Archived: Oak Court

At our previous inspection in September 2017 we rated the service as requiring improvement because it was in breach of regulations. There were not enough staff at night to ensure the comfort, dignity and safety of people who required two care workers to support them with personal care.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions Safe, Caring, Responsive and Well-led to good.

We found that improvement had been made. People’s night time needs had been reassessed with the support of the local authority’s Single-Handed Assessment Team. People who had previously required the support of two care workers were supported by staff trained in ‘single handed support’ with the provision of additional equipment. Staff were available at night to support people with in an emergency situation. People we spoke with consistently told us they felt safe and that their care needs were met.

This service provides personal care to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for extra care housing; this inspection looked at people’s personal care service.

People lived in a modern apartment block consisting of 50 self-contained apartments. Oak Court has communal areas including a dining room, activities rooms, a hair salon and cinema room. The provider occupies two offices on the ground floor from which the service is run.

Not everyone living at Oak Court receives the regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; for example, help with tasks related to personal hygiene and eating.

The service had a registered manager. 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.

People were supported by staff who knew how to recognise abuse and how to respond to concerns. Risks in relation to people’s daily life were assessed and planned for to protect them from harm. People consistently told us they felt safe when receiving personal care and throughout the day and night.

People were supported by enough staff to ensure they received care and support when they needed it.

The service had safe arrangements for the management of medicines which meant that people received their medicines as prescribed.

People were supported by staff who had the knowledge and skills to provide safe and appropriate care and support. Staff were supported through training and had opportunities to obtain further qualifications to further their career in social care.

People felt cared for. People consistently told us that staff were caring. People’s support needs were recognised and responded to by a staff team who cared about the individual they were supporting.

People were supported to have maximum choice and control of their lives; the policies and systems in the service supported this practice.

People had access to information about their care and the service. They had their care plans in their apartments. They were kept informed of developments at the service at resident’s meetings. People told us the registered manager was approachable, friendly and helpful.

People were supported to access health services when they needed them.

People’s care plans included assessments of their needs and clear guidance for staff about how to support people. People knew how they could make complaints using the provider’s complaints procedure. They told us they were comfortable about discussing any concerns with the registered manager or staff.

There was an open and transparent culture at the service. People were involved in giving their views on how the service was run. Staff were kept informed and involved in developments at the service.

The registered manager had systems in place to monitor and improve the quality of the service provided. The provider also monitored the service and supported the registered manager. The provider promoted the organisations values that were understood and practised by staff.

Oak Court is registered to provide personal care for people. It is an ‘extra care housing’ service for people aged over 55 who require at least three-and-a-half hours of care and support per week. Oak Court is a purpose built complex of 50 self-contained apartments. It includes a cinema, recreation rooms, a restaurant and a sensory landscaped garden. Oak Court is in a residential area close to the centre of Blaby, a village in south Leicestershire. At this inspection, there were 37 people living in the service.

This was the first inspection of the service since it opened in September 2015.

People were safe at Oak Court. They were protected against the risk of abuse. People felt safe in the service. Staff recognised the signs of abuse or neglect and what to look out for.

Staff followed appropriate guidance to minimise identified risks to people's health, safety and welfare. There were enough staff to keep people safe during the day. At night only one staff member was on duty, but there were seven people who required the support of two staff with their mobility. Those people did not have the required level of support available to them at night. People moved into the service with the expectation that their care needs would be met at day and night, however, due to financial constraints the provider can only provide care they are commissioned to.

The provider had appropriate arrangements in place to check the suitability and fitness of new staff.

Medicines were managed safely and people who required support with their medicines received them as prescribed.

Staff were supported through training and supervision which equipped them to carry out their roles.

The provider and staff understood their responsibilities under the Mental Capacity Act 2005. Staff sought people’s consent before providing care and support.

People were supported to eat and drink enough to meet their needs. They also received the support they needed to stay healthy and to access healthcare services.

Staff were caring and treated people with dignity and respect. They ensured people's privacy was maintained particularly when being supported with their personal care needs during commissioned hours. However, some people described feeling undignified outside commissioned hours having been left unable to reach toilet facilities.

People received information about what they could expect of the service. They told us their expectations were met until April 2017 when changes were made to how staff were deployed. The residents association and people challenged whether the service was delivering what it had promised.

Each person had an up to date, personalised support plan, which set out how their care and support needs should be met by staff. These were updated daily and reviewed regularly. People did not feel their needs were met outside commissioned hours. The provider had sought to explain why care and support could only be provided during commissioned hours and outside those hours if urgent.

A residents activities committee organised activities. There were not enough staff to ensure that people who required support with mobility and who wanted to participate in activities were able to attend these. Those people experienced social isolation at those times.

The provider ensured the complaints procedure was made available to people to enable them to make a complaint if they needed to. Regular checks and reviews of the service continued to be made to ensure people experienced good quality safe care and support.

The registered manager provided good leadership but they were constrained by being able to provide support only during hours commissioned by the local authority. This meant that people did not have access to the 24 hour care they believed they were entitled to and what had been promised when they moved in.

The provider had effective arrangements for monitoring the quality of the service people experienced. This included obtaining people’s views of their experience. People and staff were encouraged to provide feedback about how the service could be improved. This was used to promote changes and improvements that people wanted.

We found two breaches of the regulations. You can see what action we have told the provider to take at the back of the full version of the report.