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We are carrying out a review of quality at Oakdene. We will publish a report when our review is complete. Find out more about our inspection reports.

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 September 2018

We inspected Oakdene on 14 August 2018. The service is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Oakdene provides personal care and accommodation for up to 40 people living with mental health needs. At the time of our inspection 38 people were using the service.

At the last inspection in September 2016, the service was rated ‘Good’ in all the key questions. At this inspection, we found the fundamental care standards were not being fully met, resulting in the rating for the service changing to ‘Requires Improvement.’

At the time of our inspection there was a registered manager in place but they were unavailable on the day of the inspection due to being on leave. A registered manager is a person who has been registered with the Care Quality Commission (CQC) to manage the service. Like registered providers they are “registered persons”. Registered persons have the legal responsibility for meeting the requirements of the Health and Social Care Act 2008 and associated regulations about how the service is run.

Risks associated with people’s needs had not always been effectively assessed, planned for or monitored. Information to guide staff of how to manage risks lacked detail or was not consistently followed.

Some shortfalls were identified in the management of medicines, this was in relation to medicines prescribed to be used ‘as and when required’. Staff were not consistently provided with guidance of the administration of these medicines. Body maps were not routinely used to instruct staff where prescribed creams should be applied and two staff signatures were not used for transcribing hand written entries.

Infection control and cleanliness of the service had been improved. This included new systems for monitoring how infection control measures were met. However, further time was required for these to be fully imbedded and improvements to be sustained.

People were protected from the risk of abuse as far as possible because staff had received safeguarding training and followed the provider’s safeguarding policies and procedures to safeguard people. Staffing levels and skill mix were sufficient at the time of this inspection. The provider had a dependency tool used to review staffing level requirements, staff covered any shortfalls and new staff were being appointed to fill vacancies.

Staff received an induction and ongoing training opportunities to formally review their work, training and development needs.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the provider’s policies and systems in the service supported this practice. Where people lacked mental capacity to consent to their care and treatment, assessments to ensure decisions were made in their best interest had been completed. The provider was making further improvements to support staff by implementing new documentation to support the assessment of people’s capacity.

People received a choice of meals and their nutritional care needs were known, understood and followed by staff. The staff team worked well with external healthcare professionals when required in meeting people’s health needs. The internal and external environment met people’s individual needs. There was a well maintained and secure garden with a smoking shelter.

Staff were aware of people’s needs, routines and what was important to them. Staff were kind, caring, and they supported people ensuring their privacy, dignity and respect was met. Independence was encouraged and supported. Information about independent advocacy services was available.

People’s care plans were not consistently detailed. Staff were aware of people’s needs but there was a risk new staff, would not have sufficient written informa

Inspection areas

Safe

Requires improvement

Updated 29 September 2018

The service was not consistently safe.

Risks associated with people’s needs were not always managed or assessed effectively.

People’s medicines were not always safely managed.

Staff were aware of safeguarding procedures and used these when required to ensure people’s safety.

Staffing levels were sufficient and safe staff recruitment checks were completed.

Improvements had been made to cleanliness and infection control practice.

Effective

Good

Updated 29 September 2018

The service was effective.

Staff received an induction and ongoing training and support.

Improvements were being made to how people’s mental capacity was assessed in making specific decisions.

People received choices of what to eat and drink and menu options met people’s individual needs and preferences.

People received support with their healthcare needs and staff worked well with healthcare professionals to inform this.

Caring

Good

Updated 29 September 2018

The service was caring.

People were cared for by staff who showed kindness and compassion in the way they supported them. Staff were knowledgeable about people’s individual needs.

People had information about independent advocacy services to represent their views if needed.

People’s privacy and dignity were respected by staff and independence was promoted.

Responsive

Requires improvement

Updated 29 September 2018

The service was not consistently responsive.

People’s care plans were not consistently detailed to inform an individualised approach to their care.

People’s diverse needs had been assessed and were being met.

People had access to the provider’s complaints procedure.

End of life care needs had been discussed and planned for with people and staff worked well with healthcare professionals in providing end of life care.

Well-led

Requires improvement

Updated 29 September 2018

The service was not consistently well-led.

The systems and processes in place to monitor the quality and safety of people’s care were not consistently operated or effective, resulting in shortfalls in the fundamental standards.

People, external professionals and staff were positive about the registered manager’s leadership.

People received opportunities to share their experience about the service.