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Inspection carried out on 24 July 2019

During a routine inspection

About the service

Oaklands is a residential care home, registered to support eight people in an adapted building over two floors. It provides personal care and accommodation for people with mental health needs. On the day of our visit eight people were using the service.

People’s experience of using this service and what we found

Medicine systems and processes were not fully effective to ensure people received their medicines as prescribed. For example, there was no clear audit trail, regarding who had made changes to a person’s medicines. Risks to people's safety had been assessed. However, we found the registered manager did not have access to one person’s risk assessment, as it had not been saved in accordance to the providers policy.

Some areas of the home environment required attention. For example, the kitchen tiles were greasy, as they had not been accessible by staff.

Staff told us they had received training in a range of areas to support them in their roles. Recruitment procedures ensured prospective staff were suitable to care for people receiving personal care

in their own homes. Staff were aware of how to reduce the risk of infection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People told us they felt safe at Oaklands. Staff understood their responsibility to safeguard people from harm and knew how to report concerns.

Care records provided information in relation to people's backgrounds, interests and the support they required.

People were supported to maintain relationships with people important to them. Staff were caring in their

approach and had good relationships with people. Staff treated people with respect and their dignity and privacy was respected.

Promoting independence was a part of the ethos of the service and people were supported by staff to maintain their independence.

People were supported to maintain their health and well-being and had access to healthcare professionals such as GP's when required. People were supported to eat and drink enough to maintain a balanced diet. Refreshments were available to people throughout the day

People and their representatives were involved in their care to enable them to receive support in their preferred way. People were supported to take part in activities and were supported to access local community facilities to enhance their well-being.

The provider’s complaints policy and procedure was accessible to people who used the service and their representatives. People knew how to make a complaint.

Systems were in place monitor the quality of the service to enable the registered manager to drive improvement. Lessons were learnt when things went wrong. Relatives and staff felt they could approach the registered manager if they had any concerns.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 28 November 2016).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 14 November 2016

During a routine inspection

This inspection took place on 14 November 2016 and was unannounced.

Oaklands is registered to provide residential care and support for eight people with mental health needs. At the time of our inspection there were eight people using the service. The service is located within a residential area, which provides accommodation over three floors.

Oaklands had 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.

We found there to be an open and collaborative approach between those using the service and staff. People’s safety and well-being was promoted through the pro-active management of risk. This was achieved through the sharing of information and agreed strategies for promoting people’s choices and independence in their day to day lives. And through the employment of sufficient staff to provide the support people require; both within the home and the wider community.

People’s medicine was managed safely, which included where people managed their own medicine, as assessments of risk were undertaken and discussed with the person involved. Audits were undertaken on a range of topics, which included medicines and maintenance of the environment to ensure people’s safety was promoted and maintained.

People told us that staff had had a positive impact on their lives due to the care and support they received. Staff told us that they undertook training which enabled them to provide good quality care. Staff received continued support through supervision and appraisal, providing an opportunity to discuss their professional development.

The registered manager and staff were clear about their responsibilities around the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and were dedicated in their approach to supporting people to make informed decisions about their care. Assessments to determine people’s capacity to make informed decisions about their care had been undertaken.

The open and inclusive approach to people’s care meant all decisions actively involved the person themselves and their views were recorded and acted upon. People’s independence was supported in all aspects of their daily lives. This included supporting people to manage their own medicine. Where staff had responsibility for the administration of people’s medicine this was managed safely.

People developed menus with staff support. People’s needs with regards to their diet were respected and supported, which included dietary requirements to support individual cultural beliefs and health needs. People were supported to shop for groceries, and with the support of staff to prepare and cook meals both individually and collectively.

People were supported by staff that had developed positive and professional working relationships with them, this gave people who used the service the confidence to speak with staff and talk about issues affecting them. People were relaxed in the company of staff and were able to talk about their lifestyle choices and the impact their decisions had on their well-being and future plans. People considered Oaklands to be their home and took pride in the environment in which they lived, sharing household chores. People’s views were sought and their comments were listened to and acted upon, which meant people knew their views would bring about change.

The registered manager and staff were committed to meeting the needs of people and improving their sense of well-being by encouraging people’s independence through the achievement of their goals and aspirations. Encouragement and ideas from staff to pursue hobbies and interests had a positive impact on people’s mental and physical health.

The provider had quality a

Inspection carried out on 20 August 2014

During a routine inspection

One inspector carried out this inspection. At the time of our inspection eight people were using the service. Below is a summary of what we found.

We spent time speaking with people who lived there as well as speaking with staff and relatives. We reviewed records and spent time observing people in the home.

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

Is the service safe?

