Oakleigh Residential Care Home

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.

At our last inspection, we rated this key question requires improvement. At this inspection the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 50 (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 did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

People's needs were assessed, but care plans did not always accurately reflect or respond to those needs. Care plans did not consistently include clear, personalised information to guide staff, including how to recognise pain or respond to specific needs.

Some records contained contradictory or incomplete information, and key areas such as preferences, emotional support and daily routines were sometimes missing or lacked sufficient detail. This reduced assurance that staff always had accurate information to provide effective care and support.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People did not always receive care in line with their assessed needs and care planning guidance.

Care was not always delivered in line with best practice guidance. Systems to monitor and manage health conditions were not implemented consistently. Records showed blood glucose monitoring was not always completed in accordance with care planning instructions, reducing assurance that people's health needs were being monitored effectively.

The provider used recognised assessment tools, including the Abbey Pain Scale. However, care plans did not always explain how these tools should be applied to each individual, and guidance was often generic rather than personalised. This meant staff did not always have clear information about how people communicated pain, which reduced assurance that pain could be recognised and responded to consistently.

The provider did not always work well across teams and services to support people. They did not always share their assessment of people’s needs when people moved between different services.

The service worked with external healthcare professionals, including GPs, district nurses and other specialists, to support people's care and treatment needs.

However, systems to support communication and coordinated care were not always effective. During handovers, people were often referred to by room number rather than name, and discussions did not consistently include relevant information about people's care and support needs. External professionals also raised concerns about the quality and consistency of care provided. This reduced assurance that important information was always shared effectively to support continuity of care.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People had access to healthcare professionals when required. However, health monitoring and support arrangements were not always completed consistently in line with assessed needs. Records showed that monitoring relating to some people's health conditions was not always completed in accordance with care planning guidance, reducing assurance that changes in people's health would be identified and responded to promptly.

Relatives raised concerns that food choices did not always reflect people's preferences. This reduced assurance that people's dietary preferences and wellbeing were consistently considered when planning and providing meals.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and

consistent, or that they met both clinical expectations and the expectations of people themselves.

Systems to monitor and improve outcomes were not consistently effective. Records did not consistently demonstrate how outcomes for people were monitored, reviewed and used to improve care. Some assessments identified changes in people's needs. However, records did not always demonstrate how these changes were reflected in updated care planning, risk management arrangements or reviews of care.

We found limited evidence that information gathered through monitoring was routinely used to evaluate the effectiveness of care or identify alternative approaches. For example, some people received ongoing 'when required' (PRN) medicines without clear evidence that alternative strategies had been explored, and some restrictions remained in place without clear evidence of regular review.

This reduced assurance that care was consistently reviewed and adapted to support positive outcomes for people.

The provider did not always tell people about their rights around consent and did not always respect their rights when delivering care and treatment.

Consent processes were not always applied in line with legal requirements. While staff were able to describe the principles of the Mental Capacity Act (MCA), this was not consistently reflected in practice.

Decision-making processes were not always followed correctly or documented appropriately. Records showed that some best interest decisions were recorded after restrictions had already been implemented, meaning decisions were reactive rather than planned.

For example, environmental restrictions were in place before a best interest decision had been recorded. The decision-making process did not demonstrate appropriate involvement of family members or relevant professionals, and there was no clear evidence that less restrictive options had been considered.

This reduced assurance that people were always supported to make decisions about their care and that decisions made on behalf of people who lacked capacity were lawful, person-centred and made in their best interests.