Oak House

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice and independence. Peope using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

We found the following examples of good practice.

The home had responded to peoples’ choices and individual needs during the pandemic to help them carry out activities outside the home safely. For example, ensuring lateral flow testing each day before they leave the home and providing packs of masks and hand sanitiser to take with them.

The provider had not admitted any new resients to the home during the Covid 19 pandemic. However, systems were in place to ensure a safe transition would be achieved. This included adhering to current national guidelines, a test before entering the home, period of isolation and then a further test at the end of the isolation period. Staff carried out regular welfare and mental health checks throughout the isolation period.

The staff were aware of who to contact should they have an outbreak of Covid 19 and the protocols to follow.

The provider did not place any restrictions on the number of visitors that residents had but they needed to book in before coming to ensure the home was not overcrowded. Visitors had to carry out a test at the main entrance before entering the home.

The home had alternative methods to support social contact for visitors when residents were isolating. For example, residents using their own mobile phone or the use of the home’s tablet for video calling.

The home had sufficient supplied of Personal Protective Equipment (PPE). There were PPE stations throughout the premises. Staff had received training in infection prevention and control and how to don and doff PPE.

Each resident had received a tailor made support plan which was reviewed on a three monthly basis. The plan included the use of PPE in different situations, the zoning system used within the home, identifying possible symptoms, testing and guidelines for visitors.

Easy to read guidance information was used to help explain situations relating to the pandemic. For example, how to identify symptoms, how to test and what Covid 19 is.

The provider had a system in place to ensure staff had the necessary vaccinations and had completed the necessary Covid 19 testing prior to working at the home.

All residents had received the Covid 19 vaccination.

The layout of the service and communal areas supported social distancing. The premises looked clean and hygienic throughout. There were cleaning stations in place and adequate ventilation.

We were assured that this service met good infection prevention and control guidelines as a designated care setting.

Oak House is a residential care home providing personal care and accommodation to up to three people with a range of conditions including mental health needs, autism and learning disability. At the time of the inspection there were three people living at the service. The home is on a residential street in a community setting and designed to promote people's inclusion and independence.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service:

People, relatives and a health professional told us staff were kind and caring. People told us they liked living at the service. They also said they felt safe there.

Staff were safely recruited and supported in their role through training and supervision. There were enough staff to meet people’s needs.

People were safeguarded against the risks of abuse and harm by staff who understood what to do if people were at risk of harm. Risks to people were assessed and mitigated. Staff understood people’s needs and preferences and were able to work safely with the range of risks presented.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were involved in a range of activities within the community including attending college. The provider ran an activities centre locally to encourage vulnerable people in the local area to be involved in sports and hobbies. People from the service were able to use these facilities if they chose to.

People were supported to access external health professionals to help promote good health and wellbeing. We received positive feedback from a health professional who worked in partnership with the service.

The provider and local management team carried out quality checks to ensure the service was of a good quality. When accidents or incidents occurred, Information was shared across the service and through provider management meetings with other managers and senior personnel. This showed the provider worked to minimise re-occurrence of risk behaviours.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

The last rating for the service was good (published 7 July 2017).

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

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.

At the last inspection of 8 June 2015, the service was rated ‘Good’. We carried out this unannounced inspection of the service on 9 June 2017. At this inspection, we found that the service had maintained its 'Good' rating.

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 were safe at the service. People received support from staff who had received relevant training on how to identify and report potential abuse to keep them safe. Risks to people were identified and managed to keep them safe.

Recruitment and selection procedures in place were appropriate and followed to ensure people received care from suitable staff. There were sufficient numbers of staff deployed to meet the needs of people. People were supported to take their medicines. Medicines were administered and managed safely by staff who had the competency to do so.

People continued to receive effective care because staff had attended training to undertake their role. Staff were supported in their role. Staff received regular supervision and appraisal of their performance to enable them to reflect on their practice and make improvements when needed.

Staff sought people’s consent to care and treatment. People’s care was provided by staff with a good understanding and application of the Mental Capacity Act. People enjoyed the food provided at the service and were involved in menu planning. Staff supported people to prepare their food and drink. People’s dietary and nutritional needs were met and they had access to healthcare professionals as appropriate.

