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Archived: Oakleigh Care Home Inadequate

The provider of this service has requested a review of one or more of the ratings.

Inspection Summary


Overall summary & rating

Inadequate

Updated 13 February 2018

The inspection took place on 6 and 21 November 2017 and was unannounced on both days. There were six people living in the home on 6 November and five on 21 November 2017. Four people were permanent residents at the home.

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

Oakleigh accommodates a maximum of 29 people in one adapted building.

The last inspection was in May 2017. At that time we found the provider was in breach of four regulations. Two of these Regulation 9 (Person centred care) and Regulation 17 (Good governance) were continued breaches since the previous inspection in November 2016. The other breaches were in relation to Regulation 12 (Safe care and treatment) and Regulation 11 (Need for consent). The overall rating was requires improvement, however, the service was placed in ‘special measures.’ We do this when services have been rated as 'Inadequate' in any key question over two consecutive comprehensive inspections. The ‘Inadequate’ rating does not need to be in the same question at each of these inspections for us to place services in special measures. In this case we rated the service inadequate in the ‘well led’ domain on two consecutive inspections.

On the first day of our inspection there was a registered manager in place. However, they told us they were leaving on 17 November 2017. They have made an application to cancel their registration with CQC. 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.

On the second day of our inspection there was no registered manager and the provider told us the ex-manager would be returning to work in the home as a senior care worker.

People told us there were enough staff to meet their needs. There was some disruption to the staffing as in the course of our inspection the registered manager and two senior care workers left. This would have left the service without enough staff to cover the rota. However, all three staff retuned to work at the home within a week. We were concerned the registered manager, provider and care staff had not identified the staffing situation as a potential safeguarding issue.

People who lived at the home told us they felt safe. Staff knew how to recognise and report abuse. The provider did not always work co-operatively with external agencies to ensure safeguarding concerns were fully investigated.

We found the provider had not taken suitable action to be sure agency care workers had been properly checked before they started working in the home.

For the most part people’s medicines were managed safely. However, there was a risk of overuse of medication by staff who were not familiar with people’s needs.

Risks to people’s safety and welfare were not always well managed. The provider had addressed most of the issues with the environment which we brought to their attention at the last inspection. However, there were still concerns and some of these were repeated from the last inspection. For example, we found weekly checks on the fire systems had not been done. The design and décor of the building did not take into consideration the needs of people who lived at the home. This was the third consecutive inspection where we raised issues about the low levels of lighting.

Staff had received training on safe working practices and said they felt supported by the registered manager.

Overall, people were satisfied with the food and told us they were offered a choice of meals. We found the meals offered were not always nutritionally balanced.

The home was

Inspection areas

Safe

Inadequate

Updated 13 February 2018

The service was not safe.

People told us they felt safe. However, when safeguarding concerns were raised the service did not always work openly with other agencies.

The required checks were not always completed for agency care workers which created a risk of people being supported by staff unsuitable to work in a care setting.

Risks to people’s safety and welfare were not always managed well.

Overall people’s medicines were safely managed. However, there was a risk of overuse of medication by staff who were not familiar with people’s needs.

The home was clean but the décor was showing signs of wear and tear.

Effective

Requires improvement

Updated 13 February 2018

The service was not always effective.

The service was working in line with the requirements of The Mental Capacity Act which helped to ensure people’s rights were protected.

Staff received training and support on safe working practices.

People were generally satisfied with the food and confirmed they were offered choices. People were not always offered nutritionally balanced meals.

People were supported to meet their health care needs.

The design and décor of the building did not take account of the needs of the people who lived there.

Caring

Good

Updated 13 February 2018

The service was caring.

Staff treated people with dignity and respect.

Staff knew about people's needs.

Responsive

Requires improvement

Updated 13 February 2018

The service was not consistently responsive.

There was a risk people would not always receive care which was appropriate to their needs.

People were not supported to plan for their end of life care.

People know who to talk to if they had any concerns. There had not been any formal complaints about the service.

Well-led

Inadequate

Updated 13 February 2018

The service was not well led.

The provider did not have effective systems in place to monitor, assess and improve the quality of the services provided.

The provider did not have effective systems in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.