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Inspection carried out on 13 May 2019

During a routine inspection

About the service: Oakbank Care Home provides, accommodation, personal and nursing care to up to 55 older people. The home is situated in the Harpurhey area of Manchester.

People’s experience of using this service:

Emergency evacuation procedures were not robust to enable people to be safely evacuated.

Temperature checks were not in place to ensure medicines stored in a medicines trolley on the first floor were at the correct temperature. All other medicines across the home were stored at the appropriate temperature and checks were in place.

Staffing levels were satisfactory and permanent staff members were now in post at the home.

People felt safe while living at the home. Family members also confirmed this.

People were supported to eat a healthy and nutritious diet. People were monitored for weight loss or gain and appropriate action taken.

People received support from health professionals in a timely manner.

The home ensured it followed the principles of the Mental Capacity Act.

We observed caring and kind interactions from the staff to people living at the home. People and their families were complimentary about the staff team.

Care plans were detailed and regularly reviewed and captured people’s personal preferences.

Activities were varied but were not available every day.

End of life care was planned and recorded for most people. Staff could describe what plans were in place for each individual.

Audits were in place to monitor and improve the service, however, they did not identify concerns with safe emergency evacuation and storage of medicines. We made a recommendation for the provider to review this.

Staff felt well supported by the registered manager. People and their families told us the registered manager was approachable.

The registered manager and provider were aware of their responsibilities under their registration.

Rating at last inspection: The rating of this service at the last inspection was good. The report was published on 9 November 2017.

Why we inspected: The inspection was brought forward due to concerns about staffing levels.

Enforcement We found two breaches of the Health and Social Care Act 2018 (Regulated Activities) Regulations 2014. More information can be found at the end of this report.

Follow up: We will work with the provider following this report to understand how they will make changes to ensure the service improves their rating to at least good.

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

Inspection carried out on 10 October 2017

During a routine inspection

The inspection took place on 10 October 2017 and was unannounced. At the previous inspection we identified breaches of the with regard to staffing, recruitment, nutrition and quality monitoring. At this inspection we found improvements had been made in all areas.

Oakbank Care Home is owned by Unity Homes Limited and is in the Harpurhey area of Manchester. Local shops and amenities are within easy walking distance of the home. The home is registered to provide accommodation for up to 58 people including those who need nursing care. On the day of the inspection there were 44 people using the service.

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.

There were sufficient numbers of staff on duty on the day of the inspection to adequately meet the needs of the people who used the service. Staff recruitment was robust and staff files included relevant documentation.

There was an appropriate safeguarding policy and procedure in place. Staff demonstrated an understanding of the procedure and had undertaken training in safeguarding.

There was a health and safety policy and procedure and staff undertook training in infection control. General and individual risk assessments were in place to help ensure people’s safety.

The service had an appropriate medicines policy in place medicines systems were robust.

The induction process was robust, mandatory training was undertaken and there were ample training opportunities for staff.

The environment was pleasant and well appointed. There were no unpleasant odours detected within the home and there was some signage to help people orientate around the home.

The food was plentiful and nutritious and there were ample choices. The mealtime experience could have been enhanced with more conversation and interaction.

The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA) and Deprivation of Liberty Safeguards (DoLS).

People who used the service felt the care was good and staff were kind and caring. We observed staff interactions and saw they offered care with compassion and respect.

Privacy and dignity were maintained by staff knocking on people’s bedroom doors and waiting to be invited in. All rooms were single occupancy and people were able to spend time in their rooms if they wished to have some privacy.

People who used the service and their relatives, where appropriate, were involved with care planning and reviews of care. There were regular scheduled meetings for relatives and friends to attend.

People who used the service that we spoke with felt they were listened to. Care files included information about people’s backgrounds, interests, significant events and things that were important to them. We saw evidence of regular care file audits, with actions to address any shortfalls.

Activities included arm chair exercises, table top games, film afternoons, shopping trips, arts and crafts, sewing, relaxation hand and arm care, dominoes and card games and one to one chats with people.

Questionnaires were completed regularly throughout the year by people who used the service, relatives and professionals. Recent questionnaires completed by people who used the service were positive

There was an appropriate complaints policy which was displayed within the home. There had been six complaints or concerns recorded for 2017 and these had been responded to and actions taken. A number of compliments had been received by the service.

Staff we spoke with felt supported and said management were approachable. Staff supervision sessions and appraisals were undertaken regularly to help ensure staff were supported.

There were sys

Inspection carried out on 11 April 2016

During a routine inspection

We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to provide a rating for the service under the Care Act 2014.

We inspected the service on the 11, 12 and 15 April 2016. Oakbank Care Home is owned by Unity Homes Limited and is in the Harpurhey area of Manchester. The home is registered to provide accommodation for up to 55 people including those who need nursing care. The home has two floors and has gardens at the rear of the home. Car parking is at the front of the home.

At the time of the inspection there had been no Registered Manager in post who was registered with the Care Quality Commission (CQC) since 2012. This was due to person who was in the process of being registered as manager, going off on long term sick. However, the current manager was in the process of registering 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.

We did not speak with the manager until the third day as they were not present due to planned leave.

Care records contained person centred information to guide staff on the care people needed and had agreed to. However, these were not always reviewed and updated when changes occurred. We saw a variety of health assessments were in place to ensure referrals to other health professionals were made as appropriate.

Staff we spoke with were knowledgeable of the needs and preferences of the people they cared for. We spoke with people who lived at the home and their relatives. We were told they were happy with the service the home provided. Comments we received included; “Oh I’m well looked after here I can assure you” and “Staff are great.”

