Oake Meadows 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 assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (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.

People’s health, care, wellbeing and communication needs were assessed before moving to the home, and ongoing assessments were reviewed to help ensure support remained effective. Assessments covered people’s physical, psychological, social and wellbeing needs, including areas such as cognition, mobility, nutrition, risks and communication. Care plans and risk assessments were reviewed regularly through systems such as the ‘resident of the day’ process and reflected changes in people’s needs. Staff told us care plans were accessible, up to date and provided the information needed to support people safely.

Health professionals told us the service worked collaboratively to assess people’s needs and support positive outcomes. One professional commented, “The nursing team and therapy team are very efficient with their assessments of the clients and collectively we work together to assess, plan and support for their discharge.”

We found some ‘This is Me/About Me’ information was incomplete and some social history information was not consistently detailed within records. Although these issues did not prevent people from receiving support that met their needs, opportunities remained to strengthen the recording of people’s life histories and preferences.

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 and current evidence-based good practice and standards.

Staff received regular training to make sure their practice was in accordance with up-to-date best practice guidelines and legislation. One professional told us, “The nursing and care team are very knowledgeable and insightful regarding their residents' physical health, mental health, dementia care needs, and overall holistic care. I have noticed that both nurses and carers speak with a high level of confidence.” Another professional commented, “The staff have sound knowledge of their residents and a clear pathway of working with some complex situations.”

People received support with nutrition and hydration. Records demonstrated people received nutrition and hydration. However, on 1 occasion records showed a person’s fluid intake target had not been met, we discussed this with the registered manager who identified it as a recording error.

People mostly spoke positively about food quality and people said they had a choice of meals. One person told us, “The food here is nice, there are choices and I can eat when I like. You get the choice of where to eat; they come in and ask you what you want.” Comments from relatives included, “The food is very good and [name of person] does eat it all” and “[Name of person] has quite a choice [of food]. I think they are happy with the food. They [staff] do encourage [name of person] to eat.”

Our mealtime observations were mixed. Some staff did not explain meals to people while supporting them to eat, which could affect people’s understanding and experience of their meal. We discussed this with the registered manager, who told us managers carried out lunchtime observations and provided feedback to staff. They gave assurances the concerns would be addressed. However, we observed people being offered choices, staff supporting people appropriately with eating and drinking and meals being adapted to meet dietary requirements. Dietary information was shared between care, nursing and kitchen teams to ensure people’s nutritional needs were met.

The registered manager told us they recently selected a new food supplier, this was in response to people’s feedback. People were invited to sample a range of meals, alongside their relatives and members of staff. This gave people the opportunity to experience the food for themselves, provide feedback and have a say in whether the proposed change would improve their dining experience.

Staff used recognised tools and assessments, including assessments to determine if a person is at risk of malnutrition, pressure care monitoring and dysphagia guidance where required. Care plans contained guidance for staff on how to meet people’s specific health needs, and specialist advice from health professionals was incorporated into care delivery.

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.

The provider worked effectively with health and social care professionals and promoted collaborative working to support people’s needs and outcomes. Staff across the service described good communication between teams and told us they worked well together. Daily handovers, flash meetings and governance processes helped ensure information about people’s care and any changes in needs were shared appropriately.

Health and social care professionals provided consistently positive feedback about partnership working. One professional told us, “I find partnership working to be very transparent, open and honest with clear communication.”

Relatives also told us communication and teamwork was effective. One relative said, “The staff work well together.” Another relative commented, “They are very good like that [with communication].”

We observed evidence of multidisciplinary working. Staff described communication as positive and told us they felt able to approach colleagues for support and advice. Where specialist input was needed, referrals were made to appropriate professionals.

The provider did not always support people to manage their health and wellbeing to maximise their independence, choice and control.

Our observations and feedback about activities and engagement were mixed. We observed a period of time in 1 area of the home where people were largely disengaged, with limited stimulation, social interaction or meaningful occupation taking place. Several people sat or slept in the lounge while no activity was evident. We were not assured people's social and wellbeing needs were consistently promoted throughout the day. We reviewed 3 people’s records which showed people had limited activities, exercise, meaningful engagement and access to outdoor space.

People and relatives gave mixed feedback about opportunities for activities. Some people enjoyed bingo, singing and visiting entertainers. Others described a lack of stimulation and activity. One relative commented they would like to see more happening during the day when families were not present. Although we observed some positive examples of engagement, including music sessions, bingo and people being encouraged to participate in activities, improvements were needed to ensure all people had regular opportunities to maintain their wellbeing and live healthier lives. We discussed our observations with the registered manager and provider. The provider told us they were completing a piece of work across the organisation to improve meaningful engagement and how this is captured within records.

The registered manager demonstrated they were addressing lack of activities within specific areas of the home.

People had access to a range of healthcare professionals including GPs, therapists, dietitians, nurses and other specialists. The provider told us they paid a monthly retainer for an enhanced GP service, with 2 visits each week to review people’s health and respond promptly to changes. The provider described how these arrangements supported proactive healthcare and communication with the GP team, helping to address concerns within the home where possible and avoid unnecessary hospital admissions.

Relatives told us they were kept informed about healthcare appointments and outcomes. People confirmed their healthcare needs were met and professionals spoke positively about the service’s responsiveness and partnership working. One relative told us, “They [staff] are really helpful. The doctor has been and they phoned me after to let me know the outcome.”

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

People’s outcomes were monitored through regular reviews of care plans, risk assessments, nutritional status, pressure care and healthcare interventions. Staff worked with professionals to support rehabilitation, monitor health conditions and review changing needs. Examples included regular weight monitoring, wound reviews, falls analysis and multidisciplinary reviews. One professional told us, “It is a place I would recommend to others, and I regularly see residents transform there from unsettled and distressed to comfortable and settled over time.” Another professional commented, “It’s an absolute pleasure to work at Oake Meadows being able to support staff to achieve the best outcomes for the people but also recognising the wonderful staff from the welcome at reception right through to the cleaners and the catering staff.”

We identified some gaps in recording and examples where monitoring information could have been more comprehensive, including aspects of personal care and activities. We were however assured people’s outcomes were being monitored and reviewed.

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

People were involved in decisions about their care and treatment and they confirmed their consent was sought before support was provided. We observed staff asking for people’s consent before providing care and support, and people told us staff respected their choices. One person said, “If I object they won’t do it.” A relative commented, “They [staff] are always clear about what they are trying to do. [Name of person] will say straightaway if they don’t want anything. There are no issues.” Relatives told us staff explained what they were doing and involved people in decisions wherever possible.

Care records contained assessments of people’s capacity and records of Mental Capacity Act (MCA) decision-making where required. MCA assessments and best-interest decisions were in place for a range of areas, including medicines, continence care, restrictions intended to keep people safe and accommodation arrangements. Staff demonstrated an understanding of the importance of respecting people’s choices and described revisiting support where people initially declined care.

Some of the records we reviewed required improvement. We found examples where relatives who did not hold legal authority, such as a Lasting Power of Attorney for health and welfare, had signed consent documentation. We discussed this with the registered manager who gave assurances this would be reviewed.