Archived: Oakdene Residential Home

Updated 10 April 2019

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This unannounced inspection took place on 4 February 2019 and was carried out by two adult social care inspectors.

Before our inspection we reviewed information we held about the home, including any statutory notifications that the provider is obligated to send us. We also spoke with the local authority to gain their perspective about the service.

During our inspection we looked at the care records of four people living at the home, four staff personnel files and records relevant to the management of the service. We looked round the environment of the home, including the basement, some people's bedrooms, the kitchen, bathrooms, garden and the lounge areas.

We spoke with four people who lived at the home, three members of care staff and the home manager.

Updated 10 April 2019

This unannounced inspection took place on 4 February 2019.

Oakdene Residential Home 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 home is registered to provide accommodation and personal care for up to 16 people. At the time of our inspection 8 people were living at the home.

The home required and 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. The registered manager is also the nominated individual and the provider (a director of the company that owns the home). They had delegated the day to day running of the home to a home manager (in this report referred to as the manager). The manager had been working at the home since March 2018, however the registered manager remains legally responsible for the safe running of the home.

At our inspection in January 2018 the overall rating for the home was, 'Inadequate'. Since then the service has been in 'special measures'. This inspection was to see if significant improvements had been made.

At our last comprehensive inspection in August 2018 there was breaches of Regulation 9, 10, 11, 12, 13, 17, 18 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. There was also a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

In November 2018 we completed a focused inspection due to specific information of concern in relation to a lack of heating and hot water at the home. During that inspection the provider took steps to restore these essential services at the home.

At this inspection we saw that the provider had addressed many of the significant shortfalls previously identified. However, there are still some areas of concern and the provider was still in breach of Regulations 11, 12, 17 and 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Therefore, the service continues to be rated ‘Inadequate’ and remains in ‘special measures’.

The provider had not taken steps to assure themselves that the service was consistently safe. For example, the manager had not assured themselves over a period of five or six days, that an adequate fire detection system was in place on the first floor of the home. Also, the manager had appointed a new member of care staff with very little information with regard to the staff member’s suitability for the role and therefore placed people’s safety at risk.

Fire safety and safe recruitment of staff are both areas of the management of the home that have been in breach of the regulations due to significant concerns at recent inspections. The systems in place at the home to ensure the service was safe, were not being used effectively to mitigate risks.

We looked at people’s care files and saw that any risk present in their care and support had not always been appropriately assessed and appropriate guidance had not consistently been provided for staff members to reduce the risk.

This meant that the manager and therefore the registered manager could not be assured that the service was consistently safe.

The service was not always working within the principles of the Mental Capacity Act (2005). Assessments of people’s capacity did not outline the decision they were assessing the person’s capacity to be able to make. Assessing people’s capacity is done when there is a reason to believe the person may not have capacity and a significant specific decision needs to be made. After reading people’s capacity assessments it was unclear if it had been deemed that the person had capacity or not.

Since our last inspection there had been an improvement in the systems that support people to manage their healthcare appointments. If needed people were supported to manage their mail and correspondence and appointments were recorded in the diary. Staff helped to ensure people were able to get to their appointments.

Each person now had a recent care plan that was stored on an electronic system. There had been improvements in the quality of people’s care plans at the home. However, some information in people’s care plans was missing or did not always match the care they received. We recommended that the provider arranged for people’s care plans to be reviewed.

People told us that they were happy living at Oakdene; and they felt well cared for. One person said, “The staff are very caring, they look after me.” We saw that the day to day interactions between staff and people living at the home were caring. People were provided with compassionate emotional support and staff spent time interacting with people in the lounge during the afternoon. One staff member told us that they now did this more often. They said, “We have more time to spend with people. We used to be up the wall.”

There had been a significant improvement in the activities available that people can choose to be involved in. One person told us, “There is more stuff going on now. We have had singing and dancing today, we do jigsaws, have the piano man come and the ukulele lady; they are very good.” During our inspection we observed a sing along at the home which people enjoyed. One person who was singing said, “When you are singing you just forget about everything, don’t you?”

People were positive about the food provided at the home. Comments about the food from people included; “Really nice”, “Very tasty”, “Marvellous” and “Compliments to the chef”. We observed one lunchtime and saw that there has been a significant improvement in people’s dining experience.

Staff told us that they felt that recently there was more support available for them. Since our last comprehensive inspection, a new training provider had been sourced and staff were working through a programme of computer based training courses. There had also been recent one to one refreshment of training and assessment of staff knowledge in safeguarding vulnerable adults and the safe administration of medication, with the manager. Recent safeguarding alerts had been appropriately dealt with at the home.

The manager was very enthusiastic about the home and the people living there. It was clear that the people living in the home had a warm and positive relationship with the manager. One person told us, “The manager is brilliant. You can see them just for a chat.” Staff members spoke about the manager having a positive influence on the home. One staff member told us they had, “Seen a lot of changes recently, positive changes.”

At this inspection the safety of the environment of the home had significantly improved. The risks previously identified in August 2018 had been resolved. The manager arranged for a series of checks, audits and services to take place at the home to ensure it was safe. The home appeared clean to an acceptable standard and the communal areas of the home had been refurbished.

Most audits and checks that took place at the home had been effective in raising standards. For example, the medication administration audits had been effective in reducing medication recording errors. This was because it had led to an improvement in staff’s practise and the administration of medication was now safe. The home’s cleaning and kitchen cleaning audit had contributed to a nicer environment. The manager had been responsive in using information from the audits to improve the quality of the support provided for people.

The overall rating for this service is still 'Inadequate'. This service has been in 'special measures' since it was first rated 'Inadequate' following our inspection in January 2018.

Following our inspection in January 2018 we issued a notice of decision to cancel the provider's registration. The provider started an appeal process against this decision. This appeal has now been withdrawn by the provider; therefore the decision to cancel the provider's registration took effect.