Oakley Grange

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first inspection for this newly registered service. This key question has been rated good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Pre- admission assessments involved people and their relatives and explored people’s personal identities, cultural requirements, religious needs and communication preferences. One relative described how involving and interactive the assessment process was. They told us, “[Name of staff member] came out and did a home assessment. While we were doing the assessment I obviously let [Name] speak for herself and at the end, [staff member] spoke to me outside. I was very involved in the process. I went in for the day with [Name] and it was really easy to talk about likes and dislikes. I had to advocate but it didn’t stop them asking [Name] who they really involved in the process and then I filled in the blanks.”

Information from assessments was used to generate personalised care plans which were regularly reviewed and updated to ensure they reflected people’s current needs and supported safe care practices. Relatives confirmed they were involved in the review process.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation. They worked to develop evidence-based good practice and standards.

The provider was proactive in ensuring they used the most up to date and effective assessment tools to identify risks to people’s health and wellbeing. For example, they had recently changed to an evidence-based, decision-making pathway to assess people’s risk of skin damage.

Staff received a structured induction when they started working at the home and regular refresher training to ensure their practice reflected current guidance and standards. All staff, whatever their role in the home, received training in dementia care. Non-care staff particularly spoke about how this training had increased their understanding of dementia, so they felt confident to interact with people and provide emotional and social engagement.

People were supported to eat and drink enough to maintain a balanced diet. Information about people’s dietary requirements was recorded and staff followed recognised best practice for modified diets. Where people had been identified as losing weight, this was monitored where necessary and they were referred to external healthcare professionals for specialist support.

People told us they were happy with the choice and quality of the meals provided. Comments included: “They come and ask you what you want just before lunch. There is a choice and a reserve menu option. I’m happy with the food overall” and “The food here is very good with lots of choices.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had access to people’s risk assessments and care plans through the electronic care planning system. Information about people and any changes in their needs was communicated to staff through handovers, daily meetings and updates to their care plans.

The local GP surgery carried out a weekly ‘ward round’ at Oakley Grange, supported by systems to ensure effective communication and information sharing. The provider’s electronic care planning system was linked to GP Connect which allowed direct access (with consent) to people’s health and care records, so information did not have to be repeated. GP Connect is a national NHS service that allows authorised health and social care professionals to securely share and view patient data across different IT systems for direct patient care.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The provider understood the importance of providing people with opportunities to engage in activities that kept them healthy and active. For example, the introduction of drum fit classes had improved people’s co-ordination and fitness levels as well as supporting social engagement.

People were encouraged to attend regular screening appointments with healthcare professionals such as chiropodists, opticians and audiologists to maintain their everyday health and wellbeing. Where a deterioration in people’s health was identified, they were referred to the GP surgery for advice and guidance. A visiting healthcare professional confirmed referrals were timely and appropriate.

One relative described flexibility in how staff supported their family member in response to any changes in their presentation or preferences. They explained, “If there is a day [Name] doesn’t fancy anything on the menu, there are options for something else. They have flexibility because her appetite hasn’t been quite up to par due to the weather, so she has had sandwiches in her room rather than go to the dining room.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff monitored people for signs of infection, for example, urine infections and respiratory symptoms and referred them promptly to external healthcare professionals. One relative told us about their family member’s skin condition which had recently. Improved. They told us staff had liaised with other healthcare professionals and, “They (staff) had looked at it all the time and measured it and photographed it regularly – very detailed observation.” Another relative told us, “[Name] has had a number of health complications that have been dealt with so well.”

Some people required monitoring to make sure care delivery met their identified needs. For example, 1 person needed to be regularly repositioned to prevent the risk of skin damage and some people needed to have their nutritional intake recorded to ensure they had enough to eat and drink. Monitoring records reflected that risk management strategies were being followed to improve people’s outcomes. However, 1 person was on a modified diet, and this was not always reflected in the records of what food they had eaten. The deputy manager assured us they would address this with the staff team. Detailed records help staff and other healthcare professionals assess the effectiveness of people’s planned care.

Staff told us they monitored people’s responses and presentation in their day-to-day interactions with them. They said they would not hesitate to escalate any concerns people were unwell or not presenting as themselves and that senior staff responded promptly. This ensured people received healthcare support when they needed it to promote positive outcomes.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People told us their choices were respected and they did not feel unduly restricted. Comments included: “I feel quite able to move around as I wish. They encourage me to do the activities, but they don’t force me”, “We are free to move around as much as we like, they encourage us to do so” and “They came and asked me what time I wanted to get up, and they stick to it.” On the dementia community a person showed some anxiety and explained to a member of staff they wanted to go to the local shop. The staff member demonstrated a non-restrictive approach by arranging a time later in the day when they could go together.

Mental capacity assessments were completed when required, were decision specific and showed how people had been involved in decision making processes.