Archived: Oak Tree Lodge

Oak Tree Lodge is a residential care home providing personal care for up to 60 people aged 65 and over at the time of the inspection.

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

Relatives we spoke with said risks to people were managed safely. We found risks to people’s health and wellbeing had been assessed, regularly reviewed and actions taken to prevent future risk of harm.

The home was clean and free from malodour. There were appropriate, up to date infection control measures in place in line with current government guidance.

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 requires improvement (published 24 October 2018).

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about risk management. We also looked at infection control practice in the service. The overall rating for the service has not changed following this targeted inspection and remains good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

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.

Oak Tree Lodge is situated in the Harehills area of Leeds. It is a purpose built home with 60 beds, providing care for older people and people living with a dementia related condition. There were 59 people living at the service at the time of inspection. The building was split into three floors, with the ground and first floor catered towards people living with a dementia related condition, and the top floor was for people requiring personal care and accommodation. The building was wheelchair accessible with lift access to all floors, and the building was secured with keypad entry.

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 told us they felt safe in the home. There were enough staff to deliver care safely, and staff had appropriate training. Staff had a good understanding of safeguarding vulnerable adults. People had plans in place to manage risks, which were understood by staff.

People received their medicines safely and as prescribed. Medication Administration Records (MAR charts) accurately recorded prescribed medications delivered and medicines were stored safely. People had regular and appropriate access to health professionals to meet their needs. Staff worked in partnership with health professionals who had no concerns with care provided at the service.

There were adequate recruitment processes in place to ensure staff were recruited safely and that they were suitable to meet people’s needs. Staff had sufficient training to ensure they could carry out their roles effectively. Staff were supported with regular appraisals, and the service was starting a new appraisals process to enhance existing mechanisms.

There were policies and procedures in place in relation to the Mental Capacity Act (MCA) 2005. Staff were trained in the principles of the MCA and could describe how people were supported to make decisions; and where people did not have the capacity; decisions were made in their best interests.

People received support from kind and compassionate staff who understood their individual needs. Care plans were person centred and evidenced input from people and their relatives.

People were supported to eat and drink safely and there was evidence people were able to choose what they wanted. If people did not like the options, kitchen staff were able to prepare alternatives from a well-stocked pantry containing fresh produce. People’s weight was monitored and nutritional risk assessed appropriately.

There were systems in place for people to raise any concerns, and we saw evidence that complaints were responded to, in line with the provider’s policy in a timely and appropriate way.

There was an appropriate programme of meaningful activities for people delivered by staff, and people’s participation was recorded. People were able to access the community and people’s ideas and suggestions were listened to and acted upon. We saw that the service asked people what they thought of their care and that their views generated actions taken by the service to address them.

There was a clear leadership structure with the registered manager holding oversight of governance arrangements. The registered manager provided clear leadership, and staff understood their roles and what was expected of them. We saw that there was an effective quality assurance process, with a range of audits and monitoring systems in place to ensure quality of care was maintained and the environment of the home was safe.

Oak Tree Lodge is registered to provide accommodation and personal care for up to 60 people. The service had recently transferred from Ideal Carehomes to Anchor Carehomes. At the time of the inspection, the service had a manager registered with the Care Quality Commission (CQC). 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 told us staff responded to their needs promptly, although we saw occasions where communal lounges were not staffed. The service was in the process of recruiting to some vacant posts. Medicines were generally well managed. However we saw some examples where medicines had been signed for as given before they were administered.

Recruitment practices were mostly found to be safe. People told us they felt safe living in the home and staff who had received safeguarding training were able to describe the action they would take to report abuse. Risks were being managed effectively in the service.

Staff were satisfied with the induction they received and records we looked at showed most staff were up-to-date with their training. The registered manager acknowledged there were gaps in staff supervisions and appraisals. Staff told us they were happy with the support they received from the registered manager.

This service was meeting the legal requirements of the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards (DoLS). Staff supported people to access healthcare services and people were found to have been supported with their nutritional needs. People and staff provided mixed feedback about the quality of food.

People and relatives spoke positively about the support they received from staff who had good working relationships with them. Staff were able to describe how they protected people’s privacy and dignity, although we found one example when this did not happen.

People expressed frustration at the lack of activities taking place. On the day of our inspection there were no activities happening. The activities planner included ‘hairdresser’ and ‘family day’ as activities.

People’s care plans generally contained sufficient detail for staff to be able to provide effective care. We saw some examples of care plans which had not been fully completed.

People and relatives knew how to complain if they were unhappy with the service they received. We saw complaints were recorded and responded to appropriately. The registered manager had started a weekly ‘clinic’ to meet with people and relatives.

The home was generally clean and tidy, although we found concerns with the storage of clinical waste. Some maintenance checks had not been completed as scheduled and we found this had not been monitored appropriately.

We found a notification had not been sent to the CQC as required under the terms of the provider’s registration, although this had been submitted to the local authority. There was limited evidence of the registered manager’s involvement in audits carried out in the home, although the area manager carried out their own checks. Confidentiality was not always been maintained as sensitive records were being stored in an unsecured area.

We found breaches of regulations of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see the action we have told the provider to take at the end of this report.