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Inspection carried out on 13 April 2017

During a routine inspection

We inspected Oakdown House on the 13 April 2017 and the inspection was unannounced. Oakdown House provides care and support for people living with profound physical and learning disabilities and complex communication needs. The service is registered to accommodate up to 45 people, and is split across three separate residential units. At the time of our inspection, there were 38 people living at the service.

The service had a registered manager in post. 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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Some people were not able to communicate with us using speech, we therefore spent time observing how staff and people interacted and gained feedback from people's relatives. One relative told us, "It is a lovely place to live and the carers are all kind.” People also told us how they enjoyed living at Oakdown House. One person told us how they enjoyed tapestry and had recently been out for fish and chips and was looking forward to the morning activity of seeing the farmer and making things.

People were encouraged and supported to eat and drink well. Care plans included clear guidance on people’s nutritional needs and the level of support required. People’s weight was monitored, however, it was not consistently clear how it was decided how often people should be weighed. We have made a recommendation for improvement.

The provider was not consistently working within the principles of the Mental Capacity Act 2005. It was not consistently clear if people had consented to their care plans, taking of photographs and sharing of information. Where restrictive practice was in place, appropriate applications had been under the Deprivation of Liberty Safeguards (DoLS). For those applications which had not yet been authorised, the provider was unable to demonstrate whether the person had consented to the use of restrictive practice or not. We have made a recommendation for improvement.

The management of risk was safe. Risk assessments were in place and actions were in place to address specific risks such as the risk of choking. We identified concerns in relation to the easy accessibility of latex gloves, but the registered manager took appropriate action to address this concern.

Peoples' health was monitored and they were referred to health services in an appropriate and timely manner. Any recommendations made by health care professionals were acted upon and incorporated into people's care plans. Care plans were person centred and provided clear guidance for staff to follow on how to provide person centred care.

Staff treated people as individuals with dignity and respect. Staff were knowledgeable about people's likes, dislikes, preferences and care needs. They approached people in a calm, friendly manner which people responded to positively. Staff also spoke with people in a dignified way and knew how people liked to receive care.

People told us they liked the staff and were always treated with respect and dignity. We observed good care, a gentle manner and what looked like genuine friendship between people and carers and among people themselves.

People received a personalised service as staff knew people well enough to care for them in a way that met their needs and preferences. People’s preferences and social needs were respected. Activities were many, stimulating and varied and people were supported to maintain links with the community and their relatives.

Staff had received essential training and there were opportunities for additional training specific to the needs of the service, including autism, behaviour that may challenge, and the care of people living with dementia.

There was an open, transparent culture and good communication wit

Inspection carried out on 29 May 2015

During a routine inspection

We carried out this inspection on 13 May 2015 and it was unannounced.

Oakdown House is a residential care home for adults with learning difficulties. It is set in a rural location and has three separate residential units which have the combined capacity to provide support for up to 45 adults requiring varying degrees of support.

The home 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.

People were kept safe from abuse and harm because staff were knowledgeable about how to respond to possible abuse. People were not at risk of unsafe practices when helped to move around the home as staff followed moving and handling best practice.

The provider followed safe recruitment procedures to ensure staff who provided care and treatment were suitable for their roles. Staffing levels were based on people’s needs and promoted their safety and wellbeing.

Medicines were stored, recorded and administered safely.

Staff had the necessary skills and knowledge to ensure they could meet people’s diverse needs. Staff received the supervision and support they needed to enable them to carry out their roles effectively.

While the care and support staff gave people was of a high standard, care plans did not always accurately reflect people’s current needs. We have made a recommendation about this.

Staff were kind and compassionate in their approach. Staff always listened to people and treated them with respect. Staff always responded to people’s requests for help in a timely manner.

People received a personalised service as staff knew people well enough to care for them in a way that met their needs and preferences. People’s preferences and social needs were respected. Activities were many, stimulating and varied and people were supported to maintain links with the community and their relatives.

People were supported to be as independent as possible. Visitors were welcomed and their involvement encouraged.

The service was well led. The registered manager had made improvements in the home to provide personalised care. Staff were clear about their roles and were confident they could raise concerns with the manager.

The registered provider had shown how they had learned from incidents in the home and had used the information to improve care.

Inspection carried out on 21 October 2013

During a routine inspection

During our visit we spoke with four people who used the service. We also spoke with seven members of staff. These were the registered manager, personnel manager, two team leaders, two support care workers and an admin assistant. We also looked at surveys and meeting minutes to help us understand the views of the people who used the service.

The people we spoke with told us they were happy living at Oakwood house. One person who used the service told us “I love it here, I like everyone and we have fun activities”. Another person we spoke with told us “I enjoy the activities we do together and painting is my favourite”.

Staff we spoke with were happy in their roles and felt fully supported by their manager. One member of staff told us “We are a great team at Oakwood house, person centred care is so important and we provide great activities in the day centre that all the people enjoy”.

We looked at care plans, staff records and observed levels of staff. We saw the service had enough experienced and skilled staff to meet the people’s needs.

Inspection carried out on 21 February 2013

During a routine inspection

During our inspection we found that people living at the home were accommodated in clean, safe surroundings and cared for by well trained, safe staff. The premises were clean, tidy and well maintained. We found the atmosphere generally relaxed and homely and observed care being delivered with kindness and good humour. People appeared happy and settled in the home and staff supported them to be as independent as possible.

The provider had suitable arrangements in place to ensure that people were safeguarded against the risk of abuse. Staff were trained in how to recognise and respond to any concerns and there were policies and procedures in place to ensure that people were supported nutritionally and being given their medicines safely.

We saw that there were overarching policies, complimented by clear, effective, accessible processes for dealing with and learning from incidents, accidents, complaints and safeguarding concerns.

The people who we talked with told us they were happy living at the home and that they liked the staff who looked after them well. One said: "it's good living here" and another said "staff ask me nicely to do things" and "they are nice." People were encouraged to make their own minds up and supported to make decisions about their needs and how they wished cared to be provided.