People were cared for in an environment that was safe, clean and hygienic. Equipment at the home had been well maintained and serviced regularly. There were enough staff on duty to meet the needs of the people who lived in the home. We spoke with two people who lived there who both said that they felt safe and secure. One person said, "I've never had any worries about living here, its a very safe place." A family member said, "[My relative] is cared for by brilliant staff, they are really safe there."

Staff records demonstrated that mandatory training was up to date and that staff were trained to meet the complex needs of people who lived there. Staff were trained in caring for people with diabetes, complex communication needs and learning disabilities.

CQC monitors the operation of the Deprivation of Liberty Safeguards which applies to care homes. While no applications have needed to be submitted, proper policies and procedures were in place. Relevant staff had been trained to understand when an

application should be made, and how to submit one.

Is the service effective?

A relative told us that staff had made very good progress in their family member's rehabilitation and that they were also happy with the level of support shown to them during visits. It was clear from our observations and from speaking with staff that they had a good understanding of people's care and support needs and that they knew them well. A person who lived at the home told us that they felt supported and looked after and that they enjoyed being able to make their own decisions with support from staff.

People were cared for by staff who were supported to deliver care safely and to an appropriate standard. Staff had received training to meet the needs of the people living at the home and told us that they were able to put their training into practice.

Is the service caring?

People were supported by kind and attentive staff. We saw that care workers showed patience and gave encouragement when supporting people. Staff took into account the complex needs of people when planning activities so that they could take part in these safely. We spoke with a person who said, "I have a busy life here, every day I do something I like and help out with the cleaning and cooking. It keeps me busy and staff help me to do a good job."

Staff said that they were satisfied with the level of professional and emotional support they received from the manager. A relative said, "Staff are more than supportive. I've always found them very approachable."

Is the service responsive?

People's needs had been assessed before they moved into the home and these were checked by regular reviews, in which they were involved. People's needs assessments included consideration of their dietary and nutrition requirements as well as their need for social interaction and stimulating activities that helped them to develop independent living skills.

People's preferences and interests were acted on by staff who used weekly meetings to support people to meet their needs and goals. People had access to activities that were designed to stimulate them such as attending arts and pottery classes at a local college. We found that care was delivered using individual health action plans which helped people to maintain independent living skills such as preparing food, cleaning their bedroom and gardening.

Is the service well led?

Staff had a good understanding of the ethos of the home and quality assurance processes were in place. Staff told us that they were clear about their roles and responsibilities and that management support helped them to do their job effectively. One person told us, "I like talking to staff, most of them are lovely." A relative also said, "The structure of the staff and managers is very good, the home works well."

Inspection carried out on 27 October 2013

During a routine inspection

The name ‘Ms. Hazel Scully' appears on our report as being one of the registered managers at the home. At the time of our inspection this person was not a registered manager at the service and the provider has since taken appropriate action to ensure the correct details are held on our register.

People's care was reviewed regularly and their needs were met. People contributed to the development of their own care records and they were central to any care review.

People were protected from the risks of unsafe or inappropriate care and treatment because accurate and informative records were maintained. One person told us, “We talk about what’s written in the plans and review them each month. The staff always make sure I understand and agree.”

People participated in activities in the community with support where needed. People told us they were able to join in local activities according to their interests. One person told us, “I enjoy going out and meeting my family and doing my art classes. The staff helped me to find places I wanted to go to.”

We saw that staff treated people with respect and dignity and people told us they were happy with the support provided. People were supported by skilled and experienced staff.

Medication systems were in place and monitored to ensure people received their medicines as prescribed.

Inspection carried out on 25 April 2012

During a routine inspection

We spoke with three people who use the service they told us staff were friendly and approachable and spoke to them in a respectful way.They told us that they were happy with the care and support they received.

People who use the service told us they felt that staff treated them as individuals and understood their needs. People told us they had good relationships with and were supported by an established senior staff team.

All of the people who use the service told us they were happy living at Oaklands one person told us, �I wouldn�t like to move on; if I was offered something else I would turn it down.�

Inspection carried out on 7 September 2011

During an inspection in response to concerns

Both of the people we spoke with told us that they were actively encouraged to keep their independence and they said they were consulted about their plans of care and agreed with what was written. They both told us some staff could be �bossy.� One person told us that they had to do as they were told, they did not have a choice. The person said, �like today, I wanted to go shopping at the staff told me, �no we are going swimming.� I had no choice, I had to go.� This meant that people did not always feel they were treated with respect.

People told us they were well, healthy and they were encouraged to find things to do with their day which interested them. They told us their relatives and friends were welcome to visit them anytime.

People told us they felt safe, but we were not assured that all staff would blow the whistle on poor practice without delay. Nor were we assured that the provider had always acted promptly to protect people when concerns about staff performance were raised. This meant people were placed at risk of harm.

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