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Oak Trees (Respite) Outstanding Also known as Oak Trees

Reports


Inspection carried out on 2 December 2019

During a routine inspection

About the service

Oak Trees (Respite) is a residential care home which provides accommodation and personal care via a short break (respite) service to people with a learning disability. The service is registered to provide this regulated activity to up to four people at a time. At the time of the inspection three people were staying at the service and 33 people were using the service on a regular basis.

Oak Trees (Respite) is also registered to provide personal care to people living in their own homes. At the time of the inspection the service was providing support to 21 people with a learning disability across ten supported living locations. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

The service has been developed and designed in line with the principles and values that underpin

Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

There were deliberately no identifying signs, intercom, cameras, or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

Everyone we spoke with praised the high quality of the service provided. People, relatives, and professionals were keen to tell us about the support provided and the positive difference it made. There was a deeply embedded person centred, open, and inclusive ethos. People were fully consulted about their care arrangements and involved in the operation of the service.

People, relatives, and staff worked together to support and develop the service. There was a strong sense of ownership and investment amongst everyone involved with the service. There were strong links to the local community which were utilised to benefit people using the service and this enhanced their daily lives and provided them with equal opportunities. Everyone we spoke with praised the dynamic leadership in the service, notably the registered manager’s passion and dedication. The provider was committed to developing and improving their service. They looked across the social care sector at best practice and considered how this could be implemented within their own service. Robust quality assurance systems underpinned the continual development and improvement in the service leading to positive outcomes for people. Throughout the service we found creative ideas and actions that had helped put people at the heart of their care and decision making.

People were exceptionally safe using the service. There were established relationships of trust and support between staff which enabled people to stay safe. People were empowered to make decisions about their safety, which helped avoid unnecessary restrictions being placed on people and maximised their control over their lives. Staff were very sensitive to the vulnerabilities of people living in the community. They acted proactively when concerns were identified and supported people to protect themselves. A strong sense of security and safety had been created for people by the use of the respite service location as a flexible and accessible space. One relative likened the service location to ‘a crisis centre’ offering a safe space and support for people to stay safe whenever they needed it. People were supported by a creative and inclusive approach which helped them understand potentia

Inspection carried out on 6 April 2017

During a routine inspection

The inspection took place on 6 April 2017 and was announced.

Oak Trees provides accommodation and support in the form of short respite stays, for a maximum of four people with a learning disability. Visits are normally for up to two weeks in duration. The service also provides support and personal care for people with a learning disability who are living in their own homes or shared tenancies. At the time of our inspection, there were three people using the respite service and 20 people receiving support in their own homes.

A new service provider had registered with us the year before our inspection took place. There was a registered manager in place who had been in post for a long time, and under the previous provider. 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 were trained to recognise signs that might show someone was at risk of abuse or harm. They knew the importance of reporting their concerns to promote people’s safety. The management team took action to reinforce this with staff when they needed to.

Staff had guidance about how to minimise risks to people’s safety and welfare. Staff supported people to understand risks themselves and to learn what they could do to promote their own safety and welfare. This included encouragement for people to manage their own medicines fully or in part, if they were able to and wished to do so. Where staff supported people with their medicines, they did so in a safe way.

Although staff turnover had increased following a change of ownership of the service, this had stabilised and there was a core of long-standing, experienced staff. There were enough staff on duty, who were trained to meet people’s needs and recruited in a way that contributed to promoting people’s safety.

Staff understood the importance of seeking consent and encouraging people to make their own decisions. If someone’s capacity to make an informed decision was in doubt, staff consulted others who knew the person well. They involved the person, professionals and families to help determine what was in the person’s best interests. This included when people needed appointments to maintain their health or receive treatment. Staff incorporated professionals' views into the way that they offered support. Staff enabled people to access health care professionals to promote their wellbeing if they needed assistance in this area.

People using the care home service had a choice of enough to eat and drink to ensure their wellbeing. Where people needed support in their own homes with food and drink as part of their care package, they received it. The management team planned to introduce a more formal and consistent assessment in future.

There was a friendly and cheerful atmosphere between staff and people using the service, both in the care home and in their own homes. People’s privacy and dignity was promoted and staff treated people with warmth and respect. People were encouraged to say how they wanted staff to deliver their care and, in some cases, to draw up their own guidance for their support staff.

The management team took account of people’s support needs when they were planning respite stays and the mix of people who would be using the care home service. They reviewed people’s needs each time they came to use the respite service to see whether anything had changed. Staff knew about people’s individual needs and preferences. They knew how to meet these and had guidance within care plans focused on each person. Staff acknowledged that it was sometimes difficult to meet the recreational and social needs of people when they were receiving respite care. This was in part due to a lack of transport, which staff and people usi