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Inspection carried out on 21 October 2017

During a routine inspection

The inspection took place on 21 October 2017 and was unannounced. Oaklands is a residential care home for up to nine people. It specialises in the care of people who have a learning disability and associated conditions. At the time of this inspection there were nine people living there.

The service 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.

At the last inspection on the 23 and 24 September 2015, the service was rated Good. At this inspection we found the service remained Good.

Why the service is rated good:

People when asked if they felt safe said; “Yes.” A relative said; “If he wasn’t safe here I wouldn’t be sat here I would be at head office!” Another said; “I honestly can’t say a bad word about the place.” Staff said; “Very safe because staff are very conscientious about the people they look after.”

People remained safe at the service. There were sufficient staff to meet people's individual needs and support them with activities and trips out. Risk assessments were completed to enable people to retain as much independence as possible. People received their medicines safely by suitably trained staff.

People continued to receive care from staff who had the skills and knowledge required to effectively support them. Staff were well trained and competent in their roles. 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's healthcare needs were monitored by the staff and people had access to a variety of healthcare professionals.

The staff had built strong relationships with people. We observed staff being kind, patient and caring. People's privacy was respected. People or their representatives, were involved in decisions about the care and support people received. One relative said they were invited and attended review meetings.

The service remained responsive to people's individual needs and provided personalised care and support. People were able to make choices about their day to day lives. Complaints were fully investigated and responded to. A relative said; “If I raise any issue we meet with the manager to resolve them. The manager is very good.”

The service continued to be well led. People, staff and relatives told us the registered manager was approachable. The registered manager and provider sought people's views to make sure people were at the heart of any changes within the home. The registered manager and provider had monitoring systems which enabled them to identify good practices and areas of improvement.

Inspection carried out on 23 & 24 September 2015

During a routine inspection

The inspection took place on the 23 and 24 September 2015 and was unannounced. We last inspected the service on the 14 December 2013 and had no concerns.

Oaklands provides residential care for up to nine older or younger adults with a Learning Disability. They could have range of other needs including autistic spectrum disorder, a physical disability, sensory impairment or dementia. There were eight people living at the service when we visited.

There was a registered manager employed to manage Oaklands. 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 were protected by staff trained in recognising how to identify and keep people safe from abuse. There were enough staff to look after people safely who were recruited safely. Staff underwent regular training, supervision and appraisal to ensure they remained effective in their role.

Care plans were individualised and updated often to reflect changes in people’s needs. Risk assessments were in place to assess and reduce the possibility that people may come to harm. Staff were trained in identifying and meeting people’s specific, highly complex needs and the risks these may pose. Risk assessments, care plans and training for staff were clearly linked and reviewed to ensure people’s needs were met.

People’s medicine was administered safely. People had their nutritional and health needs met. People were supported to attend hospital and see health professionals as required.

People had their right to consent to care and freedom of choice respected. People had their mental capacity assessed in line with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, as required.

Staff treated people with kindness and respect. People’s dignity was respected at all times. People were involved in planning their care and choosing how they wanted their day to look like. People were supported to take an active role in their local community. Activities were provided that supported people to meet their needs and provided entertainment.

Staff used their knowledge of people to ensure any complaints, concerns and feedback on the service were listened to and responded to quickly.

There were clear systems of governance and leadership in place. Staff told us the registered manager and senior management were approachable and responsive to any new ideas. The registered manager ensured the quality of the service was maintained.

Inspection carried out on 14 December 2013

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service because people had complex needs and were unable to verbally tell us about the care and support they received. We met and spoke to all the people who used the service, spoke to staff about the care given and looked at the care records of four people who used the service. We met four relatives visiting during our inspection. We looked at other records and observed staff working with people. We saw staff spoke to people in a way that demonstrated a good understanding of people's choices and preferences. We saw that the staff had a good understanding of people's individual needs and that they respected people’s privacy and dignity.

All the staff we spoke to said that they felt well supported by their colleagues and management. We saw staff received the training they required to carry out their roles.

We saw that people's personal support plans described their needs and how those needs were met. We saw records that showed that multi-agency meetings had been arranged to determine particular procedures were in people’s best interest.

We saw that medication was administered by suitably trained staff. People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to administer and record medication.

We saw that the service held all records securely to protect people’s confidentiality.

One staff member said, “Good team work and we support each other” and a family member said, “Couldn’t wish for anything better”.

Inspection carried out on 9 February 2013

During a routine inspection

We (the Care Quality Commission) used a number of different methods to help us understand the experiences of people using the service because the people had complex needs which meant they were not able to tell us their experiences. None of the people living in the home were able to inform us about the care they received.

We met all nine people who used the service and two relatives. We spoke to the registered manager, six staff members on duty and checked the provider's records. We spoke to staff about the care given and looked at the care records of four people. We looked at other records pertaining to them and observed staff working with them.

Oaklands is divided into two living areas, with four people living in one area and five in the other. Each area has its own living space which includes a lounge and kitchen.

We saw that staff treated people with consideration and respect. For example, we observed staff knocking on doors. They supported people to meet with us, and introduced us to people living in the home. We observed that the staff responded to people with patience and understanding at all times.

We saw and heard staff speak to people in a way that demonstrated a good understanding of people's choices and preferences. They demonstrated a good understanding of what kinds of things might constitute abuse, and knew where they should go to report any suspicions they may have had.

One relative said, “We have been happy since X moved into the home”.

Inspection carried out on 18 January 2011

During a routine inspection

People that live at Oaklands either have no speech or it is very limited. A number of the people that live in the home are dependant on a wheelchair for their mobility. Other people that live in the home have complex behaviours that challenge services and they need specialist care and support to meet these needs. All of the people that live in the home have complex care needs that require complex packages of care to meet these needs.

The people that live at Oaklands are highly dependant on the support given to them by the service both to meet their personal care needs and to have a good quality of life.

As people could not tell us about their experience of the home we relied on other sources of information. We observed people being supported by the staff and we got information from the staff and management about peoples’ experience of living in this care home. We saw smiles and expressions of happiness from people. For example we saw one gentleman really enjoying the atmosphere and food during his breakfast mealtime.

The staff ensure through their delivery of care and support that everyone’s human rights, privacy and dignity are respected and protected. For example staff talk to people respectfully and ensure that doors are closed when people are receiving personal care.

We heard about peoples daily activities and read about how everyone that lives in the home gets out to enjoy their community.

The people that live in the home are routinely offered choice in all aspects of their daily lives and peoples consent to each part of their care and support is sought by the staff. For example we saw one person during their meal, being asked between each piece of food they were being supported to eat, if they were happy to accept the next piece, to which they either agreed or refused their consent.

As described previously everyone that lives at Oaklands has complex needs. We saw that the service is meeting their care needs, is supporting people to access health services either continuously or as they need them, and is working effectively with professionals from outside the home.

None of the people that live in the home can manage their own medication safely. The service is managing everyone’s medicines safely and effectively through a carefully considered and planned system.

We saw that the two houses that make up the care home were being well maintained and were homely pleasant places to live. We also saw that the houses were clean and hygienic. We saw that there was enough equipment of the right type to meet peoples’ needs. This also was being well maintained and was clean.

The staff that are employed by the provider have been properly recruited and are well trained which helps them to deliver good quality care, safely. We saw that the service had the number of staff on duty that they said were needed. We also checked that the numbers on duty could meet the needs of the people that live in the home.

The service has appropriate safeguarding procedures and the staff team are aware of how to use the protection of vulnerable adults systems. There is a complaints system in place that is working effectively to help the service maintain the quality of care being delivered.

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