People were cared for by staff who were kind and compassionate. Staff treated people with respect and upheld their privacy and dignity. People were supported to maintain relationships that were important to them. Staff understood people’s communication needs.

People had their needs assessed and reviewed and a support plan put in place detailing how their individualised care would be delivered. People received care responsive to their needs. Staff encouraged people to pursue activities of their choosing and supported them to develop new interests if they wished to do so.

People were involved in how the service was run and their views were considered. People and relatives knew how to complain about any aspect of care at the service. They had access to a complaints procedure and were confident their concerns would be resolved in a timely manner.

There was an open and transparent culture that put people at the centre of service provision. The registered manager was approachable and visible at the service. Staff were supported in their role and felt valued at the service.

Quality checks of the service ensured improvements were made when needed. People benefitted from the close partnership of the service and other healthcare organisations

Further information is in the detailed findings below.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People told us they felt safe. Safeguarding procedures were robust and staff understood their role in safeguarding the people they supported. We observed that staff spoke to people in a manner that showed respect. People were calm and relaxed in their interactions with staff. One person said, I feel safe and know they will protect me."

The three people we spoke with told us that they received the care and support they needed. They had been involved in the care planning process and taken part in reviews. One person said, "I feel involved in my care and have discussed what will happen when I leave here."

We found that there were enough qualified, skilled and experienced staff to meet people's needs. People told us that staff knew how to care for them and understood their needs. The manager had assessed people's needs to make sure that sufficient staff were available. The manager told us this would be repeated regularly and when new people start using the service.

The Care Quality Commission (CQC) monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff have been trained to understand when an application should be made, and how to submit one.

Is the service effective?

People's needs were assessed and support was delivered to meet their individual needs. Care plans gave detailed guidance for staff about how they should meet people's needs. Care plans highlighted the signs that showed when People's mental health was deteriorating, such as social isolation, auditory or visual hallucinations and changes in the person's dietary habits. Care plans provided guidance as to how these symptoms should be responded to in order to maintain People's well-being. For instance, by being involved in activities and one-to-one staff engagement with them. The two staff spoken to understood people's support needs.

Is the service caring?

People had been involved in the care planning process and taken part in reviews. One person said, "I feel involved in my care and have discussed what will happen when I leave here."

We observed that people were treated well by staff. We saw that staff understood their needs. People were spoken with in an appropriate manner. One person said, 'I can talk to staff when I need to.' Care plans provided information about people's needs. Care plans clearly identified people's needs resulting from their diverse cultural backgrounds.

Is the service responsive?

People told us that staff listened to them and responded to the requests. Staff responded to any suggestions they made about the service. One person said, 'on the whole I'm quite happy with the way they are look after me. I have no complaints.' People told us that there had been meetings where they could discuss their views of the home. Staff listened to people and acted on their views.

Is the service well-led?

People who used the service, their representatives and staff were asked for their views about their care and treatment and these were acted on. One person said, 'on the whole I'm quite happy with the way they are look after me. I have no complaints." People told us that staff listened to them and responded to the requests. Staff responded to any suggestions they made about the service. People told us that there had been meetings where they could discuss their views of the home. Staff listened to people and acted on their views.

Staff told us they were able to make suggestions to improve the home. Staff said the manager was supportive. They felt that staff meetings provided them with a way to raise issues. Staff were supported by the manager to take an active role in improving the care of people.

We looked the care plan of the person who had recently been admitted to the service. Their care plan dated 21 March 2013 stated that due to the cognitive impairment and previous incidents of absconding, "staff should always lock the front door." We observed that the front door was locked. We could not find a capacity assessment or best interest assessment that showed that the front door could be locked in order to maintain the person's safety. People may be at risk as appropriate measures have not been taken to address risks to their safety due to their changing level of capacity.

We observed staff administering medication and saw that they checked the medication administration record before giving people their medicines. Medicines were handled appropriately.

Staff told us that they had been through a detailed recruitment process that included completing an application form, interviews and references being taken up from their former employers. People's personal records, including their care plans, were accurate and had been reviewed and updated at regular intervals

People knew how to raise concerns about issues that affected their well-being. One person said, "staff listen to my concerns." People said that staff knew how to meet their needs. We saw that staff understood people's needs and how to support them. We saw that staff knew how to communicate with people. They maintained confidentiality when doing this by not sharing information when other people were present.