Oak Cottage

Updated 17 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by two inspectors on the first visit and one on the second.

Service and service type

Oak Cottage 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.

This service also provides care and support to people living in ‘supported living’, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection did not look at people’s personal care and support as no one was receiving personal care at the time of the inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on our first visit and announced on our second.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all this information to plan our inspection.

During the inspection

We spoke with one person who used the service. We spoke with five members of staff including the deputy manager, senior care workers and care workers.

We reviewed a range of records. This included two young people’s care records and medication records. We looked at four staff files in relation to recruitment and staff supervision. We also reviewed several records relating to the management of the service, including policies and procedures. We spoke with seven professionals who have were involved with people living at the service. Between, and following our visits our visits we spoke with several health care professionals, for example social workers.

After the inspection

We continued to seek clarification from the provider to validate evidence found.

Updated 17 March 2020

About the service

Oak Cottage is a care home that provides personal care and accommodation for up to five children between the age of 13 to 17 or younger adults who may have a learning disability, autistic spectrum disorder or mental health needs. There were three children living at the home at the time of our inspection.

The service was a large domestic size home. There was little in the way of identifying the home was anything other than a domestic property. Staff did not wear anything that suggested they were care staff when coming and going with children. Children shared communal areas, but all had separate bedrooms, some with ensuite facilities.

The provider is also registered to provide personal care to people that use supported living. None of the people using the supported living were receiving personal care at the time of our inspection. CQC only inspects these services where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

The provider’s management of the service was reactive, and although there was evidence of some positive changes recently, these were mostly driven by the findings from another regulator that had inspected the service prior to our inspection. The provider needed to improve their systems of governance and self-audit so changes to the service are proactive and planned.

There were occasions where some staff had not adhered to boundaries identified to keep children safe.

Young people’s medicines were not always recorded accurately meaning it was not always possible to confirm if a young person had taken their medicines and the reasons for this.

Staffing levels reflected those needed to provide for young people’s safety although there had been a period where numerous agency staff were employed to maintain staff numbers. The provider was recruiting staff, in a safe way, to ensure their reliance on agency staff was reduced and better consistency of care maintained.

The provider’s process for admitting people to the service did need review and care did need to be taken to ensure a person’s admission was safe. In addition, the impact on other people who lived at the home and the anxiety moving to the home would present to a person needed consideration.

The home's environment did not present as that within a family home, as many items had been removed due to the risk of damage, although work was been taken to repair areas of damage as quickly as possible.

Staff understood safeguarding processes related to children and adults and knew how to raise concerns and who to. The provider had kept CQC informed of any allegations of abuse or incidents where younger people may be at risk.

Staff were knowledgeable about children and what may make them anxious, and how they should respond to reduce this anxiety.

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 (last report published 19/03/2019)

Why we inspected

The inspection was prompted in part due to concerns received about the safety and management of the service following inspection by another regulator.

We received concerns in relation to the safety of young people using the service. This had triggered an inspection by OFSTED, as the care home is also registered as a children’s home.

We reviewed the information we held about the service. Areas of concern identified related to safety and management. We therefore inspected to look at the domains safe and well led. Ratings from previous comprehensive inspections for those Key Questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvement. Please see the safe and well led sections of this report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Oak Cottage on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to some elements of the management of the service.

Please see the action we have told the provider to take at the end of this report.

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.

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.