Oak House

Updated 15 December 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 was 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 7 November 2017 and was announced. The service was given short notice of the inspection (24 Hours) This was to ensure someone was available to support us with the inspection.

The inspection was carried out by one adult social care inspector. People at the service were living with complex needs, and some people needed support and reassurance from staff before they would feel comfortable speaking with us. Other people were happy to meet us and proudly showed us their accommodation and craft work. For this reason we were not always directly speak with everyone about their experiences in private, but spent time with people living at the service during the day observing relationships and contact they had, as well as having some basic discussions. We used elements of the short observational framework for inspection tool (SOFI) to help us make judgements about people’s experiences and how well they were being supported. SOFI is a specific way of observing care to help us understand the experiences people had of the care at the service.

Prior to the inspection the provider completed a PIR or provider information return. This form asked the registered provider and registered manager to give some key information about the service, what the service did well and improvements they planned to make.

During the inspection we looked at the support plans for all four people living at the service. We spoke with or spent time with all the people living at the service, two members of care support staff and the registered manager and senior support worker. We looked at records in relation to the operation of the service, such as risk assessments, medicine records, policies and procedures and two staffing files, and looked around the building and grounds.

Following the inspection we also spoke with a family member of a person living at the home with their permission.

Updated 15 December 2017

Voyage 1 Ltd is a large registered provider, having 291 registered locations across the country. Oak House is registered to accommodate up to four people in what is currently an all female service. The service provides support to people living with learning disabilities or other complex needs who need support with personal care. At the time of our inspection there were four people living at the service, which is set in a modern detached house in a residential area of Crawley.

This inspection took place on 7 November 2017. The service was given short notice of our visit. This was to ensure people would be available to support us with the inspection.

We had previously inspected the service on 18 June 2015, when the service was rated as good in all areas. We found this good practice had been sustained. The registered manager was aware of changes to the key lines of enquiry the Care Quality Commission (CQC) uses to assess services, and was prepared for the inspection.

The service has a registered manager. 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.

Oak House had a well understood, positive and open culture, with a clear set of values and ethos. The service had a happy, positive and welcoming atmosphere.

There were clear lines of management within the organisation with procedures for escalating any issues. The service received clear feedback from the provider organisation on their performance, including areas for improvement and the service also operated their own series of audits. Actions and their completion were recorded on consolidated plans to ensure prompt action was taken. The service learned from incidents and accidents following a thorough review. We saw evidence of the service and staff reflecting as a team on incidents to develop their practice and support people more consistently.

Risks to people from their care were identified and plans were put in place to minimise these risks. The service took great pains to ensure their response to risks was individual and based on supporting the person. For example one person had been supported to receive treatment in the service rather than having to attend a hospital following an accident, because this would have been very distressing for them. Risks within the environment were addressed, including the security of the service.

People had access to good healthcare services, including ‘well woman’ clinics and regular health action plans. For some people this had involved considerable work to help them understand and be responsive to the services available, such as attending dentists. Staff had for example had to support one person over several visits to become more comfortable attending a dentist for treatment. People received their medicines safely and as prescribed. Medicines were stored safely, and staff had received training in safe administration.

People were able to make their own meal choices and were involved in making decisions over shopping and meal preparation. People could be involved in cooking if they wished, and we saw people being supported to do their own laundry and prepare a lunchtime snack.

People were protected from the risk of abuse. Staff understood signs of potential abuse and how to report any issues, both within or external to the organisation. Staff understood people’s communication needs, and were aware of how each person would communicate if they were unhappy or distressed about something. Information was available for people in assisted or easy read formats to help them understand the principles of safeguarding and ‘keeping safe’. We saw people and staff being involved in positive and caring relationships. We saw people seeking staff out to share their experiences of the day or to chat with. We saw appropriate physical contact being initiated by people living at the service, and staff valuing and celebrating people’s achievements and daily successes.

Staff had a clear focus on the people they were supporting, their rights and the opportunities available to them. This included the operation of the Mental Capacity Act 2005 (MCA), and appropriate applications had been made for authorisations of Deprivation of Liberty Safeguards (DoLS). Staff recognised the importance of working consistently to help people develop new skills and have new opportunities. We saw for example how one person had been supported to exercise their rights and vote.

There were enough staff available to ensure people’s needs regarding activities could be met. Some people had a one to one staffing allocation at times, and we heard staff worked their shifts flexibly to meet people’s needs, for example for going out in the evening. Staff had been recruited safely, following a full process, including disclosure and barring service (police) checks. Staff spoke proudly of the work they carried out supporting people and were positive about the service. Staff were able to tell us about new skills they had themselves developed, and how the service had helped them to ‘grow’ and take on new responsibilities. People who could do so, or a relative told us they had no concerns over the service.

Oak House provided a comfortable home environment in a residential area of Crawley. All areas of the service we saw were clean, well maintained and had been adapted to meet people’s individual needs in a homely way. The service was near local shops, transport links and services. The town centre is within a short distance and the service had an accessible vehicle to support people to be involved with the local community. People had involved in maintaining contact with families and friends where they wished to do so. For example two people living at the service wished to remain in contact with a friend who now lived some distance away. They had been supported to visit, write letters and send postcards to their friend, and photographs were available to show when they had been able to meet and maintain their friendship.

People living at the service had contributed to the development of a care plan based on their needs and wishes. Plans were reviewed each month with each person’s ‘key worker’, and covered such areas as people’s goals and aspirations as well as basic day to day support. People also completed daily activity planners which helped some people visually understand their programme of activities for the week. Information was available for people in formats they could understand, for example the review documents or healthcare assessments people completed.

Records were well maintained and kept securely. The service had notified the CQC of incidents at the home as required by law.