We carried out a review of the data available to us about Oakwood Hall on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Oakwood Hall, you can give feedback on this service.
Oakwood Hall is a purpose built residential service which provides support for people with complex mental health needs who are often excluded from other services. Placements are for five years, with the aim of supporting people to live back in the community. Oakwood Hall can accommodate up to 12 people, which includes one respite bed. At the time of our inspection there were 10 people living at the home and one person using respite.
This comprehensive inspection took place on 20 and 23 March 2018. At our previous inspection in December 2016 we rated the service as 'Requires Improvement' overall. This was because of environmental safety concerns that had not been identified through governance systems. At this inspection we found the required improvements had been made.
There was a registered manager in place. 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.
People told us they felt safe at the service. Staff were confident about how to protect people from harm and what they would do if they had any safeguarding concerns. Risks to people had been assessed and plans put in place to keep risks to a minimum. Lessons were learnt from complaints, safeguarding and incidents to prevent reoccurrence in the future.
There were appropriate systems in place to make sure that people were supported to take medicines safely and as prescribed.
There were sufficient numbers of skilled staff on duty to make sure people’s needs were met. Recruitment procedures ensured that staff were of suitable character and background to work with vulnerable people.
Staff were provided with a comprehensive training programme as well as supervisions with a manager, to support them in their roles. Staff were led by an open and accessible management team.
The manager and staff were aware of the requirements of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). 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 told us that staff were caring and that their privacy and dignity were respected. People were encouraged to become more independent to support them to return to live in the community.
Care plans provided comprehensive information and showed that individual preferences were taken into account. People’s needs were regularly reviewed and where appropriate, changes were made to the support they received.
People were supported to maintain their health and had access to health services if needed. The service worked well with other professionals to support people's rehabilitation.
There were systems in place to look at the quality of the service provided and action was taken where shortfalls were identified. People had opportunities to make comments about the service and how it could be improved.
The registered manager had good oversight of the service and there was an open, honest culture.
Oakwood Hall provides support for people with mental health conditions. The service has accommodation for up to 12 people. The service provides residential and respite support.
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.
The premises were reasonably well maintained, however window restrictors were not always in place in accessible areas. Where they were fitted, they opened wider than the legal requirement. Following our inspection the registered provider took appropriate action. Infection control was mostly well managed.
People felt safe receiving this service and staff were aware of different types of abuse as they had received safeguarding training.
Medicines were managed safely as they were stored appropriately and people who were responsible for administering medicines had received training and were assessed as competent. Records showed people received their medicines as prescribed.
Risks to people were appropriately assessed, managed and reviewed. Recruitment processes were safe as relevant background checks had been carried out. Staffing levels were sufficient to meet people’s needs.
People were supported by staff to access healthcare services when they needed this. People were able to choose what they wanted on the menu at weekly meetings and they told us they enjoyed the food on offer.
Staff were supported through a programme of induction, supervisions and appraisals. Training records we looked at showed staff had received up-to-date training in mandatory and non-mandatory subjects.
Positive interactions between staff and people were evident throughout our inspection. Staff always took time to talk with people and were friendly and respectful. People’s privacy and their equality, diversity and human rights were respected. People’s choices were respected.
Care plans contained clear, detailed information about support needs which people helped to create and review. The service was able to demonstrate its success in supporting people to moving into more independent living settings.
People knew how to complain if they were dissatisfied. Complaints were appropriately managed. Regular community and staff team meetings were taking place.
The registered provider had oversight of the service through a series of visits including peer support systems from other service managers. Action plans were in place and there was evidence of improvements in the service. We recommended the registered provider added targeted completion dates to their service action plan. Feedback about this service was positive.
Safeguarding notifications were routinely sent to the Commission, although two instances were found where this had not happened. However, appropriate action had been taken. We recommended the registered provider further strengthen these systems to ensure all notifiable incidents were reported.
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) regulations 2014. You can see the action we have told the provider to take at the end of this report.
We inspected the service on 19 May 2015. The visit was unannounced. Our last inspection took place on 10 June 2013 and at that time we found the service was meeting the regulations.
