The inspection took place on 12 January 2016 and was unannounced, which meant the provider did not know we were coming. This was the first inspection of the service following the Care Quality Commission registration in September 2015. The service was previously registered under another provider.
The service has a registered manager who has been registered with the Care Quality Commission since September 2013. 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.
Oldfield House is a care home situated in Stainforth, Doncaster which is registered to accommodate up to 33 people. The service is provided by Runwood Homes Limited. At the time of the inspection the home was providing residential care for 19 people, some of whom had been diagnosed with dementia. The service has several communal and dining areas and easily accessible secure gardens. The home is close to local amenities of shops and healthcare facilities.
CQC is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS), and to report on what we find. The members of the management team and nurses we spoke with had a full and up to date understanding of the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). These safeguards protect the rights of adults by ensuring that if there are restrictions on their freedom and liberty these are assessed by appropriately trained professionals. We found that appropriate DoLS applications had been made, and staff were acting in accordance with DoLS authorisations.
People’s physical health was monitored as required. This included the monitoring of people’s health conditions and symptoms so appropriate referrals to health professionals could be made. For example we saw evidence that they home regularly makes contact with district nurses, community nurses for mental health issues, and peoples own doctors. Other health professionals such as dieticians, dentists, occupational therapists and opticians were also requested as needed.
There were sufficient staff with the right skills and competencies to meet the assessed needs of people living in the home. Staff told us they felt supported by the registered manager and provider however, formal supervisions and appraisals were still being transferred onto Runwood Homes Limited’s documentation.
Staff were aware of people’s nutritional needs and made sure they supported people to have a healthy diet, with choices of a good variety of food and drink. People we spoke with told us they enjoyed the meals and there was always something on the menu they liked. We observed people being offered a second helping during breakfast and lunch. Snacks of fruit and biscuits and drinks were also available for people to help themselves
People were able to access some activities. There was an activity co-ordinator who worked two days a week at the home and we saw people enjoying being pampered in the morning and two people help to arrange fresh flowers for the dining area in the afternoon of the visit. A café area had been introduced and we saw this area was well used by people who used the service. There was a strong and visible person centred culture in the service (person centred means that care is tailored to meet the needs and aspirations of each individual).
We found the service had a friendly relaxed atmosphere which felt homely. Staff approached people in a kind and caring way which encouraged people to express how and when they needed support. Everyone we spoke with told us that they felt that the staff knew them and their likes and dislikes.
Staff told us they felt supported and they could raise any concerns with the registered manager and felt that they were listened to. People told us they were aware of the complaints procedure and said staff would assist them if they needed to use it. We noted from the records that no formal complaints had been received since the transfer of services in September 2014.
Staff knew how to recognise and respond to abuse correctly. They had a clear understanding of the homes procedures in place to safeguard vulnerable people from abuse. Medicines were stored and administered safely. We saw staff administering medication to people safely
There were systems in place to monitor and improve the quality of the service provided. However, we were unable to see how effective they were embedded as audits were relatively new following their registration in September 2015. We saw copies of reports produced by the registered manager and the provider. The reports included any actions required and these were checked each month to determine progress. The regional care director shared an action plan with us that the registered manager was working towards. The action plan related to objectives set by Runwood Homes Limited