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Inspection carried out on 24 October 2017

During a routine inspection

Oatleigh Care Ltd is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care home accommodates 43 people across three separate units over three floors, each of which have separate adapted facilities including dining rooms and sitting areas. There were 38 people using the service when we visited.

This unannounced inspection took place on 24 October 2017. At the last inspection on 8 September 2015, the service was rated Good. At this inspection we found the service remained Good.

The service had a registered manager who had worked at the service for several years. 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’s medicines were administered, handled and managed safely. Risks to people were assessed and plans put in place to mitigate risks. Staff were trained on safeguarding adults from abuse. They were knowledgeable on the procedures to protect people from abuse. There were sufficient staff available to meet people’s needs safely.

The environment was safe and well maintained as health and safety checks were in place. The service was clean and free from odour. Staff followed infection control guidance. Staff reported incidents and accidents and the registered manager reviewed them and used them to improve the service.

People received food and drinks to meet their nutritional needs and dietary requirements. Staff were trained, supported and supervised to provide effective care to the people and to carry out their duties effectively. People were supported to access various healthcare services to meet their needs.

People consented to the care and support they received. The service complied with the requirements of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained and understood their responsibilities.

Staff were kind and compassionate to people. We observed that staff treated people with respect and promoted their dignity. Staff knew how to communicate with people in the way they understood. Staff also understood people’s emotional needs. Staff provided people with the comfort and reassurance they needed in times of agitation and distress.

People at the final stages of their lives were supported in line with their wishes and they were cared for in a dignified way.

People’s individual needs were assessed, planned and delivered in a way that met their needs and preferences. People and their relatives were involved in the review of their care needs. Care plans were updated to reflect people’s current needs.

People were kept occupied and encouraged to participate in activities they enjoyed. The service sought the views of people and their relatives and used these to improve the service. People and their relatives knew how to complain if they were unhappy about the service. There were regular quality checks which took place to assess and monitor the quality of service provided.

Inspection carried out on 8 September 2015

During a routine inspection

This inspection took place on 8 September 2015 and was unannounced.

Oatleigh Care Ltd provides residential care and support for up to 42 older people, many of whom are living with dementia. Nursing care was not being provided at the time of this inspection and CQC are currently considering the provider’s registration for this regulated activity.

It is one of three locations at the same address owned by the provider. The service is located in the Oatleigh building and is situated on the second, third and fourth floors also known as ‘Covent Garden’, ‘Downing Street’ and ‘Edwards Square’. Some services and facilities such as activities, kitchen and laundry arrangements are shared between the locations as a community. Oatleigh Care Ltd has its own staff and operates independently, under the overall supervision and management control of the provider.

The home had a registered manager who was also one of the registered providers. 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.

At the last inspection in October 2014, we asked the provider to take action to make improvements to the systems in place, and records kept, to monitor the quality of the service and to ensure that medicines were being managed safely. These actions had been completed.

People using the service said they felt safe and that staff treated them well. There were procedures in place to recognise and respond to abuse and staff had been trained in how to follow these. The provider’s recruitment procedures helped ensure that people were protected from unsafe care.

There were enough staff on duty day and night to make sure people’s needs were met in a safe and timely way. Staffing was managed flexibly so that people received their care when they needed and wanted it.

People’s nutritional and dietary requirements were assessed and monitored. For people assessed as being at risk of not getting the food and fluids they needed to keep them well, records were kept documenting their food and fluid intake.

People received effective care and support because the staff were trained to meet their needs. Staff understood their roles and responsibilities and were supported to maintain and develop their knowledge and skills through regular management supervision.

A Namaste Care programme commenced in March 2015 designed to improve the quality of life for people with advanced dementia. Namaste sessions include hand and foot massage and sensory stimulation and were available to people living at Oatleigh Care Ltd along with other activities taking place in the community seven days a week.

All areas of the home were clean and well maintained creating a comfortable environment for people. Each person had a single room which was appropriately furnished and homely. The standards of décor and personalisation by people supported this.

The provider acted in accordance with the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. This provides a legal framework to help ensure people’s rights are protected. Staff understood people’s rights to make choices about their care and support and their responsibilities where people lacked capacity to consent or make decisions.

Improvements had been made following our inspection in October 2014 to ensure medicines were stored, administered, recorded and disposed of safely. Staff were trained in the safe administration of medicines and kept records that were accurate.

Arrangements were in place for people and relatives to share their views or raise complaints. The provider listened and acted upon their feedback. The provider obtained the views of people using the service and their relatives or representatives and there were systems to regularly monitor the quality of the service provided at Oatleigh Care Ltd.

Inspection carried out on 21 and 22 October 2014

During a routine inspection

This inspection took place on the 21 and 22 October 2014 and was unannounced. A previous inspection took place on 4 December 2013 and at that time the service was meeting all the regulations inspected.

Oatleigh is registered to provide accommodation and personal and nursing care for 42 people. Some people at the service have a diagnosis of dementia. It is one of three locations at the same address owned by the provider. Some services and facilities such as activities are shared between the locations as a community. There was a registered manager in place who was also one of the directors of the provider company. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and associated Regulations about how the service is run.

Although the provider is registered with the Care Quality Commission to provide nursing care as part of the regulated activity, accommodation for persons that require nursing or personal care, nursing care is not currently being provided and therefore we have not inspected or rated nursing provision at this inspection. The current report therefore sets out our judgement and rating for accommodation for personal care.

People told us they thought the service was well run and organised. However, we found shortfalls with the recording and administration of medicines, and some aspects of people’s care records were not always up to date or detailed enough to guide staff. There were deficiencies with the system for assessing and monitoring the quality of the service. Audits did not always identify problems and, for some areas where shortfalls were identified, action had not been taken to ensure people’s welfare and safety. You can see the action we have asked the provider to take at the end of the full version of this report.

People told us they felt safe and well cared for and they enjoyed the facilities at the premises. They said there were enough staff to provide care at all times. The premises were well maintained and clean. We observed good relationships between staff and people at the service as well as with their relatives. We noted staff took their time to interact with people in a meaningful way and treat people with dignity and respect. We observed that staff understood people’s needs. There was a wide range of activities available which people could choose to join in with. People were also encouraged to maintain links with the community where appropriate.

People told us they enjoyed the food and had plenty of choice. People’s nutrition and hydration were monitored and they were referred to relevant health professionals when needed. Information was provided to people at ‘Relatives and Residents Meetings’ and through a monthly newsletter. A complaint’s procedure was in place and people confirmed they knew what to do if they had any concerns.

Risks to people had been identified and people had a plan for their care which they were involved in. Staff were trained to carry out their roles and said they felt well supported. CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). The service was reviewing whether any applications needed to be made in response to the recent Supreme Court judgement in relation to DoLS and was in contact with the local authority about what action it should take. Staff followed requirements in respect of the Mental Capacity Act 2005.

Inspection carried out on 4 December 2013

During a routine inspection

People and family members we spoke with told us they were happy with the care provided at the care home. One person told us "I am happy here, I like the food, no issues.” Another person said, “they (staff) look after me well here. I get my food and drinks when I want. There are activities.” One relative we spoke with told us "the care here is excellent. We are kept informed and they listen and act on our suggestions.”

At our inspection we found that people and their relatives received suitable information about the care and support and were involved in their care planning. Staff worked with other health and social care professionals to ensure people using the service received safe and effective care. People’s care records were up to date and secured safely.

Inspection carried out on 13 June 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by an Expert by Experience, people who have experience of using services and who can provide that perspective.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us.

The people and relatives we spoke with said that staff were kind and looked after their needs. They told us they were happy and satisfied with the service.