Oakhurst Lodge

Updated 15 August 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Two inspectors and an assistant inspector carried out visits to the service. A member of the CQC medicines team provided remote support and an Expert by Experience made calls to people’s relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Oakhurst Lodge 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.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since it was last inspected. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We used Talking Mats a symbol based communication tool to seek the views of 1 person about their experiences of living at Oakhurst Lodge. We also focused on completing observations throughout the day and into the evening. We spoke with the registered manager and deputy manager, a team leader and 4 support workers. We also spoke with the operations director, regional manager, chef and regional maintenance manager. We reviewed a range of records. This included 4 people’s care records and medicines records and 3 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed. Our expert by experience spoke with 5 people’s relatives and the inspector spoke with 1 further relative.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We received feedback from 3 professionals who visited the service. We received written feedback from 4 more staff.

Updated 15 August 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Oakhurst Lodge is a care home, without nursing, that provides care and support for up to 8 adults with autism and learning disabilities and other multiple needs. The home is on the outskirts of the New Forest in a community setting between Southampton and Lyndhurst.

At the time of the inspection there were 7 people using the service.

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

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture.

Right Support

More needed to be done to ensure people were consistently supported to have a fulfilling and meaningful everyday life that included achieving aspirations and goals and having regular access to meaningful activities. Whilst the service had planned for when people experienced periods of distress, the plans lacked completeness and in some cases contained inaccuracies. This increased the risk of inconsistent approaches being used which could increase people’s distress. Staff were not consistently supporting people to make decisions following best practice. Staff enabled people to access health care services in their local community and care was provided in a clean and generally well maintained environment.

Right Care

Managers had not always ensured risks faced by people had been assessed and planned for. The risks posed to people due to the complex needs of their peers had not been adequately assessed and planned for. Concerns were raised that leaders had not always responded appropriately to concerns about abuse. More needed to be done to ensure staff understood people’s individual ways of communicating. There were usually sufficient staff deployed to meet people’s needs within the home, but hours aimed at supporting community activities were not being fully utilised.

Right culture

There were a range of governance processes in place, but these were not being fully effective, as the inspection found a number of areas where the safety and quality of care being provided had fallen below the required standards. The culture within the service was kind and caring and staff in all roles were passionate about their work. Staff were recruited safely.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This last rating for this service was good 27 February 2018.

Why we inspected

We undertook this inspection to assess whether the service was applying the principles of Right support right care right culture.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance the service can respond to COVID-19 and other infection outbreaks effectively.

The inspection was prompted in part due to concerns about record keeping, the management of incidents and potential restrictive practices being used. A decision was made for us to inspect and examine those risks.

We have found evidence the provider needs to make improvements. Please see the safe, effective and well led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

Enforcement

We have identified breaches in relation to safe care and treatment, consent, person centred care, safeguarding people from abuse and good governance.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.