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Oaktree Care Home Requires improvement

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Inspection report

Date of Inspection: 14, 15, 19 May 2014
Date of Publication: 3 July 2014
Inspection Report published 03 July 2014 PDF | 111.75 KB


Inspection carried out on 14, 15, 19 May 2014

During an inspection in response to concerns

The purpose of this inspection was to find out five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, seeking experience and views from people who used the service, their relatives, and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service caring?

We found that staff we saw treated people kindly but people did not receive care in a way that respected their dignity and independence.

One person who lived in the home told us, “Some staff just complete tasks; they go through the motions or not as the case maybe. I think this is attributed to a lack of knowledge, education and that there is not enough staff”. One staff member told us, “I wish I could say care was individualised but we just don’t have the time. We do as much as we can but I have to admit we are only able to provide the basics”. We saw that staff were rushed throughout the day.

People’s personal care needs were not respected and their dignity was compromised, for example people had not been assisted to wash and dress as they would wish or helped to eat their meals. We saw people with food left in their laps following mealtimes; clothes were not always protected from spillages from food and drink.

People were not cared for in a home that was safe and clean, with poor hygiene standards throughout the home. The premises, décor and soft furnishings were tired and in need of replacement and repair.

Is the service responsive?

We saw that appropriate referrals were made to health and social care professionals. Staff had identified risks to people and how this would be managed. This included people that had swallowing difficulties and were at risk of choking.

People had been assessed by their GP and the speech and language therapists and staff were following the guidance so that people were supported appropriately and safely in order to minimise the risks.

Is the service safe?

People were not protected from the risks of inadequate nutrition and dehydration. This was because people were not helped at mealtimes so that they received sufficient amounts of the food and drink that was provided to them.

Because there were discrepancies around accurate recording in people’s charts staff and people using the service could not be assured that food and drink intake monitoring was effective. This meant that staff may not be aware that people were at risk of poor nutrition and hydration and take any necessary action.

The service was not clean and hygienic. Appropriate guidance, equipment and facilities were not in place. This meant that people who used the service were not safe or protected from the risks associated with cross infection.

People did not live in surroundings that were safe and promoted their wellbeing. We found that equipment provided to people was unsafe and not properly maintained.

The home had less staff on duty than the manager had determined were needed to meet people’s needs. Additional cover was not provided when there was any staff absence. Staffing levels did not take into account unforeseen circumstances or emergencies.

Relatives had expressed concerns about access to staff at weekends, they questioned the staffing levels in the home and they were concerned about how long people’s call bells rang before they were answered.

Is the service effective?

Some care plans only contained basic information and guidance about the care and support people required. They did not show that people had been involved in developing their own care plans so that the staff could provide them with personalised care.

We spoke with two relatives who were visiting two people living with dementia. They told us, “I have not been asked to be involved in care plans I don’t know what they are” and “It was mentioned at the relatives meeting in April that we could be involved in care plans but I haven’t heard anything since then”.

People were not supported to be independent at mealtimes because they were not provided with the appropriate equipment to help them to eat.

The needs of people living with dementia had not been considered with regards to their environment. There were no signs that would help people move around independently. Equipment was stored in en suites and in communal bathrooms and toilet facilities. This meant that people could not move around freely and safely.

Is the service well-led?

We found not all aspects of the service were well-led

The home did not have a registered manager, although an application to register had been made. The management arrangements did not provide strong leadership as action had not been taken to improve the care or environment in the home. We found that the quality monitoring systems in place were not effective and had not identified improvements where needed.

This included the homes environmental audit which had failed to identify the serious concerns we found during our visits regarding the quality and safety of the environment. The audits did not identify risks to people who used the service in order to keep them safe from harm.