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Archived: Limber Oak Good

Reports


Inspection carried out on 8 February 2016

During a routine inspection

Limber Oak is a care home which is registered to provide care (without nursing) for up to seven people with learning disabilities. The home is a detached split level building within a rural area of Crookham, Newbury. People have their own bedrooms and use of communal areas that includes an enclosed private garden. The people living in the home needed care from staff at all times and have a range of care needs.

The home has not had a registered manager since the 7 December 2015. The provider had commenced the process to recruit a manager who would apply to CQC to become the registered manager. 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.

At our comprehensive inspection of Limber Oak on the 26 and 27 January 2015, we had found the provider had not protected people against the risks associated with safeguarding people from abuse. Additionally we had recommended that the service finds out more about best practice in supporting staff development and seek guidance of best practice in quality assurance and monitoring procedures. Our rating of the service at that time was required improvement.

We revisited the service on 20 July 2015, and inspected the service against one of the five questions we ask about services: is the service safe. This was to check that the provider had followed their plan and to confirm that they had met the legal requirements to keep people safe.

At this inspection 8 February 2016, we inspected the service against the five questions we ask about services: is the service safe, effective, caring, responsive and well led.

People who use the service had a range of communication abilities that ranged from limited verbal communication and use of pictures and symbols to indicate their needs and wishes. These were understood by staff and enabled staff to support those individual’s to make choices and express their views. Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received.

People’s safety was promoted within the home. The recruitment and selection process helped to ensure people were supported by staff of good character. There was a sufficient number of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse. People’s medicine was managed safely.

People were provided with effective care from a staff team who had received support through supervision, staff meetings and training. Their care plans detailed how they wanted their needs to be met. Risk assessments identified risks associated with personal and specific behavioural and or health related issues. They helped to promote people’s independence whilst minimising any risks.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people and their care.

Improvements had been made to the environment to promote people’s privacy. This had included refurbishment of two bathrooms, and additional office space to store people’s records and promote confidential meetings about people’s care.

People were encouraged to live a fulfilled life with activities of their choosing. Further staff hours had been authorised by the provider. This was to minimise the risk of social isolation for the people who lived in the home. People’s families told us that they were very happy with the care their relatives receive

Inspection carried out on 20 July 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on the 26 and 27January 2015. A breach of a legal requirement was found at that time. This was because the management and staff had not followed safeguarding and whistleblowing procedures to protect people from abuse.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach. We undertook a focused inspection on the 20 July 2015 to check they had followed their plan and to confirm that they now met the legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for ‘Limber Oak’ on our website at www.cqc.org.uk

Limber Oak provides accommodation for up to seven people with a learning disability who require support with their daily life and personal care. There were six people living in the home at the time of our inspection.

There was 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. However, the registered manager had taken absence of leave following our comprehensive inspection in January 2015. We were informed by the provider that the registered manager would not be returning to their substantive post. In the short-term the provider had taken action to ensure a supportive management team were placed at Limber Oak whilst they recruit a new manager.

At our focused inspection on the 20 July 2015, we found that the provider had followed their plan which they told us would be completed by the 28 April 2015 and that legal requirements had been met.

Staff had received updated training on safeguarding vulnerable adults and knew how to keep people safe by reporting concerns promptly through processes that they understood well.

Inspection carried out on 26 and 27 January 2015

During a routine inspection

Limber Oak is a care home which is registered to provide care (without nursing) for up to seven people with learning disabilities. The home is a detached split level building within a rural area of Crookham Newbury. People have their own bedrooms and use of communal areas that includes an enclosed private garden. The people living in the home needed care from staff at all times and have a range of care needs.

There is a full-time registered manager. 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.

At this inspection the provider was not meeting the requirements of the law. Although the management team and staff had received training to safeguard people from abuse they had not followed safeguarding and whistleblowing procedures to protect people from abuse. This was a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations. You can see what action we told the provider to take at the back of the full version of this report.

The numbers of staff working throughout various times of the day and night were determined from people’s assessed and changing needs. Agency staff were also used to cover permanent staff vacancies and leave. Staff responded appropriately when people presented with behaviours that may cause harm or distress, which protected the person and others. Staff had received health and safety training that included how to give people’s medicines safely.

People were being provided with effective care from a dedicated staff team who had received support through staff meetings and training. However, staff did not feel fully supported by the management team. We have made a recommendation about staff training.

People were unable to communicate verbally and used methods of sign language and pictures to communicate their needs and wishes and were understood by staff.

Staff treated people with kindness and respect and had regular contact with people’s families to make sure they were fully informed about the care and support their relative received. People were encouraged to live a fulfilled life with activities of their choosing. Their families were encouraged to be fully involved at their reviews of their support needs. People’s families told us that they were very happy with the care their relatives received. Comments included: “we are very satisfied with the service; all of the staff seem very caring”.

The Mental Capacity Act 2005 (MCA) provides the legal framework for acting and making decisions on behalf of individuals who lack the mental capacity to make particular decisions.

People using the service at the time of our visit did not have the capacity to make particular decisions and were supported by staff at all times to make decisions in their best interest. The manager had submitted Deprivation of Liberty Safeguards (DoLS) applications to the local authority to provide protection for the people.

People were supported to maintain a balanced nutritional diet to suit their individual needs and taste. People had health care action plans and staff supported them to attend health care appointments.

The service had regular contact with people’s relatives who told us staff were approachable and that they felt listened to. Comments included “Oh yes I think we would be listened to, (name) is very happy there”. Health and safety checks were completed to promote people’s safety. However, there were no formal processes to monitor the services provided. Staff did not feel fully supported by the management team in meeting the support needs of the people who use the service. We have made a recommendation about about best practice in supporting staff development.

Inspection carried out on 12 November 2013

During a routine inspection

The people living in the home or their representatives had been given appropriate information about the service and the care and support they could expect. They were encouraged to make choices and be involved in decisions about the home.

People were spoken to and treated with respect. We noted that their dignity was maintained and staff supported them to maintain their level of independence.

There were appropriate arrangements in place for the management of medicines.

Staff recruitment and selection was effective. Appropriate checks were undertaken before staff began work.

There was a system in place to regularly monitor and assess the quality of the service that people received.

Inspection carried out on 13 February 2013

During a routine inspection

We looked at a range of records, spoke with the assistant manager, three support staff and the cook in private. We also spoke with a relative of a person living in the home. We saw the communal areas of the home, some people�s bedrooms and spent some time observing interactions between staff and people living in the home. We spoke with the local authority who told us that they had no concerns about the home.

People living in the home had individual communication, and behavioural needs and no one was able to provide their views about their experiences of living in the home. However we saw that people were involved with their care and the running of the home as far as they were able. We observed people being offered choices including whether to be involved in an activity.

We were told that independence and individuality were promoted within the home. People living there were supported and enabled to do things for themselves as far as they were able. They were encouraged to express their views using their preferred individual communication styles and to participate in making decisions relating to their care and treatment.

Inspection carried out on 12 March 2012

During a routine inspection

People living in the home had individual communication needs and were unable to provide their views about their experiences of living in the home. However we saw that people were involved with their care and the running of the home.

Reports under our old system of regulation (including those from before CQC was created)