Background to this inspection
Updated
26 January 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 16 November 2016 and was unannounced. The inspection team comprised of two adult social care inspectors.
Before this inspection we looked at the notifications we had received for this service. We
reviewed the information including the action plans following our last inspection. We reviewed all of this information to help us make a judgement about this care home.
We looked at a selection of record including four people’s care records. We looked at the staff file of the last person to be employed since our last inspection. We also reviewed records relating to the management of the service including: policies and procedures, quality assurance, medication, staff training, supervision and appraisal records and complaints records.
We carried out a Short Observational Framework for Inspection (SOFI) where we observed people over the lunch time period. This helped us to understand the experience of people who were not able communicate with us to see how staff interacted with people.
We spoke with four visitors, three people who used the service, four members of staff, the activity coordinator, the chef and the registered manager. We did this to gain their views about the service provided. We looked around the home and looked at how staff cared for and supported people.
Updated
26 January 2017
The Oaks is a two storey purpose built care home in Hindley Green, Wigan. The home is registered to provide personal care for up to 31 adults.
This was an unannounced inspection that took place on 16 November 2016. There were 20 people using the service at the time of the inspection.
There was a registered manager in post at the time of the inspection. 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 and associated Regulations about how the service is run.
At the inspection on 12 April 2016 we found nine breaches of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to: safe care and treatment, person centred care, safeguarding service users from abuse and improper treatment, privacy and dignity, meeting nutritional and hydration needs, premises and equipment, complaints, good governance and staffing. The home was rated as ‘Inadequate’ overall and in four of the five domains inspected. As a result of our findings the home was placed in special measures which meant they would be kept under review.
At our inspection on 16 November 2016 we found that significant improvements had been made and that the breaches from the previous inspection had been actioned and addressed.
The recruitment process was satisfactory to help ensure suitable staff were employed at the service.
Appropriate policies were in place with regard to safeguarding and whistle blowing. Staff had received training in safeguarding and those we spoke with were aware of the issues and confident of the reporting procedure.
The induction programme helped ensure new employees were equipped with the skills, knowledge and competence to work at the home. Training was on-going and mandatory training was refreshed regularly.
People’s nutritional and hydration needs were assessed and recorded appropriately. Special diets were adhered to by the chef and people were given choice with regard to meals.
People we spoke with felt the care was good and staff were kind and caring. We observed good interactions between staff and people who used the service throughout the day. People who used the service and their families were involved in discussions about the delivery of their care. Staff respected people’s dignity and privacy.
People who were nearing the end of their lives were cared for, as far as possible, in accordance with their wishes.
Care files we looked at evidenced that care was delivered in a person centred way, taking into account people’s preferences, likes and dislikes. People we spoke with said staff responded quickly to call alarms.
There was a programme of activities at the home and people were encouraged to participate if wish to. Someone to one interaction were undertaken with people who were unable to participate in group activities. A residents/relative committee had been formed to help plan and delivery activities.
The service was working within the legal requirements of the Mental Capacity Act (2005) (MCA). Deprivation of Liberty Safeguards (DoLS) authorisations were in place where required and staff were aware of the implications of these.
Medication systems were robust and medicines were managed safely at the service.
Individual and general risk assessments were in place. Equipment was fit for purpose and was regularly serviced and maintained to ensure it was in good working order.
There was an appropriate complaints policy and this was displayed throughout the home. Concerns were responded to in a timely and appropriate manner and the service had received a number of compliments and thank you cards.
People told us the staff and management were approachable. Staff felt the manager was supportive towards them. Staff were receiving staff supervisions.
We saw evidence of regular checks and audits that took place at the service to help ensure continual improvement with regard to care delivery.