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Inspection carried out on 4 February 2020

During a routine inspection

About the service

Oaklands Care Home is a residential care home and was providing personal and nursing care to 10 younger adults who have mental health problems at the time of the inspection. The service can support up to 10 people.

Oaklands Care Home is a former domestic property laid out across three floors. The ground floor accommodates the dining room, staff kitchen, service user’s kitchen and lounge, the nurse’s station is adjacent to the lounge. There is level access to the garden, which incorporates a summer house and access to the registered manager’s office. All three floors offer bedroom accommodation, the first and second floors are accessed by stairs, a stairlift is available to the first floor. All bedrooms offer en-suite facilities.

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

People told us they were supported by staff who were kind and caring. People’s dignity was maintained and their privacy was respected. The provider ensured people’s equality characteristics were met. People were supported to make their own decisions and staff went ‘above and beyond’ when supporting people to achieve their goals.

People received safe care. Staff knew how to identify potential abuse and what they would do if abuse was suspected or witnessed. There were sufficient numbers of staff to meet the needs of people and staff were recruited safely. Medicines were managed and administered in line with the prescriber’s instructions. Risks were monitored and managed safely.

The provider ensured people received a service that was responsive to their needs. People were supported to maintain and develop relationships and participate in activities that were relevant to them. Although people declined to explore their end of life preferences, the provider had supported people to fulfil ‘bucket lists’ before they passed away. Care planning was personalised and people were supported to access information that was important to them. Complaints were dealt with appropriately.

The service was well-led. Governance systems were used to identify shortfalls, errors and omissions, corrective actions were then taken. The staff and registered manager spoke about and treated people in a person-centred way. The provider had relationships with local organisations and worked to improve peoples’ experiences of care. People had the opportunity to speak about their experiences of living in the home.

People received effective care; people’s needs were assessed and staff worked in partnership with healthcare professionals, supporting people to access healthcare so they achieved good outcomes. People were supported to eat and drink enough by staff who received training relevant to their roles. The provider worked in line with the principles of the Mental Capacity Act 2005 (MCA). The home was designed and decorated to meet the needs of people living there.

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.

Rating at last inspection good (published August 2017)

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 28 May 2017

During a routine inspection

Oaklands care home is registered to provide nursing care for up to 10 younger adults who have mental health problems; some people also have learning disabilities. On the day of our inspection there were seven people resident in the home.

At the last inspection, the service was rated Good. At this inspection we found the service had met all relevant fundamental standards and remained rated as Good.

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

Risks to people were assessed and where required a risk management plan was in place to support people manage an identified risk and keep the person safe.

Staffing numbers were sufficient to meet people’s needs and this ensured people were supported safely. Staff completed training to ensure they were suitably skilled to perform their role. Staff were supported through a supervision programme.

People were supported to maintain good health and had access to external health care professionals when required.

Staff were caring towards people and there was a good relationship between people and staff. Staff demonstrated an in-depth understanding of the needs and preferences of the people they cared for.

Support provided to people met their needs. Care plans provided information about what was important to people and how to support them. People were involved in activities of their choice.

There were systems in place to assess, monitor and improve the quality and safety of the service. Staff described the registered manager as supportive and approachable. Comments from surveys and compliments received by the service confirmed that people were happy with the service and the support received.

Further information is in the detailed findings below.

Inspection carried out on 22nd April 2015

During a routine inspection

We inspected Oaklands Care Home on 22 April 2015. One Inspector carried out this inspection and it was unannounced. The last inspection took place on 15 July 2013 during which we found there were no breaches in regulations.

The service is located near to the centre of Weston Super Mare. It provides accommodation for up to 10 younger adults who have support needs associated with their mental health. At the time of our inspection there were nine people living at the service.

There was 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 legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People’s rights were protected by staff who understood the Mental Capacity Act 2005 Code of practice and the Deprivation of Liberty Safeguards, and followed the correct procedures. The Care Quality Commission is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way. This is usually to protect themselves. At the time of our inspection no-one who lived at the home had their freedom restricted.

People were supported to maintain their privacy and dignity. Staff had a good understanding of people’s needs and they were kind and respectful to people when they provided support. The registered manager and staff promoted an open and inclusive culture within the home. People had the opportunity to share their views and inions. They were involved in planning and reviewing their care. People understood how to raise any complaints or issues they had and were confident the right actions would be taken to resolve issues.

We found people’s health care needs were assessed, and met. People had access to social and healthcare professionals such as community psychiatric nurses and social workers when they needed them.

People were given choices about what they wanted to eat, when and where they had their meals. They were supported to eat and drink enough to keep them healthy. People had their special dietary requirements provided.

Staff were recruited, trained and supported to meet people’s needs appropriately. There were enough staff on each shift to meet people’s needs. Staff had a good understanding of how to manage risks and protect people from avoidable harm. They also knew how to raise any concerns they may have and report them appropriately.

The registered manager ensured there were clear arrangements in place for ordering, storing, administering and disposing of medicines.

People had been consulted about the development of the service. The manager carried out extensive audits of the service provision on a weekly, monthly, and yearly basis. Quality assurance questionnaires were provided to people who used the service and their relatives to gather feedback on the quality of the service.

We found the service followed a person centred approach ensuring that the delivery of care was tailored to the needs of the individual and personalised.

Inspection carried out on 15 July 2013

During a routine inspection

We carried out this inspection to follow up concerns raised regarding; inappropriate restraint. Lack of food stored in the home which resulted in people going without. Administration of medication inappropriately managed. This resulted in people missing important medication. We found that none of these concerns was substantiated.

We spoke with five people who lived in the home. They told us they were happy with the care and support they received. One person told us some staff had left so they had needed to build relationships with new staff members. Another person told us they felt the new staff members were beginning to adjust to the way the home was run.

We saw care planning was person centred and had been agreed with the individual. We found people were involved in day to day decisions about the running of the home. However people told us they were not happy with the introduction of a curfew for everybody who lived at Oaklands. We discussed these comments with the acting manager and provider.

People were safeguarded from harm by the policies and procedures in place.

We found the receipt, storage and administration of medication was managed safely within the Royal Pharmaceutical Society guidelines.

The provider had quality assurance systems in place that ensured people were safe and changes could be made to improve the service provided.

Inspection carried out on 23 August 2012

During an inspection in response to concerns

This inspection was carried out to follow up concerns identified around outcome 4 care and welfare, and outcome 7 safeguarding people who used services from abuse; following notifications sent to The Care Quality Commission by the provider. During this inspection we also looked at outcome 1 Respecting and involving people who used services. Outcome 14 Supporting staff and outcome 16 Assessing and monitoring the quality of service provision.

People who lived at the home were happy with the care that they received. Throughout our visit people gave positive feedback about the staff members who supported them.

We spoke with three people out of six who used the service at Oaklands. They told us that they were happy with living at Oaklands. One person told us "I give the service 8/10." We asked people about the lifestyle choices they made. People told us that staff were very friendly and helped them to complete tasks. One person told us that "We all have our little jobs to do and do them; staff are there to help us." Another person told us �The staff are always straight with you, and there are very clear boundaries." Three people told us that they made choices, for example, one person said "I am able to choose what I do; I like to go out to Tesco's every day."

We observed that the meal at lunchtime was of a good quality and appetising. We saw that staff and people who used the service sat down and ate meals together. People eating the meal confirmed to us that it was acceptable.