We carried out a review of the data available to us about Red Oaks 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 Red Oaks, you can give feedback on this service.
We found the following examples of good practice.
The service was facilitating visits in line with government guidance. A variety of visiting options were available for people to see friends and family. For example, use of the visiting suite, use of the grounds and in-house visits.
There were processes in place for staff to check the status of COVID-19 passports for visiting professionals and contractors.
There were robust cleaning schedules in place for bedrooms and communal spaces including sanitising high touch areas, which promoted safe infection control practices.
Staff had received training which included infection prevention and control (IPC). The service had a designated IPC champion who carried out audits for continual IPC improvements. Staff were observed to wear their personal protective equipment (PPE) appropriately.
The registered manager told us they had been well supported by the provider. The registered manager attended regular management meetings to keep their knowledge current and share learning with the provider’s other services.
The provider communicated IPC policy changes to staff by email. Staff and management had access to the provider’s ‘Coronavirus helpline’ to answer questions or for further guidance if required.
Visits were made by appointment and arranged flexibly throughout the day and evening. People living at the service and visitors were advised of expected infection and prevention control measures and processes on or prior to arrival. Lateral flow testing for all visitors took place at the service on the day of the visit, in a designated testing area that was accessible via a separate entrance to the main building. Individual personal protective equipment (PPE) packs were provided by the service to all visitors along with alcohol hand gel and handwashing facilities.
Following recent changes to allow a designated visitor indoors for people, staff had supported people, relatives and staff make sure everyone understood and agreed how this would be done safely. A key point of discussion had been to ensure that people and relatives were agreeable to following guidance on recommended physical contact during visits from a designated person, to help reduce the transmission of infection.
To help people stay in touch remotely the service provided several I-pads and a large screen for people to take video calls. The service had a bank of mobile phones that people who did not have one could use to call and speak with relatives for as long as they liked. People were supported to send postcards and items they had made by post to important people in their lives on a regular basis.
To help make sure social distancing and shielding guidance was being followed and risks of infection reduced, the provider had made changes made to service environment, such as creating several smaller dining and socialising areas and reducing the amount of spaces at each table. Large-scale communal dining had been an important social experience for people at the service. To reduce the impact on people, staff had involved them in ways they understood about the need for social distancing and involved them in making the changes, so they worked as well as possible. To help do this and consider people’s dementia support needs, people were provided with visual aids and staff had explained the need for changes by making a link with people’s past experiences or memories. Staff were careful not to overwhelm people with information and to approach each person on an individual basis to help them adapt to the new arrangements.
The provider had adapted an existing lounge area by building a wall with a large Perspex screen and intercom that was accessible for visitors from outside the service. This had allowed people to have visits from important people in their lives safely throughout the pandemic. There had been a large marquee available in so people could meet outside even when the weather was bad.
During an earlier outbreak and if there were any suspected cases, staff cohort on the floor of the outbreak and people are barrier nursed in their rooms for their isolation period. If current service users or recent admissions were self-isolating, activity staff made up activity baskets for people and staff regularly visited them in their rooms.
Staff were supported to be risk assessed individually and given support to furlough if needing time off due to vulnerabilities - including those related to any protected characteristics as defined by the Equality Act. Staff were supported to isolate as and when necessary. If isolating, the manager maintained contact and their emotional well-being was considered as part of the return to work process.
Staff were regularly tested and wore the correct PPE as per the latest government guidance when supporting people to help prevent the spread of infection. The service was clean and hygienic and cleaning had been revised to take place more frequently in response to COVID-19. There was an up to date Infection prevention and control policy. Infection control audits were carried out regularly and these were reviewed and checked by the registered manager and the provider’s senior management and quality team every month. The manager felt well supported by the provider to manage any infection prevention and control issues. There was a designated point of contact for IPC queries as well as daily and weekly support calls and IPC information sharing.
Red Oaks 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. The home is located in a residential area near the centre of Henfield.
Red Oaks accommodates up to 64 people across three separate units, namely Lavender (ground floor), Gardenia (first floor) and Freesia (second floor), each of which have separate adapted facilities. Two of the units provides care to people living with dementia. The home offers respite breaks.
The bedrooms are single occupancy with en-suite facilities. People have access to communal shower rooms, bathrooms and a hairdressing salon. Red Oaks has small dining rooms and sitting areas located on each floor and alcoves where people could sit with relatives, friends or in small groups. Fig Tree restaurant is a large dining area people use mainly for the lunch meal service and it can accommodate over 40 people. The building and accommodation units are accessible by wheelchair and have two passenger lifts. The service has an enclosed courtyard with level access, raised beds and a large garden at the back of the premises. The general environment was well maintained, bright and welcoming.
At the time of our inspection, 61 people were living at the service.
At the last inspection of 30 June 2015, the service met the regulations inspected and was rated Good overall.
The service did not have a registered manager. The previous registered manager had taken up a promotion and had cancelled their registration. A home manager was appointed in September 2017 and was in the process of registering with the Care Quality Commission (CQC). The registration was completed during the course of our inspection. A registered manager is a person who has registered with the CQC 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 and associated Regulations about how the service is run.