Oakwood Hall is a 12 bedded residential home which provides support and rehabilitation for people aged 18 and over who have enduring mental health problems and who have needs that are difficult for other services to provide for. Most of the people who use the Oakwood Hall service have had unsatisfactory experiences of being supported by others in the past and may have been labelled as difficult or untreatable.
The home had a 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.
People told us they felt safe in the home and we saw there were systems and processes in place to protect people from the risk of harm. People were protected against the risk of unlawful or excessive control or restraint because the provider had made suitable arrangements for staff to respond appropriately to people who communicated through their behaviour/actions.
Altercation between two of the service users, although recorded on daily diary sheets, was not reported or referred to the CQC as a ‘Safeguarding Concern’. This was in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
The care records we looked at did not contain a life history documents. These would be for the purpose of gathering information about the person and their life before they moved into the home. A life history document enables staff to understand and have insight into a person’s background and experiences. This was in breach of Regulation 9 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.
Staff had received training in the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards and they were able to demonstrate a good understanding of when best interest decisions needed to be made to safeguard people.
We found people were cared for, or supported by, sufficient numbers of suitably qualified, skilled and experienced staff. Robust recruitment and selection procedures were in place and appropriate checks had been undertaken before staff began work.
Suitable arrangements were in place and people were provided with a choice of healthy food and drink ensuring their nutritional needs were met.
People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made.
We observed interactions between staff and people living in the home and staff were kind and respectful to people when they were supporting them. Staff were aware of the values of the service and knew how to respect people’s privacy and dignity.
The manager investigated and responded to people’s complaints, according to the provider’s complaints procedure. People we spoke with did not raise any complaints or concerns about living at the home.
There were effective systems in place to monitor and improve the quality of the service provided. Staff were supported to challenge when they felt there could be improvements and there was an open and honest culture in the home.
We looked at the arrangements in place for the storage, administration, ordering and disposal of medicines and found these to be safe. Medicines were administered to people by trained staff.
Staff received regular supervision and annual appraisals. This gave staff the opportunity to discuss their training needs and requirements.
We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.
They told us they had helped complete and agreed their own support plans. They said the staff regularly checked how they were doing and met with them to review their progress every month.
People's needs were assessed and care and treatment was delivered in line with their individual care plan. Before people moved into the home their needs were assessed and any risks, to themselves or others, identified. People told us they met their keyworker most days. They said, 'The staff are really caring' and 'Staff treat me well.'
The provider had written procedures for the safe storage, administration and disposal of medication. Medication audits were carried out monthly and any errors or omissions were investigated by the duty manager.
Staff told us they were well supported and felt valued by the managers at the home. They had monthly supervision and an annual appraisal. There were records of completed training and their future development needs had been reviewed.
People who used the service and staff were asked for their views about their care and treatment and they were acted on. The residents we spoke with told us they attended house meetings and could make suggestions to improve the service or ask for concerns to be looked at.
People talked about community meetings which they said provided opportunities to make decisions about the service and discuss what they were doing. One person said, 'We talk about lots of things like trips out and what we want to eat.' One person said they chose not to attend the community meetings but said staff always asked them things individually and told them what was discussed at the meetings.
People we spoke with were complimentary about the staff team and said they were treated with respect. Everyone we spoke with said staff always knocked on their door and only went into their rooms when invited. One person said, 'Staff make an effort to talk to everyone. They are really nice. I like how they sit and eat with us. It's not them and us.'
People we spoke with said they were satisfied with the care and support they had received. One person said, 'They look at what support I need, not just for my mental health but also my physical health.' Another person said, 'My keyworker works out with me where I need help from staff and what I can do on my own, and this helps me focus.' Another person said, 'Staff talk about things with me. I do a cooking group and a leisure group and have had good support.'
Staff told us people received good care and their needs were appropriately met. They said people received support which was planned to make sure it met their individual circumstances, and effective systems were in place to make sure other agencies and professionals were involved when appropriate. They said every person had a clear plan which was regularly assessed. Staff said they had received training to understand how to meet people's specialist needs.