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Oakwood Residential Home Good

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Inspection report

Date of Inspection: 23, 24 January 2014
Date of Publication: 12 March 2014
Inspection Report published 12 March 2014 PDF

People should get safe and appropriate care that meets their needs and supports their rights (outcome 4)

Enforcement action taken

We checked that people who use this service

  • Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights.

How this check was done

We looked at the personal care or treatment records of people who use the service, carried out a visit on 23 January 2014 and 24 January 2014, observed how people were being cared for and checked how people were cared for at each stage of their treatment and care. We talked with people who use the service, talked with carers and / or family members and talked with staff.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

We also spoke with external healthcare professionals.

Our judgement

People’s needs had been assessed and care plans were being developed to meet those needs. Care and treatment was not always planned and delivered in a way that ensured people's safety and welfare. People’s risks of falling were not managed effectively. There were inadequate arrangements in place for the provision of meaningful activities.

Reasons for our judgement

At our last inspection on 11, 16 and 19 September 2013, we found the provider was failing to meet this essential standard. Care plans lacked information; people did not always experience care, treatment and support that met their needs. Assessed risks were not managed effectively; noise levels in the lounge were unpleasant; and emergency planning was inadequate.

Following the inspection we took enforcement action and imposed a condition to prevent the provider from accepting any new admissions to the home.

During this inspection we looked at 15 care plans and associated records and saw a new format had been developed. The care plans and assessments were variable and arrangements on how the provider planned to meet people’s assessed needs were not clearly stated in people’s care records seen. This meant people were at risk of their needs not being met.

We used a variety of methods to help us understand the experience of people using the service. We spoke with eight people and three family members, and observed care and support being delivered. We also used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

During our SOFI we saw staff interacting positively with people in the lounge. We heard staff using people’s preferred names and speaking with them in a calm and respectful way. Some people told us their needs were met and they were satisfied with the care and support they received. One person said, “They look after me pretty good”. Another person told us they were “quite happy with things”. One family member said the care had improved recently and that their relative was “so much better now”. Two other family members told us they had concerns about the standard of cleanliness at the home. They said their relative’s health care needs were not always met as staff did not recognise changes in the person’s condition and seek medical attention in a timely way. Concerns were also raised about the lack of chiropody that impacted on this person’s welfare.

We observed three people using our SOFI and found they did not always receive care and attention. They were left for long periods with no staff interaction and spent their time with their eyes closed or staring blankly. One person was agitated and walked up and down the lounge, at times stopping and leaning over another person. We noted that people appeared bored and were sat for long periods staring at the walls or falling asleep. The atmosphere in the lounge was not conducive to creating a relaxed atmosphere due to high levels of noise. As well as the sound of the radio and televisions, there was a constant high-pitched beeping sound from a defective door closure. This was added to by high pitched alarms sounding on a display panel used to monitor people’s call bells, which was also situated in the lounge. The home accommodated people with varying degrees of dementia. We observed the people using the service did not pay any attention to the television although this was on all day. We had identified this as a concern at our last inspection and found no improvements had been made.

Staff told us they completed the daily records which should contain information about the care people had received. We looked at daily records of care and saw they were completed for each shift; for example, from 8:00am – 2:00pm, 2:00pm – 8:00pm and 8:00pm onwards. However, we saw these provided only a summary of care and support provided and entries were not timed. The records for two people we looked at were blank for a number of occasions and staff were unable to tell us what care people had received. This was brought to the attention of the manager at the time of the inspection.

The daily care records showed that two people were refusing personal care and had been identified as at risk of self-neglect. In their care plans, we found there were no strategies in place t