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Inspection carried out on 30 October 2018

During a routine inspection

Oaklands is a care home without nursing for up to six people with learning disabilities and/or who are on the autistic spectrum. At the time of this inspection there were six people living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good in four of the five key questions, improving to Outstanding in the responsive question. This means the overall rating for the service remains Good.

Why the service is rated Good

The service continued to meet all the fundamental standards and had a registered manager as required. The registered manager was present and assisted us with the inspection.

People received extremely personalised care with staff demonstrating innovative and 'lateral' thinking in helping people to increase their independence and life skills and meet their needs. People were supported to identify their own goals and ambitions and to work towards achieving them by the highly motivated staff team.

People knew how to complain and staff knew the process to follow if they had concerns. Staff showed great skill in identifying when people, who were not able to communicate verbally, were distressed, anxious and/or concerned. Staff were quick to respond to any signs of distress. The success of their individualised interactions showed an in-depth knowledge of how each person demonstrated they were not happy and what to do to help them feel safe and calm.

People received excellent care and support from staff who were well trained and supervised. Staff demonstrated a strong commitment to ensuring people were involved in all aspects of decisions regarding their care and the development of the service. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were protected from the risks of abuse. Risks were identified and managed effectively to protect people from avoidable harm. Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable. Medicines were handled correctly and safely.

People were treated with care and kindness and their right to confidentiality was protected. People were treated with respect and their dignity was upheld. People's diversity needs were identified and incorporated into their care plans where applicable.

People benefitted from a service which had an open and inclusive culture. Staff were very happy working at the service and people benefitted from having staff who felt well managed and supported.

Further information is in the detailed findings in the full report.

Inspection carried out on 5 April 2016

During a routine inspection

This inspection took place on the 5 April 2016 and was unannounced.

Oaklands is a care home which is registered to provide care (without nursing) for up to six people with a learning disability. The home is a detached building in a village location close to local shops and other amenities. People had their own bedrooms and use of communal areas that included an enclosed private garden. The people living in the home needed care and support from staff at all times and have a range of care needs.

The home has a registered manager who works full-time within the home. 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 who use the service had a range of communication abilities. These ranged from non-verbal to limited verbal communication. Other methods of communication were used by people such as the use of pictures, symbols and objects of reference to indicate their needs and wishes. These were understood by staff. The registered manager and staff were building on and improving communication methods that and were specific to people’s assessed needs. This was in order to promote and respect the choices they made.

People’s medicines were managed safely. This had followed on from a review by the provider and local authority following concerns that were raised between 2014 and 2015. Robust processes were introduced to monitor and improve the safety of giving people their medicine.

The recruitment and selection process helped to ensure people were supported by staff of good character. There was a sufficient number of qualified and trained staff to meet people’s needs safely. Staff knew how to recognise and report any concerns they had about the care and welfare of people to protect them from abuse.

People were provided with effective care from a staff team who had received support through supervision, staff meetings and training. Their care plans detailed how they wanted their needs to be met. These were being reviewed at the time of our visit, with a particular emphasis on activities to ensure they were person centred. Risk assessments identified risks associated with personal and specific behavioural and or health related issues. They helped to promote people’s independence whilst minimising the risks.

The service had taken the necessary action to ensure they were working in a way which recognised and maintained people’s rights. They understood the relevance of the Mental Capacity Act 2005, Deprivation of Liberty Safeguards (DoLS) and consent issues which related to the people and their care.

People received good quality care. Staff treated people with kindness and respect. People were encouraged to live a fulfilled life with activities of their choosing and supported to visit and keep in contact with their families.

The registered manager who commenced employment at the service in January 2015 had made a positive impact. This had been achieved from her evaluation of the services provided and implementation of change in consultation with people, external professionals and staff. These included improvement to the environment and people’s records to promote individualised care and support for the people who lived in the home.

The provider had an effective system to regularly assess and monitor the quality of service that people received. There were various formal methods used for assessing and improving the quality of care.

Inspection carried out on 7 February 2014

During a routine inspection

We were not able to speak to people who used the service as they had complex needs and difficulty communicating. We gathered evidence of people's experiences of the service by reviewing records, observing care practices and talking with the manager, staff on duty a family member and an advocate for three of the people who use the service.

During our visit we observed there was a relaxed atmosphere with people choosing where they wished to spend time. One person was seen to be enjoying colouring in the dining room and another watching telly in the lounge.

We observed staff treating people with affection, kindness and patience. Staff demonstrated how well they knew people's needs and ensured people were treated with privacy and dignity. We looked at people's records and noted that they incorporated their care plans, risk assessments and health care needs. We found that they encompassed the safety and well-being of people who use the service. Staff and the family member we spoke with said they knew how to raise a concern or complaint and felt confident in doing so.

We looked at the management of medicines. The quality management system and reviewed staff records and found the provider had adequate systems in place which ensured the care and welfare of people who use the service..

Inspection carried out on 3 August 2012

During a routine inspection

We spoke with an advocate of three people who lived in the home and used the Short

Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care

to help us to understand the experience of people who could not talk to us. Five people smiled and nodded when asked if they liked living in the home and one person replied yes to direct questions about if it was a good place to live and if staff were good to them.

The advocate of three of the people who lived in the home told us that staff tried to make sure that people were offered choices and were respectful. They said that they were confident people were safe in the home.

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