People using the service, their relatives and health and social care professionals were highly complimentary about the standard of care provided. People consistently spoke positively of the kindness and compassionate manner of staff towards them. People using the service and their relatives experienced a care delivery that was inclusive and empowering. This resulted in people enjoying immensely spending their days at the home and an improvement of their well-being.
Staff delivered people’s care in a respectful and dignified manner. People had the privacy they required. People enjoyed professional relationships with the staff who supported them. People consistently remarked staff knew them well and showed the utmost patience and respect to meet their individual needs and preferences. People highly commended staff for creating a comfortable and vibrant environment that made them content.
People at the end of their lives received extremely high standards of care. Comments from people and everyone involved in the provision of end of life care at the service were consistently positive. People and their relatives were unanimous in agreeing that Red Oaks offered end of life care over and above expectations and were exceedingly responsive in meeting people’s needs. Staff had specialist knowledge in various aspects of providing care which considerably enriched the quality of people’s lives. People at the end of their lives and those living with dementia received care in line with best practice guidance and legislation.
People highly commended the range of stimulating and enjoyable activities. Staff creatively used the information they had about people to tailor activities to meet each person’s preferences. The planning and provision of activities took a prominent role at the service and greatly enhanced people’s lives. People had memorable occasions at the service. Staff supported people to enjoy once in a lifetime opportunities in their social lives and to pursue their hobbies and interests. This enabled people to live fulfilling lives. People received support and encouragement to be independent.
People had access to healthcare professionals when needed. Staff managed and administered people’s medicines in a safe manner. People enjoyed the food provided and had sufficient amounts to meet their nutritional needs. People spoke positively of the dining experience and the high standard of meals.
Risks to people’s welfare were identified and managed. Staff understood and followed the safeguarding procedures to champion people’s rights and to minimise the risk of abuse. A sufficient number of suitably recruited and skilled staff were deployed to meet people’s needs.
People were supported by staff who were committed, trained and skilled for their roles. Staff demonstrated a passion in delivering care that made significant changes to people’s daily living. Staff’s practice was monitored and development plans were in place to support their learning.
Care was provided in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards.
People’s needs were assessed and reviewed. Support plans had sufficient guidance for staff on how to deliver care. Health and social care professionals commended staff for involving them in a timely manner and following their guidance when providing people’s care.
Staff had a transparent and open manner about the way they delivered care. Staff learnt from their mistakes and improved their practice. People benefitted from a person centred culture at the service that made them the focus of decisions about their care. Staff were supported in their roles by senior colleagues and the management team.
People’s quality of life improved because of the close working partnerships between the service and external agencies and other health and social care professionals. People enjoyed maintaining links and involvement with their local community.
People using the service and their relatives were confident about raising a concern or making a complaint. The provider ensured people had opportunities to share their views about the service. People’s feedback was acted on to develop the service.
Audits and checks of the service ensured people’s care was subject to monitoring. Improvements were made to the quality of care provided when needed.
The inspection took place on 30 June 2015. Red Oaks was last inspected on 1 September 2014 and no concerns were identified. Red Oaks is located in Henfield, West Sussex. It is registered to support a maximum of 63 people. The service provides personal care and support to people with nursing needs, some of whom were living with dementia, and many who had complex health needs and required end of life care. The service is set over three floors. On the day of our inspection, there were 58 people living at the service.
There was no registered manager in post. The home has been without a registered manager for approximately two months. However, a manager had been appointed and was due to start in post in July 2015. They had started their process to register with the Care Quality Commission. 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 happy and relaxed with staff. They said they felt safe and there were sufficient staff to support them. One person told us, “I feel safe here, no problem”. When staff were recruited, their employment history was checked and references obtained. Checks were also undertaken to ensure new staff were safe to work within the care sector. Staff were knowledgeable and trained in safeguarding and what action they should take if they suspected abuse was taking place.
Medicines were managed safely in accordance with current regulations and guidance. There were systems in place to ensure that medicines had been stored, administered, audited and reviewed appropriately, including the administration of controlled drugs.
People were being supported to make decisions in their best interests. The registered manager and staff had received training in the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS).
Accidents and incidents were recorded appropriately and steps taken to minimise the risk of similar events happening in the future. Risks associated with the environment and equipment had been identified and managed. Emergency procedures were in place in the event of fire and people knew what to do, as did the staff.
Staff had received essential training and there were opportunities for additional training specific to the needs of the service, such as caring for people with dementia, epilepsy, wound management, and palliative (end of life) care. Staff had received both one to one and group supervision meetings with their managers, and formal personal development plans, such as annual appraisals were in place.
People were encouraged and supported to eat and drink well. There was a varied daily choice of meals and people were able to give feedback and have choice in what they ate and drank. People were advised on healthy eating and special dietary requirements were met. People’s weight was monitored, with their permission. Health care was accessible for people and appointments were made for regular check-ups as needed.
