We carried out a review of the data available to us about Little Oaks on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Little Oaks, you can give feedback on this service.
Little Oaks is a residential care home providing accommodation and personal care to up to 14 people. There were 11 people using the service at the time of the inspection.
People’s experience of using this service and what we found
People told us they were safe and well cared for and relatives were complimentary about the care provided.
People were safeguarded from harm. Staff knew how to follow the providers safeguarding process if they were concerned about anyone using the service. Staff were safely recruited with the relevant checks in place.
Risks to people’s safety were assessed and staff knew how to report any concerns. There were enough staff available to meet people’s needs and staff received an induction and training relevant to their role. Staff told us they felt supported and valued.
Staff followed safe infection prevention and control processes and guidance was available to support staff during the COVID-19 pandemic. People received their medicines as prescribed and staff had received medicines training.
People told us the staff were kind and caring. 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.
Relatives were involved in planning and reviewing people’s care and were kept up to date about any changes. Any concerns were responded to promptly by the registered manager. Care plans were written in a person-centred way, however needed some reorganisation.
We have made a recommendation that the provider makes changes to how information is recorded in the care plans so that staff can understand people’s up to date needs.
People were well cared for towards and at the end of their life by staff who were respectful and compassionate.
The provider had systems in place to monitor the quality and safety of the service and worked effectively alongside other health professionals to meet people’s needs. People and relatives spoke positively about the culture and management of the service.
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 (published 23 April 2020).
Why we inspected
This was a planned inspection based on the previous rating.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.
Little Oaks is a care home providing personal care to people aged 65 and over. The care home accommodates 14 people in one adapted building. At the time of the inspection, 13 people were using the service.
People’s experience of using this service and what we found
The service had acted on our recommendations given in our last inspection. Improvements had been made in planning people’s needs, and supporting people to engage in social and leisure activities which interested them. This, and previous improvements made has led to improving the overall rating for this service.
We found the provider did not always retain a good working knowledge of what is happening in the service to ensure any identified issues were acted on. This is needed to maintain the improvements made over the last three inspections. We have made a recommendation to carry out monthly quality assurance visits to support the provider in this area.
Management and staff enjoyed their work, and were highly motivated, kind and compassionate. People, their relatives and visitors praised the caring, friendly staff and said they would not hesitate to recommend the service to others. One person told us, “They are all good...I am very happy with the care here.”
Staff knew people well and understood their preferred routines, likes and dislikes and what was important to them. They supported people to maintain links with those that mattered to them, and ensured their visitors felt welcomed.
People told us they felt safe living in the service and there were enough numbers of staff to support their needs. Staff knew what action to take if they had concerns over a person’s safety. Safe systems were in place to ensure people received their medicines as prescribed and were supported in a clean and hygienic environment.
People’s needs were assessed prior to being offered a place at the service. Staff monitored people’s health and welfare, liaising with external healthcare professionals to access support in a timely manner. People told us they enjoyed the food and had access to snacks and drinks to support their nutritional needs.
Staff received training and support to effectively carry out their role. There was a programme of ongoing redecoration and refurbishment which enhanced and personalised the environment. This included planned work to have the garden landscaped. Where we identified communal bathroom / shower room, and toilets had not been fitted with locks to support privacy, the provider said this had been an oversight when the new doors had been installed and locks would be fitted. People would also be consulted if they wished to have locks fitted on their bedroom doors.
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.
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 29 August 2019).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will request an action plan from 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.
Little Oaks is a care home providing personal care to people aged 65 and over. The care home accommodates 14 people in one adapted building. At the time of the inspection, 13 people were using the service.
People’s experience of using this service and what we found
Significant improvements had been made to the service since our last inspection. This included the internal environment, an accessible complaints process and a robust plan for continued improvement with clear timescales. However, some further improvements were needed.
People's care plans were personalised to help staff provide person-centred care but they were not always done in a timely way. Staff knew and respected people's preferences, routines, likes and dislikes and provided care and support the way they wanted. Some improvements were needed to the timeliness of the assessments.
We made a recommendation that the provider to review their approach to planning and assessing of people’s needs.
There were limited opportunities for people to engage in group or individual social and leisure activities in or outside of the service.
We made a recommendation that the provider consider best practice guidance in relation to social and leisure interests for people who used the service.
People told us they were safe using the service. Staff knew people well including any risks and how to manage them to keep them safe. People were supported by sufficient numbers of staff who had been safely recruited. Medicines were safely managed by staff who were trained and competent. People were protected from the risk of infection as prevention and control measures were in place.
Staff received training, supervision and appraisals to give them the skills and knowledge to do their job. Improvements to the environment continued to be completed through an ongoing improvement plan. 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. People had access to a range of good food and drink which met their needs and preferences. Referrals to health care professionals were made in a timely way to maintain people’s health and wellbeing.
Staff were kind and caring and knew people well. People felt listened to and included in decisions about their care and support. Staff treated people with dignity and respect and maintained their privacy. People were encouraged to be independent and were supported to maintain important relationships.
People and their relatives were included in reviews of their care and support. If people had end of life needs and preferences, these were explored and documented. The complaints process had been updated and was now accessible should people need to use it.
The service was well led by an experienced registered manager who promoted a person-centred, open and inclusive culture. People, relatives and staff were positive about the management and improvements made to the service. The quality assurance processes were still in need of improvement to ensure the monitoring and oversight of all aspects of the service was in place and effective.
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 3 July 2018) with recommendations. At this inspection, the service was still Requires Improvement with two recommendations.
