Oakley Grange

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

This is the first inspection for this newly registered service. This key question has been rated good. This meant people’s needs were met through good organisation and delivery.

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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

Staff promoted person centred care by respecting people’s preferences and routines and encouraging their independence. One staff member explained, "Why should people change their routine because it is convenient to us, their life should continue here as it was in their own home." Another staff member commented, “It is important to keep to their routines, so they feel valued, respected and seen. It helps them to settle in and feel it is their home." A relative explained how this approach had a positive impact on their family member’s day. They told us, “It’s the simple little things, like they did a small activity where a couple of them were peeling vegetables and then they used them for dinner. [Name of staff member] is 1 of the only carers Mum will let shower her. If she is working downstairs, she will come up especially to make sure Mum has her shower.” Another relative commented, “I think they’re quite holistic in their approach to things. For example, [Name] has always been quite hardy and enjoys gardening and planting. They produced a mini greenhouse for her and a little watering can that she is able to carry.”

Where people could not always express their everyday wishes, care plans contained information to help staff provide care that was relevant to the person and connected them to their past. For example, 1 person’s care plan contained information about their favourite programmes and style of music so staff could consider this when turning on their television. A staff member explained, "It is not about the dementia, it is about the person. A lot of people with dementia remember their past and you can tailor what they did in their lives and their interests into their activities. You are building relationships by getting to know them and chatting about their history. If a person is upset, talking about their past history, settles them because they start reminiscing with you." A second member of staff told us, “It helps us channel their care to suit them and make it personal and we have something to talk about to remind them of their past. When we know what they have done in the past, it helps with communication and bonding." A relative commented, “I don’t know how many carers there are involved with the residents, but they often are just sitting and having a chat with them.”

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People were able to make choices about who provided their care. For example, people were offered the opportunity to transfer their medical care to the local GP surgery or maintain continuity by retaining their existing GP.

A weekly ward round with the local GP practice meant people had consistent oversight of their health and clinical needs.

Relatives were encouraged to be involved and maintain an active role in supporting their family member’s health where they wanted to. One relative commented, “It is a 2-way dialogue. We update each other every time we go in, and they record that. If [Name] has a couple of appointments, they handle triaging with the GP surgery. They will make sure [Name] has it in her diary and they know to make sure she is ready. The care plan is regularly dynamically updated.” Another relative told us, “To start with I was there every day as that’s what [Name] was used to, I’m always welcome and I’m always involved.”

The provider supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

People’s communication needs were assessed to identify any visual or hearing impairments, speech or cognitive difficulties, preferred language and format. Care plans guided staff on how to communicate information in ways people could understand.

During our inspection we saw staff adapted their communication in response to people’s sensory needs and did not rush people when talking to them.

Where a need was identified, people were referred to other healthcare professionals such as opticians, audiologists and speech and language therapists to ensure their sensory and communication needs were supported to promote effective communication.

Information was available in alternative formats to meet people’s individual needs and consideration was given to environmental factors that could impact on people’s communication. For example, poor lighting and background noise. People were encouraged to use technology and their mobile and landline phones to stay connected with their families and friends. Land phones with big buttons were provided for people with visual impairments.

The provider made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff involved people in decisions about their care and told them what had changed as a result.

People were involved in decision making about their care and home environment through conversations, meetings and reviews. Regular food forums with the kitchen team provided people with an opportunity to give their feedback which was used to improve their mealtime experiences. One person told us, “We go to the residents’ meetings, they are interesting. They changed the mealtimes around from the main meal in the evening to lunch time instead.” Another person told us how visitors had been issued with name badges following a suggestion at a recent meeting. People had nominated a resident ambassador who shared people’s feedback about the service.

Relatives told us they were involved and consulted about their family member and any changes in their needs. One relative commented, “If they have any issues, they are on the phone to us and when [Name] is resident of the month, they let us know and we run through everything.”

The provider had a complaints policy and procedure which was available to people and other visitors to the home. Action was taken in response to complaints received to improve people’s experiences and ensure standards were maintained. People, relatives and visitors were encouraged to provide immediate feedback during their visits and annual satisfaction surveys.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

Assessments and care plans considered any factors that could increase the risk of people being disadvantaged because their needs were not being recognised or met. For example, any health condition, sensory impairment or communication need.

Staff used a range of tools to identify when people who could not verbally express their pain or discomfort needed to be referred to external professionals for routine or emergency healthcare support. This included monitoring for subtle changes in people’s emotional presentation or physical responses. One staff member explained, "Someone might not necessarily be able to tell you they have pain but looking at their facial expressions or body movements may indicate they have pain. We have got the NEWS tool and there is a new pain checker on our handsets.” The NEWS tool (National Early Warning Score) is a standardised clinical assessment system used by healthcare professionals to quickly recognize when a person’s condition is deteriorating.

The environment was designed to promote independence and accessibility. Accessible communal areas, adapted bathrooms and personalised mobility equipment enabled people with varying abilities to move around the home safely.

People had opportunities to access a range of activities and events. One staff member gave examples of how they adapted their approach so people with sensory needs could fully engage with the different activities in the home.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

The provider and registered manager were committed to ensuring everyone in the home had the same opportunities and experiences. A recent provider assessment had identified some people living within the dementia community did not always achieve the same positive outcomes as others because their experiences were sometimes limited. Solutions were being developed to address this inequality through more in-depth staff training in dementia, enhancing the provision of activities and providing more opportunities for visits within the local community. The registered manager explained, “Just because there is a diagnosis and terminology, that is not seen as a barrier to how we are supporting that resident. It is our job to support our residents to live an independent life. The language I want staff to use is 'how can I support that person and how can I make it happen'." A relative confirmed, “They are creating an amazing community up there where residents are wanting to spend time with each other.” This demonstrated a commitment to removing barriers and promoting inclusion.

Staff received training in Equality and Diversity and Human Rights, so they understood their responsibility in meeting the needs of people with protected equality characteristics. One staff member told us they would not hesitate to advocate on behalf of people who were at risk of not receiving the care and support they needed. They commented, “People don’t always have a voice themselves, and they don’t always remember that, for example, their eye test is due or that their eyes are getting worse. They rely on us to look at those things for them and advocate for them."

People were supported to express their individual needs so they could be assured their religious practices were respected. Diverse cultural events and religious festivals were celebrated to promote an inclusive and welcoming environment.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Relatives whose family members had received end of life care at Oakley Grange gave positive feedback about the service. One relative described the empathy, consideration and thoughtfulness staff had demonstrated to their family member and their partner during their family member’s final days. Another relative had recently recorded their thanks for the care their loved one received and commented, “Everyone at Oakley has shown what a wonderful end of life is possible. [Name] was treated with so much love that her dignity grew. She knew how much people were there to care with the utmost respect."

People’s wishes for their end-of-life care were discussed with people, if they wished to do so, during the pre-admission assessment. When people were identified as being at end of life, a care pan was implemented to reflect how they wanted to be cared for in their final days. We discussed with the registered manager the benefits of developing advanced care plans at an earlier stage, and they assured us they would explore this further.

Staff spoke with compassion about supporting people at their end of their life. One staff member told us, “Residents moving here get a very warm welcome and they get a very dignified end of life. At the end of the day, we are talking about the most precious person in someone's life. However someone passes, you want them to die in the most dignified way, and it is a privilege to look after someone's loved one. When somebody leaves, we make sure they have a dignified goodbye."