We inspected The Oast on 7 and 8 September 2017. The Oast provides care and support for up to 28 older people some of whom were living with dementia. At the time of our inspection, 21 people were living at the service.This was The Oast’s first inspection since it re-registered with a new provider.
The service had a registered manager in post. 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 had good knowledge of safeguarding adults and knew what actions to take if they suspected abuse was taking place. The provider had ensured that appropriate employment checks had taken place to ensure that staff were safe to work with people at the home. There were sufficient numbers of staff to keep people safe. The provider gave staff appropriate training to meet the needs of people. Staff received supervisions and appraisals from the registered manager
People’s medicines were being managed by trained staff and were stored safely at the service. However, staff had not received competency assessments since the new provider took control of the service on 16 September 2016. Medicines were being effectively audited by senior staff.
People's needs had been assessed and detailed care plans developed. Care plans contained risk assessments that were personalised to people’s needs. Staff were aware of the potential risks and how these should be mitigated. The provider had ensured that the environment was safe for people to live in. People were being referred to health professionals when needed. People’s records showed that appropriate referrals were being made to GP’s, speech and language therapists, dentists and chiropodists. Staff supported people who required assistance with their nutrition and hydration needs. Appropriate assessments were in place when required.
People are supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. Mental capacity assessments were being carried out and these were decision specific. Staff and the registered manager demonstrated good knowledge of the Mental Capacity Act 2005. The CQC is required by law to monitor the operation of Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Consent was sought after by staff before providing personal care. However, we found that there were inconsistencies with the signing of consent forms.
People and relatives spoke positively about staff. Staff communicated with people in ways they understood when providing support. People’s private information was stored securely and discussions about people’s personal needs took place in a private area where it could not be overheard. People were free to choose how they lived their lives. People could choose what activities they took part in.
The provider had ensured that there were effective processes in place to fully investigate any complaints. Records showed that outcomes of the investigations were communicated to relevant people. People were empowered to manage any personal disputes they had. People and their relatives were encouraged to give feedback through resident meetings and yearly surveys. The provider had ensured that there were quality monitoring systems in place to identify shortfalls within the service. However, these had not been fully embedded within the service. We have made a recommendation about this in our report.
Relatives and staff spoke positively about the registered manager. The registered manager had an open door policy that was used by staff. The registered manager was approachable and supportive and took an active role in the day-to-day running of the service. Staff were able to discuss concerns with the registered manager at any time and had confidence appropriate action would be taken. The registered manager was informing the CQC of all notifiable events detailed in the regulations.