Why we inspected
This was a planned inspection based on the previous rating.
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.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
This was an unannounced inspection carried out on the 1 May 2018. At our last inspection 10 April 2017 the service was rated requires improvement. This was because we had concerns relating to the environment. At this time, these topic areas were included under the key question of Effective. We reviewed and refined our assessment framework and published the new assessment framework in October 2017. Under the new framework, this topic area is included under the key question of safe.
After the last inspection, we asked the provider to improve some aspects of the garden, to install a bath hoist and a ramp to the front of the building. These improvements had been carried out. At this inspection, the service was still rated requires improvement. This was because improvements to other aspects of the environment was now needed, and some parts of the service and external areas needed to be cleaner. This is the second time the provider has been rated as requires improvement. You can see what action we have asked the provider to take at the back of the full version of the report.
At our last inspection, we found that the provider had breached Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities). Regulations 2014; Good Governance. At this inspection on 1 May 2018, improvements had been made, a registered manager was in post and audits were carried out and used to monitor the quality of the service people received.
A registered manager was 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.’
All the people we spoke with said they felt safe at Little Oaks. Staff supported people to be as independent as they wanted to be and protected them from risks to their safety. Staff were trained in protecting people from abuse and understood their responsibilities to keep people safe.
Staff received regular supervision and had been given the training they needed to meet people’s needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so.
People were cared for and supported by staff that understood their needs and knew them well. Staff treated people with dignity and respect and were sensitive to their needs regarding equality, diversity and their human rights. The care and support people received was individualised.
The service had appropriate systems in place to keep people safe and staff followed these guidelines when they supported people. There were a sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time.
The provider had a robust recruitment process in place to protect people from the risk of avoidable harm. They had been recruited safely with the skills and knowledge to provide care and support to people.
People’s health and emotional needs were assessed, monitored and met in order for them to live well. The service worked closely with relevant health care professionals and people received the support they needed to have a healthy diet that met their individual needs.
We have made a recommendation about the management of complaints and the accessible communication standards.
At the time of the inspection the service did not have 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.
The provider did not have a clear approach to monitoring the quality of the service and overseeing the day-to-day management. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities). Regulations 2014; Good Governance. You can see what action we asked the provider to take at the back of the full version of the report.
The service did not always look at ways it could continuously improve the service offered to people. Feedback was obtained via surveys, but changes were not always made quickly. The service had recently introduced new audits to review the quality of the service being delivered to people and they had identified areas for development but, despite this, action had not always been taken.
Improvements could be made to the general décor of the home and external area’s which would improve people’s day to day lives.
People would benefit from having more access to meaningful and stimulating activities. People had enough to eat and drink, but they thought the mealtime experience could be improved.
There were enough staff on shift to meet the needs of people who used the service and staff supported people in the least restrictive way possible.
Staff understood how to keep people safe and could describe the correct steps they would take if they were concerned that abuse had taken place.
Accidents and incidents were appropriately recorded and risk assessments were in place for people who used the service.
The general manager and staff involved people to make decisions about the service they received and obtained people’s feedback on how the service should be run.
People told us that staff understood their needs and preferences well, and they received effective care and support from well-trained staff.
Staff had developed caring relationships with the people they supported and that there was a positive and relaxed atmosphere.
Medicines were managed safely and staff member's understood their responsibilities.
People who used the service, family member's, and visitors were encouraged to make comments, complaints or compliments about the service.
Further information is in the detailed findings below.
We inspected this home on the 12 March 2015. Since our last inspection in June 2014 this home has been sold and is now under new ownership. This is the first inspection since the change of registration.
The service was registered for twelve people but has since increased to accommodate fourteen older people with or without dementia. On the day of our inspection there were twelve people at the service. There was a registered manager in post who was also the new owner. However, he had two full time members of staff in day to day control of the home.
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.
There were enough staff to meet people’s needs and keep them safe. However, staffing numbers were reduced in the evening and we could not see how the provider assessed people’s needs to ensure they had enough staff.
There were safe systems in place to ensure people received their medicines safety. Staff were trained and observed by senior staff to ensure they were able to administer medicines competently.
Risks to people’s safely were identified and as far as possible reduced. People’s needs were kept under regular review and staff responded appropriately to changes in people’s needs.
Staff were aware of how to protect people as far as possible from abuse or harm. Staff received training to help them identify abuse and had access to policies and procedures which told them what to do.
Staff received training and support to help them fulfil their role and staff demonstrated that they had sufficient knowledge and skills.
People were supported with decision making by staff that knew and understood the Mental Capacity Act, so could act lawfully.
People were supported to eat and drink, but we found a number of people usually independent with their meal did not receive support and ate very little. We felt the meal time experience could be improved upon to ensure everyone received the support and encouragement they needed.
People’s care plans were written in a very detailed, insightful way and were individualised. They clearly described people’s needs and preferred routines. We observed staff meeting people’s individual needs. People were supported to have their health care needs met and there were records in place to support this.
There was good communication in the home and people and their families were aware of how to raise concerns should they need to. They also told us they were asked to comment on the service provided to them. This enabled improvements to be made. Both staff and people using the service told us the acting managers and the registered manager was available and approachable.
This was a run well service which put people first. Staff were well supported and the manager and acting managers were clear about how they wanted to improve the service and had consulted with people about how best to achieve this.
There were systems in place to monitor people’s safety and well- being and to enable staff to take the most appropriate actions to promote people’s health.