulation 15 premises and equipment. We found that people who used the service were not always protected from detecting and controlling the spread of infection, Regulation 12 safe care and treatment. We found that the treatment and care provided did not always reflect peoples assessed needs, Regulation 9 person-centred care. We found that the registered person failed to have an effective system in place to monitor and assess the quality of care and make improvements because of these quality assurance measures, Regulation 17 good governance. We found that treatment and care was not always provided in a safe way and the registered provider did not take reasonable steps to mitigate such risks, we served a warning notice for Regulation 12 safe care and treatment.

Following our comprehensive inspection in June 2017, the service submitted an action plan detailing how they would improve to ensure they met the needs of the people they were supporting and the legal requirements.

We undertook a focused inspection on 3 October 2017 to assess the breach of regulation 12 in relation to inadequate risk assessments to ensure people were safe from receiving inappropriate care. At this focused inspection, we found that the service had followed their plan and legal requirements had been met. We found that risk assessments were in place for areas such as pressure ulcers, falls, epilepsy and diabetes. There were measures in place to give guidance to staff on how to manage risks. There was evidence the risk assessments were reviewed regularly to ensure they remained relevant and reflective of people's needs.

Oakleigh House Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Oakleigh House Nursing home is registered to provide accommodation and nursing care to maximum of 20 people. At the time of this inspection 17 people were living at the home.

At the time of our inspection there was no manager registered with the CQC. The registered manager left in November 2017. A registered manager is a person who has registered with the CQC to manage the service. Like registered services, 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 home was managed by one of the company directors, who was not a registered nurse.

During our inspection we had some concerns about the fire safety at Oakleigh House Nursing Home. We shared our concerns with the London Fire and Planning Authority (LFEPA). The LFEPA is the regulator for fire safety in non-domestic premises, such as care homes. The LFEPA visited Oakleigh House Nursing Home on 2 July 2018 and issued Oakleigh House Nursing Home with an enforcement notice. In the response to this enforcement notice the registered provider decided to initiate the closure of Oakleigh House Nursing Home. We received written confirmation from the registered provider that on 20 July 2018 all people using the service had moved to alternative accommodation and that the home was planning to close.

We found that while people’s risks had been assessed, guidance to mitigate such ri

Inspection areas

Safe

Inadequate

Updated 11 October 2018

The service was not safe. Risk to people was not always assessed and guidance to mitigate such risks had not been followed.

The service did not always deploy sufficient staff suitably qualified and skilled to meet the needs of people who used the service.

Medicines were not always managed safely and people did not always receive their medicines as intended by the prescriber.

The service ensured that staff employed were of good character and safe to work with vulnerable adults.

Appropriate measures had been taken to ensure people who used the service were protected by the prevention and control of infections.

Effective

Requires improvement

Updated 11 October 2018

The service was not always effective. People�s health care needs were not always fully met.

People who used the service were not always assisted appropriately with their nutrition.

Peoples needs were assessed, however the lack of detail within the pre-assessments led to some people�s needs not fully been met.

Training, supervisions and appraisals were offered and provided to care workers, however, supervisions were not frequent and not all staff had received dementia specific training.

The environment was maintained and decorated and was conducive to people who used the service.

People who used the service were not deprived of their liberty and specific authorisations were sought in line with the principles of the Mental Capacity Act 2005 if required.

Caring

Requires improvement

Updated 11 October 2018

The service was not always caring. People who used the service did not always receive dignified care and their needs were not always respected.

Information regarding the treatment or care had been made available to people who used the service, however this was not always accessible to all people who used the service.

Responsive

Requires improvement

Updated 11 October 2018

The service was not always responsive. People�s care records were available; however, these had not always been updated if needs had changed.

Regular tailor-made, stimulating and individual activities were not always offered to people who used the service.

People who used the service and relatives were mostly satisfied that there concerns and complaints were dealt with and responded to appropriately.

The service could provide end of life care, however none of the people currently living at the home received such care.

Well-led

Inadequate

Updated 11 October 2018

The service was not well-led. Quality assurance systems to monitor and assess the quality of care were not always robust and effective in addressing shortfalls appropriately.

The service lacked clear and consistent leadership and clinical guidance to ensure people�s complex needs were fully met.

People who used the service, relatives and care workers mostly spoke positively about the new manager and the changes implemented.

People who used the service, relatives and care workers were involved in the service and their views were sought.