Archived: Oakendale Residential Care Home

Updated 8 February 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection was also carried out to follow up on breaches of regulations which we identified at our last inspection in June 2015 and in response to heightened concerns from the Local Safeguarding Authority.

The inspection took place on 29 & 30 October 2015 and was unannounced. This meant the provider did not know we would be visiting to inspect.

The inspection was carried out by the lead inspector for the service and an additional adult social care inspector.

Prior to our inspection, we reviewed all the information we held about the service which included intelligence we had been passed from the Local Authority and members of the public.

At the time of our inspection there were 11 people who lived at Oakendale Residential Care Home. During our inspection, we spoke with six people who used the service, two relatives, six staff and the Registered Manager.

We looked in detail at care records and associated documentation for five people. We also looked at a range of records relating to the management of the service. We spent time observing the environment and how staff interacted with people who used the service.

We spoke with service commissioners, the Local Safeguarding Authority and social workers during the inspection to gain feedback about people's experiences of using the service.

Updated 8 February 2019

This inspection took place on 04, 06 & 09 May 2016 and was unannounced. The inspection was carried out to check whether improvements had been made with regard to the concerns we raised following our inspection in October 2015, when the service was placed into 'Special Measures'.

At our last inspection we found breaches of legal requirements in respect of: staffing levels, staff training and support, recruitment practices, the safe management of medicines, how risks to people were assessed and managed, accuracy and completeness of records, consent to care and treatment, nutrition and hydration, taking people's views and opinions into account when care was assessed, planned and delivered, dignity and respect, management and leadership, quality assurance systems and statutory notifications not having been submitted as required.

During this inspection, we found some improvements had been made, but the Provider was still in breach of legal requirements, as set out in the rest of this report.

Oakendale Residential Care Home is a small care home which is registered to provide 24 hour care for up to fifteen older people. The home is a converted large domestic property, split over three floors. The home has been fitted with a lift and stair lift to reach the upper levels. At the time of our inspection, there were eight people who lived at the home.

The service did not have a registered manager in post. 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.

The provider had not ensured that sufficient numbers of suitably qualified, competent, skilled and experienced persons were deployed at all times. This was in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Recruitment procedures had not been operated effectively to ensure persons employed at the service were of good character and had the qualifications, competences, skills and experience necessary to carry out their role. This was in breach of Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service had not established, and operated effectively, systems for the proper and safe management of medicines. This was in breach of Regulation 12 (2) (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The Provider had not established, and operated effectively, systems and processes to prevent abuse of service users. Staff were not able to describe what forms abuse may take and were not aware of local reporting procedures. Information for staff about how to report concerns and who to report to had not been made available to them. This was in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The provider had not ensured staff had received such appropriate support, training, professional development, supervision and appraisal as was necessary to enable them to carry out the duties they were employed to perform. This was in breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service was not working within the principals of the Mental Capacity Act 2005. Additionally, the service had not sought and recorded people's consent to care and treatment in each case. The service had allowed a family member to make decisions on a person's behalf without having sight of the proper authorisation. This was in Breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service had not ensured they worked collaboratively with the person to deliver responsive care which met people's needs and reflected their preferences. This was in breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

The service did not demonstrate good management and leadership at all levels. The systems designed to assess, monitor and improve the quality of the service provided were not being operated effectively. This was in breach of Regulation 17 of the Health and Social Care Act (Regulated Activities) Regulations 2014.

Following our last inspection, the registered manager had implemented new documentation with regard to risk assessments and care planning. We found improvements had been made in this area. However, since the registered manager had left the home, risk assessments had not been reviewed and updated accordingly. This meant people's written plans of care may not have met their needs fully.

Staff followed infection prevention and control guidelines and used personal protective equipment appropriately.

The service had made improvements with regard to the accuracy and completeness of records, which now included a good level of detail.

People's nutrition and hydration needs were being met. The service had implemented a new menu, with input from people who lived at the home. Monitoring of people's weight and nutritional intake was being undertaken appropriately.

The Provider had continued with their program of refurbishment and redecoration at the home. The majority of bedrooms and the lounge had been redecorated and provided light and pleasant surroundings for people who lived there.

We observed staff to take a very caring approach to people who used the service. Staffing levels had remained constant whilst the number of people who used the service had decreased, which meant staff were able to spend more time with people. Staff treated people with dignity and respect. Staff knew people well and showed genuine care for them in their interactions.

The service had undertaken a lot of work to gather more information about people, their life histories, likes, dislikes and preferences. The information had then been used, along with reviews of care where the person was involved; to shape the care delivered to people.

The Provider had recently implemented satisfaction surveys in order to gain feedback from people about their experience of care at the service.

We found several breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, as shown above.

You can see what action we have told the Provider to take at the back of the full version of the report.

Services awarded an inadequate rating for any key question will be re-inspected within six months. If there remains an inadequate rating after six months, in any key question the service will go into special measures.

If sufficient progress has not been made when we re-inspect and there are inadequate ratings for any key questions, further action will be taken to prevent the service from operating, either by proposing to cancel their registration or to vary the terms of their registration. We will then closely monitor the service until it either closes or substantial and rapid improvements are made.

Therefore this service will remain in special measures.

Where we have identified breaches of regulation during inspection which are more serious, we will make sure action is taken. We will report on any action when it is complete.