Our observations during the inspection showed us that people were not always supported by sufficient numbers of staff. Staff recruitment was not safe as the service had failed to carry out all the required checks on staff to ensure they are safe to work with vulnerable adults. Staff we spoke with confirmed they attended training and development activities to maintain their skills and that further training was planned. We also viewed documentation that showed us there were recruitment processes in place and staff confirmed these had been carried out when they had been employed.

During the inspection we saw staff were attentive and patient when supporting people and people were encouraged to eat and drink to meet their needs. However, staff were task focused at times due to staffing levels and the needs of people. We observed people being offered a limited choice and if people required assistance to eat their meal, this was done in a dignified manner.

We saw that there were procedures in place to instruct staff in the action to take if they were concerned that someone was at risk of harm and abuse and the staff we spoke with were knowledgeable of these procedures.

We discussed the quality assurance systems in place with operations director and the manager of the home. We were told audits of accidents, incidents and falls were carried out and these were investigated by the manager to ensure risks were identified and improvements made.

We identified breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have taken at the back of the full version of the report.

Inspection carried out on 19 and 21 November 2014

During a routine inspection

We carried out this unannounced inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, and to provide a rating for the service under the Care Act 2014. We inspected the service on the 19 and 21 November 2014.

Oakbank Care Home is owned by Unity Homes Limited and is in the Harpurhey area of Manchester. The home is registered to provide accommodation for up to 58 people including those who need nursing care. The home has two floors and has gardens at the rear of the home. Car parking is at the front of the home.

At the time of the inspection there had been no Registered Manager in post who was registered with the Care Quality Commission (CQC) since 2012. 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. We did not speak with the manager as they were not present due to unplanned leave.

Care records contained up to date and accurate information to guide staff on the care people needed and had agreed to. We also saw a variety of health assessments were in place to ensure any changes in people’s needs were identified and referrals to other health professionals were made as appropriate. Staff we spoke with were knowledgeable of the needs and preferences of the people they cared for. We spoke with people who lived at the home and their relatives. We were told they were happy with the service the home provided. Comments we received included; “Oh I’m well looked after here I can assure you” and “Staff are great.”

We spoke with one visiting health professional who told us they found the home to be responsive to their instructions and they were happy with the way the home met people’s needs.

Our observations during the inspection showed us that people were supported by sufficient numbers of staff. We saw staff responded to people’s needs and wishes promptly and we viewed documentation that showed us staff were enabled to maintain and develop their skills through training and development activities. The staff we spoke with confirmed they attended training and development activities to maintain their skills and that further training was planned. We also viewed documentation that showed us there were recruitment processes in place and staff confirmed these had been carried out when they had been employed.

During the inspection we saw staff were attentive and patient when supporting people and people were encouraged to eat and drink sufficient amounts to meet their needs. We observed people being offered choice and if people required assistance to eat their meal, this was done in a dignified manner.

We saw that there were procedures in place to instruct staff in the action to take if they were concerned that someone was at risk of harm and abuse and the staff we spoke to were knowledgeable of these.

We discussed the quality assurance systems in place with the training and development manager, and the owner of the home. We were told audits of accidents, incidents and falls were carried out and these were investigated by the manager to ensure risks were identified and improvements made. We saw documentation that showed us this took place.

Inspection carried out on 12 November 2013

During a routine inspection

We saw that comprehensive assessments were carried out prior to admission and on admission to Oakbank Care Home.

We looked at the care records for four people living at Oakbank. We found that people's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

The home had a safeguarding adults procedure that complied with all of the relevant legislation and good practice guidelines. Staff understood their responsibilities to protect people from harm.

A robust staff recruitment process was in place, which helped to ensure that people were supported by staff members who were suitable for their required roles. From the staff records we looked at we were able to see that the staff currently working for the home had been appointed correctly.

The provider had an effective system to regularly assess and monitor the quality of service that people receive. The quality of the service was monitored through monthly internal audits and included monthly service user feedback questionnaires.

Inspection carried out on 9 February 2013

During a routine inspection

Not all the people we spoke with were able to give us their views about the care and attention they received. However, those people who were able, told us that they were consulted about their care and treatment. Relatives visiting the home told us they thought the care at the home was of a good standard and that staff attended to people’s needs in an inclusive and respectful way.

We saw records that showed people were asked to give consent and had signed to confirm they agreed with their care plans. People we spoke with said they understood their care plans and that staff had explained things to them in detail.

We found that all of the records we reviewed were comprehensive, accurate, up to date and had been regularly reviewed.

People were protected against the risks associated with medicines because there were appropriate arrangements in place to manage medicines.

We looked at the staffing levels, for both day and night staff, and saw there were systems in place to ensure the staffing levels were adjusted according to occupancy and dependency levels of the people using the service. Staff talked positively about their work.

People told us they thought that staff were knowledgeable regarding their individual care needs. They said they were treated well and their experiences in the home were positive. Five people told us that if they had a complaint they would talk to the staff and they said they were confident any issues would be dealt with properly.

Inspection carried out on 9 March 2012

During a routine inspection

The people who were able to say told us that they were being treated well by the staff members supporting them and that they were involved in all aspects of their care. One person who had recently moved into Oakbank said; “They are looking after me well with respect and dignity”.

The people using the service who were able to tell us said that they were happy living in the home and that the staff members looking after them were good. Comments included; “I like it here, the staff members are very good and they are looking after me”, “They are very good here”, “I like it here and have no problems”, “This is a great place and they treat me like a king”.

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