Oakleigh Residential Care Home

Oakleigh Residential Care Home provides accommodation and personal care for up to 27 older people and people living with dementia in one adapted building. At the time of our inspection there were 21 people living at the service.

We found the following examples of good practice.

The service managed infection prevention and control (IPC) through a range of measures. These included temperature checks, COVID-19 tests, completing a health questionnaire and wearing personal protective equipment (PPE). Only essential visits were being facilitated at the time of our inspection such as for end of life care. Other systems had been introduced that enabled people to communicate with relatives such as video technology, letters and regular telephone calls. Staff supported people with additional pastimes and interests such as, puzzles, newspapers and people's family photographs.

The registered manager gained assurance of good IPC practise through audits, staff training, observations of staff and having enough stocks and supplies of appropriate PPE. Any contaminated or infectious wastes was stored and disposed of safely. Plans were in place if any outbreak of COVID-19 occurred such as staff who worked in groups. Each group would only work in one part of the care home.

The service looked clean and furniture had been positioned to help promote social distancing but in a way that still enabled people to socialise. Staff were seen washing their hands and correctly wearing their PPE. People's rooms and areas frequently touched by people and staff such as door handles were cleaned regularly and deep cleans took place weekly. This helped reduce the risk of infections and cross contamination.

The service had a GP as the clinical lead and they regularly visited the service and offered support to people and staff. The GP had trained staff to use equipment to identify at an early stage any person at risk of infections. The provider supported the registered manager with up to date COVID-19 guidance and policies to manage various scenarios including plans for any potential outbreaks.

Oakleigh Residential Care Home is a residential care home providing personal care to 21 older people at the time of the inspection. The service can support up to 27 people in one partially adapted building.

People’s experience of using this service and what we found

People were happy with the care home and the staff that provided their care.

People felt safe living at the home because staff knew what they were doing, they had been trained, and cared for people in the way people wanted. Staff assessed and reduced risks as much as possible, and there was equipment in place to help people remain as independent as possible. There were enough staff, and the senior staff also spoke with people regularly. The provider obtained key recruitment checks before new staff started work.

People received their medicines and staff knew how these should be given. Medicine records were completed accurately and with enough detail. Staff supported people with meals and drinks. They used protective equipment, such as gloves and aprons. Staff followed advice from health care professionals and made sure they asked people’s consent before caring for them.

People were supported to have choice and control in most areas 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. However, people were not free to leave the home and authorisations to make sure this practice was lawful had not been completed. Some adaptations had been made, although more could have been made for those people living with dementia. We have made a recommendation about consulting guidance for changes to the environment.

People liked the staff that cared for them. Staff were kind and caring, they involved people in their care and made sure people’s privacy was respected. Staff worked well together, they understood the home’s aim to deliver high quality care, which helped people to continue to live as independently as possible.

Staff kept care records up to date, although there was little individual information and not all care records were written in enough detail. We have made a recommendation about personalising care records. There was a complaints procedure in place, although no complaints had been made. People were happy with the activities that were provided. However, staff missed opportunities to spend time with people and they spend long periods alone with little to do. We also found this at our last inspection in March 2017. We have made a recommendation about developing activities for people with dementia.

Systems to monitor how well the home was running were carried out. Changes were made where issues had occurred elsewhere, so that the risk of a similar incident occurring again was reduced. People were asked their view of the home and this was overwhelmingly positive.

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 13 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Enforcement

We have identified breaches in relation to acting in accordance with the Mental Capacity Act 2005.

Please see the action we have told the provider to take at the end of this report.

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.

We will request an action plan for 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.

This inspection was undertaken by one inspector and an expert by experience. At the last inspection on 5 January 2015 we found that improvements were required. This was in relation to the way that risks to people were identified and managed. During the inspection we found that the required improvements had been made.

At this inspection we found the service remained 'Good'.

A registered manager was in post at the time of this inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Staff were knowledgeable about how to recognise, and protect people from, harm. Risk to people were effectively managed. Incidents were responded to and changes were made or were in the process of being implemented to help keep people safe. Medicines were administered and managed safely.

People's assessed care needs were met by a sufficient number of suitably qualified staff. Staff were recruited through a robust and thorough process. This helped ensure that staff who were subsequently employed were suitable to work with people who used the service.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People's needs were assessed by skilled staff who then implemented people's care and support based upon people's preferences.

People’s care plans were detailed and provided staff with sufficient guidance to care for people and meet their assessed needs. People's health and nutritional needs were met by staff who had been trained to support people with these needs. Staff enabled people to access health care support when this was needed.

Staff were aware of what was expected of them and they were provided with supervision and guidance on areas they needed to develop and what they had done well. A range of audits and quality assurance systems were in place to assess, monitor and improve the service.

People's, staff's and relatives views about the quality of the service were sought through day to day contact, questionnaires and telephone calls.

Further information is in the detailed findings below.

People's clothes looked clean and people appeared well cared for.

One person said, "Staff will help if you need it. We can ask for anything." Another told us, "Staff are absolutely wonderful. They don't mind what bother they go to." People told us the food was, "...excellent' and "...get a big choice of food". During the inspection we saw that one person was having a cooked breakfast whilst another had opted for cereal and toast.

People told us there were activities and people came to entertain, although others said they could choose not to attend any activity if they wished.

One health professional told us that, "They do much more than residential." They stated that people were not sent to hospital at the end of their lives, if at all possible, and remained in the home to be cared for by staff they knew.

We found the provider to be compliant on 8 November 2012 when we inspected.