Archived: Oakhurst Nursing Home

Oakhurst nursing home provides accommodation and nursing care for up to 26 adults with mental health problems. On the date of the inspection there were 18 residents in the home. The service did not have a registered manager in post and had not since 1 March 2013. The new home manager had recently submitted an application to become the registered manager.

People told us they were happy living in the home, were safe and that staff were friendly and kind. People said they were free to do what they wanted to do. Some people told us they thought there wasn’t enough to do in the home and would prefer more activities.

Systems and processes were in place to protect people from foreseeable harm, with staff aware of how to deescalate conflict and act on concerns in order to keep people safe. CQC monitored the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care homes and hospitals. We found there were no DoLS orders in place and staff had received training on DoLS. We did not observe any restrictions of people’s liberty during the inspection.

People were able to make choices in relation to their daily lives, for example choosing what they wanted to do and staff respected these wishes. However, there was no evidence people were involved in the review of their care plans. This meant people were not involved in long term care planning and setting objectives and goals. Care plans were not written in a format that promoted involvement of people that used the service and there was a lack of information provided to people on their care and treatment options. The problems we found breached Regulation 17 (Respecting and Involving people who use services), of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Staff were up-to-date with a range of mandatory training and received regular supervision and support. However, there was no provision for Mental Capacity Act 2005 (MCA) or mental health training on the annual training programme which meant staff may not have the specialist skills and knowledge to meet some people’s needs.

We found improvements had been made to the environment following our previous inspection, however further improvements were required to ensure all outstanding maintenance was completed, to give the home a more homely feel and to ensure people were able to make the most of the facilities and grounds available. The problems we found breached Regulation 15 (Safety and suitability of premises), of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

Staff displayed warmth and compassion with people and treating them with dignity and respect. People spoke positively about their relationships with staff.

People’s needs were assessed and care and support was planned and delivered to meet people’s individual needs. Support plans contained personalised information to ensure staff knew how to support people and meet their needs. Staff were familiar with people’s individual needs and their key risks. In one case, the service could have been more pro-active in seeking advice to ensure responsive care and treatment following the completion of a capacity assessment which concluded the person did not have the capacity to make decisions about their personal care.

The manager had only been working at the service for two months, but had developed a plan to improve the service. Staff spoke positively about recent changes and were confident further improvement would be achieved. More could be done to involve people in the running of the service and ensure people’s views, comments and opinions were used to make changes and drive improvement. Some risks to people’s health, safety and welfare were not identified, and there was an underreporting of incidents which meant that some incidents were not analysed and investigated. There were no systems in place to identify safe staffing levels. The problems we found breached Regulation 10(Assessing and monitoring the quality of service provision), of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.