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Red Oaks Care Community Requires improvement

The provider of this service changed - see old profile

Reports


Inspection carried out on 22 May 2019

During a routine inspection

About the service: Red Oaks Care Community is a care home which provides personal and nursing care for up to 40 people, some of whom are living with dementia. There were 25 people living there at the time of this inspection.

People’s experience of using this service: People did not always receive effective care that was personalised to their needs. There was not always guidance to make sure they received the right support with medicines.

Although some clinical training for nurses has improved, staff had not been provided with training in some specific needs of people, including support with distressed behaviours.

The service was not always following the principles of the Mental Capacity Act 2005. There was contradictory information about who could support people to make decisions where they lacked capacity.

The provider’s quality assurance checks had not been effective in highlighting the gaps in medicines, personalised support and record keeping.

Most people and relatives felt staff were kind and friendly. People were treated with respect. People being nursed in bed were provided with some one-to-one support to prevent social isolation. There was a range of activities for people to join in if they chose.

People were supported to use local health services and a visiting healthcare professional said there was good communication with the home.

The provider had encouraged people and relatives to give their views. Monthly meetings were being arranged for people and their relatives. A complaints policy was in place although recent complaints and actions taken had not been recorded.

Staff said they felt able to approach the manager with any comments or concerns. They felt morale at the home was improving. The manager held daily morning meetings with senior staff from all departments.

Relatives felt that there had been some improvements since the new manager took up post. They felt there was a more consistent staff team and communication had improved.

Rating at last inspection: Requires Improvement (report published in November 2016).

Why we inspected: This was a planned inspection to assess what improvements had been made by the registered provider.

Enforcement: We have identified continued breaches in relation to staffing and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up: We asked the provider to submit to the Commission an action plan to show how they will make changes to ensure the rating of the service improves to at least Good. We will monitor the progress of the improvements, working alongside the provider and local authority. We will return to visit as per our re-inspection programme.

Inspection carried out on 22 February 2018

During a routine inspection

Red Oaks Care Community is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Red Oaks Care Community provides accommodation, nursing and personal care for up to 40 older people and younger adults. The service provided care to people living with a range of physical and mental health conditions, including some people living with dementia and acquired brain injury from accidents or stroke. At our last inspection in December 2016 the service was rated as Good.

We carried out this inspection on the 22 and 26 February 2018. At the time of our inspection there were 33 people living at the service. This included 29 people who received nursing care.

There was a registered manager at the time of our inspection. 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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run. Since our inspection the provider has informed us the registered manager has now left the service and a new manager has been appointed.

People’s safety from risks associated with their health conditions or some equipment used for their care was not always consistently ensured. Related care and safety improvements were either, made or in progress following recent local authority safeguarding investigations concerned with people’s care at the service.

Overall people and relatives felt people were now safe at the service. People and their relatives knew how to raise any concerns they may have about people’s safety but sometimes experienced delays before these were dealt with by the provider.

Staff knew how to recognise and report suspected harm or abuse of any person receiving care. Revised care incident reporting measures were recently introduced, which staff now understood. This helped to protect people from the risk of harm of abuse.

The provider had not always ensured sufficient or timely staff planning and deployment arrangements to meet people’s changing needs. Recently revised staffing arrangements and additional staff recruitment helped to reduce any risk to people from insufficient staffing.

The provider followed required staff employment and nurse professional registration checks. This helped to ensure staff were safe to provider people’s care

Improvements were made to ensure people’s medicines were safely managed. However, the provider was not proactive to ensure this until relevant external authorities concerned with people’s care had asked them to.

The service was clean and well maintained. The provider’s arrangements for cleanliness, infection prevention and control helped to protect people from the risk of acquired health infection. Staff were not always provided with relevant safety equipment relating to people’s care in a timely manner.

People were able to move around the home safely and independently with sufficient space and relevant equipment to enable them to do so.

Staff were not always trained, informed or supported to ensure people always received effective and consistent care.

People were not always supported to maintain their health in a timely or consistent manner. Related records were not always accurately maintained to help ensure this. Management improvements to rectify this were was not yet fully completed or shown to be maintained.

People were supported to have the required type and consistency of food and drinks they enjoyed.

People’s care plans showed how their consent or appropriate authorisation was obtained for their care. Best interests’ decisions were made for people’s care when required, but not always accurately recorded. We recommended the provid

Inspection carried out on 6 December 2016

During a routine inspection

This inspection took place on 6 and 7 December 2016 and was unannounced.

Accommodation for up to 40 people is provided in the service over two floors. The service is designed to meet the needs of older people living with or without dementia. There were 33 people using the service at the time of our inspection. This location was registered for this provider by the CQC in April 2016.

A registered manager was in post but she was on extended leave. An acting manager was in place and was available throughout the inspection. 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.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Risks were generally well managed so that people were protected from avoidable harm and not unnecessarily restricted.

Sufficient staff were on duty to meet people’s needs and staff were recruited through safe recruitment practices. Medicines were safely managed.

Staff received appropriate induction, training and supervision. People’s rights were protected under the Mental Capacity Act 2005. People received sufficient to eat and drink.

External professionals were involved in people’s care as appropriate. The environment had been adapted to support people living with dementia.

Staff were kind and knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received care that respected their privacy and dignity and promoted their independence.

People received personalised care that was responsive to their needs. Care records contained information to support staff to meet people’s individual needs, though care plans could be further improved.

A complaints process was in place and staff knew how to respond to complaints.

People and their relatives were involved or had opportunities to be involved in the development of the service. Staff told us they would be confident in raising any concerns with the management team and that appropriate action would be taken.

The provider was meeting their regulatory responsibilities. There were effective systems in place to monitor and improve the quality of the service provided.