People chose how to spend their day and they took part in activities in the service and the community. People told us they enjoyed the activities, which included gardening, exercises, films, arts and crafts and themed events, such as National Armed Forces Day. People were encouraged to stay in touch with their families and receive visitors.
People felt well looked after and supported. We observed friendly and genuine relationships had developed between people and staff. One person told us, “The staff are kind, I can’t speak highly enough of them”. Care plans described people’s needs and preferences and they were encouraged to be as independent as possible.
People were encouraged to express their views and completed surveys, and feedback received showed people were satisfied overall, and felt staff were friendly and helpful. People also said they felt listened to and any concerns or issues they raised were addressed. One person said, “I have complained about things. They are very quick to respond”.
Staff were asked for their opinions on the service and whether they were happy in their work. They felt supported within their roles, describing an ‘open door’ management approach, where managers and senior staff were always available to discuss suggestions and address problems or concerns.
The provider undertook quality assurance reviews to measure and monitor the standard of the service and drive improvement.
This summary is based on our observations during the inspection, discussions with ten people, three relatives, the manager, the service's head of care, seven carers and the activities coordinator. We also reviewed records relating to the management of the service and six people's care and health records. As some people could not talk with us about their experiences of living at the service we spent time observing how they were cared for and treated by staff. We observed interactions between staff and people who lived at the service for three hours during the morning and lunchtime period.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
There were enough suitably qualified and experienced staff on duty to meet people's needs. Staff that we spoke with told us that there were enough staff and that they were able to spend social time with people. They told us that there had been a difficult period with staffing but that new staff had been recruited. One member of staff said, 'It has improved, it's a lot better now.' We observed that staff responded quickly to meet people's needs and ensure their safety. One relative said, 'The staff are lovely, they're so cheerful'.
CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. We noted examples of capacity assessments and best interest meetings. The manager told us that six DoLS applications had been submitted and approved. They demonstrated a good understanding of their responsibilities in this area.
Is the service effective?
We found that people's care plans were detailed and that they had been reviewed on at least a monthly basis. This ensured that the care provided was in line with their individual needs and preferences.
As many of the people living at the service were unable to speak directly of their experience, we spent time observing the care and support that they received. Staff demonstrated skill and experience when supporting people. One person told us, 'If I can't be at home, there is nowhere else I would rather be than here'. Another said, 'They're very good'.
Is the service caring?
People were supported by kind and attentive staff. We saw that staff were patient and gave encouragement when supporting people. We spoke with ten people. They were all satisfied with the care that they received. They told us they were able to do things at their own pace and were not rushed. Our observations confirmed this. One person told us, 'It is a happy, pleasing place'. Another said, 'They treat you very well here, they're so helpful. They tend to spoil you'. We found that people were involved in making decisions about their care and treatment. They were assisted by staff who knew them well and understood how they liked to be supported. One member of staff said, 'It's nice to be able to engage with the residents. You feel like you're making a difference'.
Is the service responsive?
People's complaints were fully investigated and resolved where possible to their satisfaction. People told us that they were able to raise suggestions or concerns and that they were regularly consulted about changes in the service. One said, 'People seem pleased to speak with you'. A member of staff told us, 'It's all about the residents' happiness. It feels like our own little family'.
Relatives told us that they were kept informed and updated if there were any issues or concerns regarding the health of their family member.
Is the service well-led?
People, relatives and staff told us that they were able to approach the manager with any suggestions or concerns. One member of staff said, 'You're always free to go and talk to the manager'. When we arrived, senior staff had just finished a daily morning meeting where they reviewed the current needs of people and the service. People told us that their views had been taken into consideration regarding any changes in the service. There were regular residents' meetings which provided a formal opportunity for people to share their thoughts and opinions.
The relatives we spoke with told us how satisfied they were with the treatment within the care home. One relative said 'I would struggle to fault it' and another said 'I would recommend it to anyone' and 'it is the next best thing to being in your own home'. Both relatives mentioned the friendly and cheerful greetings they received from all staff, in all positions.
We observed the people living in the home having lunch and staff supporting them with their meals and drinks. The atmosphere was calm and relaxed and the service was offered with discretion and with respect for the dignity and autonomy of the people living in the home. After lunch we observed people, dressed in warm clothes, leaving the building to get some fresh air in the grounds, either walking, or sitting in their chairs.
We saw that people had their own rooms with their own personal items including photographs and ornaments and each had a television and en-suite facilities. One person we spoke with said 'I am completely satisfied with supper in my room watching the BBC news and reading the newspaper headlines'. As we walked around three floors the manager greeted people and offered words of encouragement. The manager noticed that one of the beds was unmade and said 'we put people's needs before bed making!'
Care plans were focussed on people as individuals and we found that staff had a good awareness of people's needs, preferences and personalities. Staffing levels were sufficient to meet the needs of all the people at the home. We observed that staff were actively involved with people throughout the day. One staff member told us they "Love working here".
The home had a positive approach to managing risk. People's freedom and independence was encouraged.
There were good systems in place for ensuring that the service was operating effectively and that any issues were identified and action taken where necessary. There were opportunities for people at the home to have their say about the service. Comments or complaints were handled appropriately.